Popescu Sanda Mihaela, Nechifor Mihai, Baniceru Mihaela, Croitoru Octavian, Popescu Florica
Department of Preventive Dentistry, Faculty of Dental Medicine, University of Medicine and Pharmacy, Craiova, Romania.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Apr;105(4):e19-23. doi: 10.1016/j.tripleo.2007.12.010.
The objective of this study was to determine the effect of propranolol pretreatment on mepivacaine serum concentrations in dental patients.
In a double blind, randomized, 2-way crossover study, 10 patients ingested 30 mg propranolol or placebo, 2 hours before local anesthesia for dental scaling. Each subject received a single dose of 51 mg mepivacaine for posterior superior alveolar nerve block. Mepivacaine in venous serum was measured for up to 1 hour, after 5, 15, 30, 45, and 60 minutes from injection. Serum concentrations of mepivacaine were determined by gas chromatography. Blood pressure and heart rate were measured before and after propranolol or placebo and after each sampling.
Peak serum concentrations of mepivacaine, C(max) (1.214 +/- 0.746 microg/mL(-1)), were significantly increased by propranolol (2.249 +/- 1.559 microg/mL(-1), P < .05). Propranolol pretreatment reduced blood pressure and heart rate.
Although propranolol pretreatment increased almost doublefold mepivacaine serum concentrations and reduced blood pressure and heart rate, mepivacaine can be used safely in dental patients taking propranolol for short-duration interventions.
本研究的目的是确定普萘洛尔预处理对牙科患者甲哌卡因血清浓度的影响。
在一项双盲、随机、双向交叉研究中，10名患者在进行牙垢洁治局部麻醉前2小时服用30毫克普萘洛尔或安慰剂。每位受试者接受单剂量51毫克甲哌卡因用于上牙槽后神经阻滞。在注射后5、15、30、45和60分钟后，测量静脉血清中甲哌卡因长达1小时。甲哌卡因的血清浓度通过气相色谱法测定。在服用普萘洛尔或安慰剂之前和之后以及每次采样后测量血压和心率。
普萘洛尔使甲哌卡因的血清峰值浓度C(max)（1.214±0.746微克/毫升(-1)）显著升高（2.249±1.559微克/毫升(-1)，P<.05）。普萘洛尔预处理降低了血压和心率。
虽然普萘洛尔预处理使甲哌卡因血清浓度几乎增加了一倍，并降低了血压和心率，但甲哌卡因可安全用于短期干预服用普萘洛尔的牙科患者。
