Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Arq Bras Cardiol. 2009 Nov;93(5):463-742. doi: 10.1590/s0066-782x2009001100005.
The effects of local dental anesthesia with lidocaine and epinephrine on cardiovascular parameters of pregnant women with heart valve diseases and their fetuses are not fully understood.
To assess and analyze cardiotocographic, blood pressure and electrocardiographic parameters of pregnant women with rheumatic heart valve disease undergoing local anesthesia with 1.8mL of lidocaine 2% with or without epinephrine 1:100,000 during restorative dental treatment.
Maternal ambulatory blood pressure and electrocardiographic monitoring as well as cardiotocography of 31 patients with rheumatic heart disease were performed between the 28th and 37th week of gestation. The patients were divided into two groups, those with or without vasoconstrictor.
A significant reduction in maternal heart rate was shown in both groups during the procedure in comparison with the other periods (p<0.001). Cardiac arrhythmia was observed in nine (29.0%) patients, of which seven (41.8%) were from the group of 17 pregnant women who received anesthesia plus epinephrine. No difference in maternal blood pressure was observed when periods or groups were compared (p>0.05). The same occurred (p>0.05) with the number of uterine contractions, baseline level and variability, and number of accelerations of fetal heart rate.
The use of 1.8mL of lidocaine 2% in combination with epinephrine was safe and efficient in restorative dental procedures during pregnancy in women with rheumatic heart valve disease.
局部麻醉中使用利多卡因和肾上腺素对患有心脏瓣膜疾病的孕妇及其胎儿心血管参数的影响尚未完全了解。
评估和分析在修复性牙科治疗中，局部麻醉下使用 1.8mL 2%利多卡因加或不加 1:100,000 肾上腺素对患有风湿性心脏瓣膜疾病的孕妇的心电描记图、血压和心电图参数的影响。
在妊娠 28 至 37 周期间，对 31 例风湿性心脏病患者进行了母亲动态血压和心电图监测以及胎儿心图描记术。将患者分为两组，一组有血管收缩剂，另一组没有。
与其他时期相比，两组患者在手术过程中均出现明显的母亲心率下降（p<0.001）。9 例（29.0%）患者出现心律失常，其中 7 例（41.8%）来自接受麻醉加肾上腺素的 17 例孕妇组。当比较时期或组时，母亲血压无差异（p>0.05）。子宫收缩次数、基线水平和变异性以及胎儿心率加速次数也无差异（p>0.05）。
在患有风湿性心脏瓣膜疾病的孕妇中，在修复性牙科手术中使用 1.8mL 2%利多卡因加肾上腺素是安全有效的。
