Unidade de Hipertensão, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Arq Bras Cardiol. 2012 Aug;99(2):724-31. doi: 10.1590/s0066-782x2012005000062. Epub 2012 Jun 28.
Felypressin has been added to local anesthetic to increase the length of the anesthetic effect and reduce toxicity during dental procedures. However, the effect on blood pressure remains uncertain, and this may be highly relevant in the dental treatment of hypertensive patients.
To investigate the effect of felypressin on blood pressure in hypertensive patients with controlled BP.
71 subjects with these characteristics and in need of periodontal treatment were studied. After 10 minutes of rest, local anesthesia (prilocaine) was infiltrated with and without addition of felypressin. Then, a deep subgingival scaling was performed. Blood pressure was measured by an automated oscillometric device (DIXTAL DX2010). Ten minutes after the administration of the anesthetic, peak anesthetic action was recorded. The State-Trait Anxiety Inventory (STAI) was used to assess the patients' trait anxiety.
Systolic blood pressure increased after anesthesia, regardless of association with felypressin, throughout the dental procedure (p<0.05) and this response can be explained, at least in part, by the trait anxiety levels of the subjects. However, a further increase in diastolic blood pressure was observed when prilocaine was associated with felypressin (p<0.05), but this response did not change with trait anxiety levels.
Felypressin increased the diastolic blood pressure of hypertensive patients with controlled blood pressure. Patients with high trait anxiety presented increases in systolic blood pressure upon some procedures, suggesting that an increase in blood pressure might also be related to fear or anxiety.
在牙科手术中，为了延长局麻药的作用时间并降低毒性，常将费利喷丁加入局麻药中。然而，其对血压的影响尚不确定，而这在高血压患者的牙科治疗中可能非常重要。
研究在血压控制良好的高血压患者中，费利喷丁对局麻药血压的影响。
本研究纳入了 71 名具有这些特征且需要牙周治疗的患者。休息 10 分钟后，在局部麻醉（布比卡因）中加入或不加入费利喷丁。然后进行深牙周刮治。采用自动示波装置（DIXTAL DX2010）测量血压。麻醉后 10 分钟记录麻醉高峰作用。采用状态-特质焦虑量表（STAI）评估患者的特质焦虑。
无论是否加入费利喷丁，麻醉后所有患者的收缩压均升高（p<0.05），这一反应至少部分可以用患者的特质焦虑水平来解释。然而，当布比卡因与费利喷丁联合使用时，舒张压进一步升高（p<0.05），但这一反应并不随特质焦虑水平的变化而改变。
费利喷丁增加了血压控制良好的高血压患者的舒张压。特质焦虑高的患者在某些操作中收缩压升高，这表明血压升高也可能与恐惧或焦虑有关。
