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在下颌第三磨牙手术中比较2%利多卡因和4%阿替卡因加1:100,000肾上腺素的血流动力学变化。

Hemodynamic changes comparing 2% lidocaine and 4% articaine with epinephrine 1: 100,000 in lower third molar surgery.

作者信息

de Morais Hécio Henrique Araújo, de Santana Santos Thiago, da Costa Araújo Fábio Andrey, de Freitas Xavier Ruth Lopes, Vajgel André, de Holanda Vasconcellos Ricardo José

机构信息

Oral and Maxillofacial Surgery, Pernambuco School of Dentistry, Universidade de Pernambuco-Faculdade de Odontologia de Pernambuco, Camaragibe, Pernambuco, Brazil.

出版信息

J Craniofac Surg. 2012 Jul;23(4):1204-11. doi: 10.1097/SCS.0b013e31824f66a0.

Abstract

BACKGROUND

An increase in blood pressure during dental treatment has been investigated with regard to potential medical risks since previous studies suggest that dental procedures may cause stress to the patient and, consequently, the cardiovascular system. The aim of the present study was to analyze hemodynamic changes following the administration of either 2% lidocaine (L100) or 4% articaine (A100) (both with epinephrine 1:100,000) in the surgical removal of symmetrically positioned lower third molars.

METHODS

A prospective, randomized, double-blind, clinical trial was carried out involving 47 patients. Each patient underwent 1 surgery at each of 2 appointments--one under local anesthesia with L100 and the other with A100. The following parameters were assessed at 4 different times: systolic, diastolic, and mean blood pressure; heart rate; oxygen saturation; rate pressure product; and pressure rate quotient.

RESULTS

No hypertensive peak was observed in systolic, diastolic, and mean blood pressure at any evaluation time. Moreover, the type of anesthetic solution did not affect diastolic blood pressure, heart rate, or oxygen saturation during the surgeries. The pressure rate quotient was the only parameter to exhibit statistically significant differences between groups at different evaluation times (P < 0.05).

CONCLUSIONS

The hemodynamic parameters evaluated in third molar surgery with 2% lidocaine and 4% articaine (both with epinephrine 1:100,000) did not show significant differences.

摘要

背景

由于先前的研究表明牙科手术可能会给患者带来压力,进而影响心血管系统,因此对于牙科治疗期间血压升高的潜在医疗风险进行了研究。本研究的目的是分析在手术拔除对称位置的下颌第三磨牙时,给予2%利多卡因(L100)或4%阿替卡因(A100)(均含1:100,000肾上腺素)后血液动力学的变化。

方法

进行了一项前瞻性、随机、双盲临床试验,纳入47例患者。每位患者在两次就诊时各接受1次手术——一次使用L100进行局部麻醉,另一次使用A100。在4个不同时间点评估以下参数:收缩压、舒张压和平均血压;心率;血氧饱和度;率压乘积;以及压力心率商。

结果

在任何评估时间,收缩压、舒张压和平均血压均未观察到高血压峰值。此外,麻醉溶液的类型在手术期间未影响舒张压、心率或血氧饱和度。压力心率商是唯一在不同评估时间组间表现出统计学显著差异的参数(P < 0.05)。

结论

在第三磨牙手术中使用2%利多卡因和4%阿替卡因(均含1:100,000肾上腺素)评估的血液动力学参数未显示出显著差异。

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