Department of Gerontology and Gerodontology, Gerodontology and Oral Rehabilitation, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
Clin Oral Investig. 2020 Jan;24(1):239-246. doi: 10.1007/s00784-019-02924-x. Epub 2019 May 12.
This study aimed to evaluate pulse pressure fluctuation on dental local anesthetic administration in diabetic patients with and without coronary heart disease undergoing tooth extraction.
This retrospective study in diabetic patients undergoing tooth extraction included 33 patients with coronary heart disease (mean age 79.3 ± 7.4, 64% male) and 49 patients without coronary heart disease (mean age 78.6 ± 6.5, 29% male). The increase in pulse pressure before and after administration of local anesthetics was compared between diabetic patients with and without coronary heart disease.
Pulse pressure was increased in male diabetic patients with coronary heart disease compared with those without coronary heart disease following administration of 3% prilocaine hydrochloride with felypressin 0.03 IU/mL (prilocaine) (15.6 ± 15.4 mmHg in those with coronary heart disease (n = 11) versus 4.3 ± 10.9 mmHg in those without coronary heart disease (n = 13), p = 0.03).
Prilocaine administration increased pulse pressure in male diabetic patients with coronary heart disease compared with those without coronary heart disease. Further study is needed to reveal the mechanisms involved in the increase in pulse pressure.
This is the first study of pulse pressure fluctuation in diabetic patients with and without coronary heart disease following administration of local anesthetics. Our findings can help guide the choice of local anesthetics and serve as a predictor of coronary vascular condition in diabetic patients during dental treatment.
本研究旨在评估糖尿病伴或不伴冠心病患者行拔牙术时局部麻醉药物注射前后的脉压波动。
本回顾性研究纳入了 33 例伴冠心病（平均年龄 79.3±7.4 岁，64%为男性）和 49 例不伴冠心病（平均年龄 78.6±6.5 岁，29%为男性）的糖尿病拔牙患者。比较了伴或不伴冠心病的糖尿病患者局部麻醉药物注射前后的脉压变化。
与不伴冠心病的患者相比，伴冠心病的男性糖尿病患者在接受 3%盐酸丙胺卡因与 0.03 IU/mL 去氨加压素（盐酸丙胺卡因）后，脉压增加（伴冠心病患者中 11 例患者的脉压增加 15.6±15.4 mmHg，而不伴冠心病患者中 13 例患者的脉压增加 4.3±10.9 mmHg，p=0.03）。
与不伴冠心病的患者相比，丙胺卡因给药后，伴冠心病的男性糖尿病患者的脉压增加。需要进一步的研究来揭示脉压增加的相关机制。
这是第一项研究糖尿病伴或不伴冠心病患者行局部麻醉药物注射后的脉压波动。我们的研究结果有助于指导局部麻醉药物的选择，并可作为糖尿病患者在牙科治疗期间预测冠状动脉状况的指标。
