Kyosaka Yuka, Owatari Tsuneto, Inokoshi Masanao, Kubota Kazumasa, Inoue Minoru, Minakuchi Shunsuke
Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Dental Center of the Medically Compromised Patient (DEMCOP), Kyushu Dental University, Fukuoka, Japan.
Anesth Prog. 2019 Fall;66(3):133-140. doi: 10.2344/anpr-66-02-04.
We assessed the effect of 2% lidocaine with 1:80,000 adrenaline (L + AD) and 3% prilocaine with 0.03 IU/mL felypressin (P + FP) on blood pressure and heart rate in older adults with systemic diseases undergoing dental extraction. This double-blind, randomized crossover study included 22 elderly participants, aged over 65 years. The participants were administered L + AD for one dental extraction and P + FP for the other. Blood pressure and heart rate were recorded immediately, 5, and 10 minutes after local anesthetic administration and the data were analyzed. The systolic and diastolic blood pressures in the P + FP group increased at all measurement points ( < .001). In the L + AD group, the diastolic blood pressure decreased at 5 and 10 minutes after local anesthetic administration ( < .05), whereas the heart rate increased at all measured time points ( < .001). There were statistically significant differences in systolic blood pressure at 5 and 10 minutes after local anesthetic administration and in diastolic blood pressure and heart rate at all time points between the 2 groups. In older adults, P + FP administration increased the systolic and diastolic blood pressures. L + AD administration increased the heart rate and decreased the diastolic blood pressure.
我们评估了含1:80,000肾上腺素的2%利多卡因(L + AD)和含0.03 IU/mL去甲肾上腺素的3%丙胺卡因(P + FP)对患有全身性疾病的老年人拔牙时血压和心率的影响。这项双盲、随机交叉研究纳入了22名65岁以上的老年参与者。参与者一次拔牙使用L + AD,另一次拔牙使用P + FP。在局部麻醉给药后即刻、5分钟和10分钟记录血压和心率,并对数据进行分析。P + FP组的收缩压和舒张压在所有测量点均升高(P < .001)。在L + AD组,局部麻醉给药后5分钟和10分钟舒张压降低(P < .05),而心率在所有测量时间点均升高(P < .001)。两组之间在局部麻醉给药后5分钟和10分钟的收缩压以及所有时间点的舒张压和心率存在统计学显著差异。在老年人中,使用P + FP会升高收缩压和舒张压。使用L + AD会增加心率并降低舒张压。