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2 型糖尿病患者拔牙过程中血皮质醇、血糖和血氧饱和度的变化。

The changes in levels of blood cortisol, glucose, and oxygen saturation in type 2 diabetic patients during tooth extraction.

机构信息

Department of Oral Surgery, University of Prishtina, Prishtina, Kosovo.

Department of Maxillofacial Surgery, University of Prishtina, Prishtina, Kosovo.

出版信息

Clin Exp Dent Res. 2022 Dec;8(6):1449-1455. doi: 10.1002/cre2.641. Epub 2022 Jul 31.

Abstract

OBJECTIVES

The extraction of a tooth exacerbates the stress in diabetic patients leading to diabetic complications so the aim was to evaluate the changes in blood cortisol, glucose, and oxygen saturation in type 2 diabetic patients during tooth extraction to pay special attention during a routine surgical procedure.

MATERIALS AND METHODS

The research included 40 patients with type 2 diabetes with indications of tooth extraction. They were divided into two subgroups by 20 participants and split according to local anesthesia (lidocaine with additional adrenaline or lidocaine only). Cortisol, blood sugar, blood pressure, arterial pulse, and blood oxygen saturation were measured. Patients were also evaluated for their sensitivity to pain through the Visual Analog Scale (VAS).

RESULTS

Cortisol and glucose levels scientifically increased throughout the procedure. Meanwhile, systolic, and diastolic blood pressure and saturation showed no difference between the measurements during and after tooth extraction (p = .280; p = .090; p = .590, respectively). Most patients (60.0%) felt no pain during/after the procedure. None of the subjects was feeling more pain than 30 points by VAS. The comparison between groups receiving lidocaine showed no statistical differences when adding adrenaline to lidocaine. Evaluation of pain by VAS showed that more patients felt pain when they were receiving lidocaine without adrenaline.

CONCLUSIONS

Diabetic patients require a more cautious approach when undergoing teeth extractions despite it being a routine procedure.

摘要

目的

拔牙会加重糖尿病患者的压力,导致糖尿病并发症,因此本研究旨在评估 2 型糖尿病患者在拔牙过程中血液皮质醇、血糖和氧饱和度的变化,以便在常规手术过程中特别注意。

材料与方法

本研究纳入了 40 例有拔牙适应证的 2 型糖尿病患者。他们分为 20 名参与者的两组,并根据局部麻醉(含肾上腺素的利多卡因或仅利多卡因)进行分组。测量皮质醇、血糖、血压、动脉脉搏和血氧饱和度。还通过视觉模拟评分(VAS)评估患者对疼痛的敏感性。

结果

皮质醇和血糖水平在整个过程中呈科学上升。与此同时,收缩压和舒张压以及血氧饱和度在拔牙过程中和拔牙后的测量值之间没有差异(p=0.280;p=0.090;p=0.590)。大多数患者(60.0%)在手术过程中/之后没有感觉到疼痛。没有患者的 VAS 评分超过 30 分。接受含肾上腺素的利多卡因组与接受不含肾上腺素的利多卡因组之间的比较无统计学差异。VAS 评估疼痛显示,接受不含肾上腺素的利多卡因时,更多患者感到疼痛。

结论

尽管拔牙是常规手术,但糖尿病患者在拔牙时需要更谨慎的方法。

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