Brand H S, Gortzak R A, Palmer-Bouva C C, Abraham R E, Abraham-Inpijn L
Department of General Pathology and Internal Medicine, Academic Centre for Dentistry Amsterdam, The Netherlands.
Int Dent J. 1995 Feb;45(1):45-8.
Patients demonstrate a physiological stress response during dental checkups and treatment. Local anesthesia and tooth extraction activate the adrenal cortex to produce cortisol. Changes in adrenaline or noradrenaline concentrations have been reported in plasma and urine after drilling and filling or extraction, and anticipation of a dental checkup increases blood pressure. Both diastolic and systolic blood pressure rise still further during restorative treatment without local anaesthesia and during extraction. In a study by the same authors, no significant changes in blood pressure were observed during restorative treatment with local anaesthesia, which suggests that the pain experienced by the patient contributes to the rise in blood pressure. Dentists must be aware that this increased blood pressure may induce cardiovascular complications during dental therapy.
患者在牙科检查和治疗期间会表现出生理应激反应。局部麻醉和拔牙会激活肾上腺皮质以产生皮质醇。据报道，在钻孔、填充或拔牙后，血浆和尿液中的肾上腺素或去甲肾上腺素浓度会发生变化，而且对牙科检查的预期会使血压升高。在无局部麻醉的修复治疗期间和拔牙过程中，舒张压和收缩压都会进一步升高。在同一组作者进行的一项研究中，在局部麻醉的修复治疗期间未观察到血压有显著变化，这表明患者所经历的疼痛会导致血压升高。牙医必须意识到，这种血压升高可能会在牙科治疗期间引发心血管并发症。
