Matsuura H
Department of Dental Anesthesiology, Osaka University Faculty of Dentistry, Japan.
Anesth Pain Control Dent. 1993 Winter;2(1):49-61.
Recently, dental patients with cardiovascular diseases, especially hypertensive and ischemic heart disease, have been increasing. Performing dental procedures on these patients could bring about the acute exacerbations of preexisting cardiac diseases. Anxiety, tension, pain, and discomfort during dental treatment and the catecholamines contained in local anesthetic solutions are thought to be causative factors. Consequently, it is important to decide whether the procedure concerned could safely be performed by dental staffs in the dental clinic. Systemic management in dental treatment includes the application of psychosedation, proper selection of the vasoconstrictor in the anesthetic solution, and control of blood pressure by vasodilating agents under continuous careful monitoring. By these means, the magnitude of hemodynamic fluctuation should be kept minimal. Management of hypertension, ischemic heart disease, and cardiomyopathies will be explained.
近年来，患有心血管疾病的牙科患者，尤其是高血压和缺血性心脏病患者一直在增加。对这些患者进行牙科治疗可能会导致原有心脏病的急性加重。牙科治疗期间的焦虑、紧张、疼痛和不适以及局部麻醉溶液中所含的儿茶酚胺被认为是致病因素。因此，确定牙科诊所的牙科工作人员是否能够安全地进行相关治疗非常重要。牙科治疗中的全身管理包括应用心理镇静、在麻醉溶液中正确选择血管收缩剂以及在持续仔细监测下通过血管扩张剂控制血压。通过这些方法，应将血流动力学波动的幅度保持在最小。将对高血压、缺血性心脏病和心肌病的管理进行解释。
