Comparison between cardiovascular effects of adrenaline and phenylephrine associated with lidocaine and the effects of felypressin with prilocaine during intrabucal anesthesia in ASA I patients
Keywords:felypressin, epinephrine, vasoconstrictors agents, blood pressure, oral surgery.
OBJECTIVE: Evaluate the cardiovascular effects by infiltration of 1:100.000 epinephrine and 1:2.500 phenylephrine associated with 2% lidocaine compared with the effects by infiltration of 0.03 IU/ml felypressin with 3% prilocaine, during surgery of third molars in ASA I patients.
METHODS: Eighteen patients were divided into two groups. In group I (GI), the effects of epinephrine vs felypressin were evaluated and in group II (GII), the effects of phenylephrine vs felypressin. Cardiovascular parameters: systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and oxygen saturation (SatO2) were measured in pre, trans and post-operative periods.
RESULTS: Statistical analysis (T-TEST) on the cardiovascular parameters demonstrated with significance that, GI: felypressin presented HR average reduction in the postoperative period and SatO2 average reduction in trans and postoperative periods. For GII: felypressin presented SatO2 average reduction in the postoperative period; SBP averages for patients submitted to phenylephrine increased in trans and postoperative periods; and DBP averages for patients submitted to phenylephrine increased in pre and trans-operative periods.
COCLUSION: We can conclude that phenylephrine may lead to increased SBP and DBP and felypressin generated a reduction in HR and SatO2. All these changes were well tolerated by ASA I patients.
Malamed SF. Handbook of Local Anesthesia. 6th ed. St. Louis: Mosby, 2013.
Pallasch T. Vasoconstrictors and the heart. J. Calif. Dent. Assoc 1998; 26(9):668-73.
Niwa H, Sugimura M, Satoh Y, Tanimoto A. Cardiovascular responses to epinephrine-containing local anesthesia in patient with cardiovascular disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92(6): 610-16.
Naftalin LW, Yagiela JA. Vasoconstrictors: indications and precautions. Dent Clin N Am 2002;46(4):733-46.
Elad S, Admon D, Kedmi M et al. The cardiovascular effect of local anesthesia with articaine plus 1:200,000 adrenalin versus lidocaine plus 1:100,000 adrenalin in medically compromised cardiac patients: a prospective, randomized, double blinded study. Oral Surg. Oral Med Oral Pathol Oral Radiol Endod 2008;105(6):725-30.
Meral G, Tasar F, Sayin F, et al. Effects of lidocaine with and without epinephrine on plasma epinephrine and lidocaine concentrations and hemodynamic values during third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 100(2):e25-e30.
Bader JD, Bonito AJ, Shugars DA. A systematic review of cardiovascular effects of epinephrine on hypertensive dental patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93(6):647-53.
Laragnoit AB, Neves RS, Neves IL et al. Locoregional anesthesia for dental treatment in cardiac patients: a comparative study of 2% plain lidocaine and 2% lidocaine with epinephrine (1:100,000). Clinics 2009;64(3):177-82.
Dionne RA, Goldstein DS, Wirdzek PR. Effects of diazepam premedication and epinephrine-containing local anesthetics on cardiovascular and plasma catecholamine responses to oral surgery. Anes Analg 1984;63 (7):640-46.
Abraham-Inpijn L, Borgmeijer-Hoelen A, Gortzak RAT. Changes in blood pressure, heart rate, and electrocardiograin during dental treatment with use of local anesthesia. J Am Dent Assoc 1988; 116(4):531-36.
Sunada K, Nakamura K, Yamashiro M, et al. Clinically safe dosage of felipressin for patients with esencial hypertension. Anesth Prog 1996; 43(4):108-15.
Cecanho R. Role of the v1 receptors and the Postrema area on felypressin efects in the cardiovascular system [thesis]. Piracicaba: Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas; 2002.
Meechan JG, Cole B, Welbury RR. The influence of two different dental local anaesthetic solutions on the haemodynamic responses of children undergoing restorative dentistry: a randomised, single-blind, split-mouth study. Br Dent J 2001;190(9):502-4.
Aboites MA, Segovia BL, David Covarrubias RD, et al. Lidocaine with epinephrine effect on arterial tension of children. Rev Méd Inst Mex Seguro Soc 2008;46(3):323-7.
Bispo CG, Tortamano IP, Rocha RG, Francischone CE, et al. Cardiovascular responses to different stages of restorative dental treatment unaffected by local anaesthetic type. Aust Dent J 2011;56(3):312-6.
de Morais HH, de Santana ST, da Costa AFA, et al. Hemodynamic changes comparing 2% lidocaine and 4% articaine with epinephrine1:100,000 in lower third molar surgery. J Craniofac Surg 2012; 23(4):1204-11.
Caldas CS, Bergamaschi CC, Succi GM, et al. Clinical evaluation of diferente epinephrine concentrations for local dental anestesia. Rev Dor 2015; 16(1):1-5.
Cáceres MTF, Ludovice ACPP, Brito FS, Darrieux FC, et al. Efeito de anestésicos locais com e sem vasoconstritor em pacientes com arritmias ventriculares. Arq Bras Cardiol 2008;91(3):142-47.
Oliveira AEM, Simone JL, Tortamano IP, Perez FEG, Ximenes PMO. Utilização de anestésicos locais associados a vasoconstritores adrenérgicos em pacientes hipertensos. J Bras Clin Odontol 2003; 7(42):484-88.
Perez FEG, Rocha RG, Carnaval T, Borsatti MA, Allegretti CE. Efeitos cardiovasculares da anestesia local de prilocaína 3% com felipressina e lidocaína 2% em normotensos. RPG Rev Pós Grad 2011;18(3):134-39.
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