seguros y efectivos para el control del dolor en Odonto- logía. El efecto . caína al 4%, uno se empleó para la anestesia troncular y medio para. Antes de comenzar el tratamiento odontológico se deben untar con . Además se recomienda la administración de anestesia troncular según. ANESTESIA DENTAL: Técnicas de anestesia troncular en el maxilar superior Odontología Virtual: ANESTESIA DENTAL: Riesgos y complicaciones en la.
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Influence of vasoconstrictors added to dental anesthetics on blood pressure and heart e. There is controversy about whether the use of vasoconstrictors in dental anesthetics has a negative effect on blood pressure and heart rate.
Measurements were taken of the patients’ anesgesia rate, systolic blood pressure and diastolic blood pressure at two moments: Statistical analysis was based on Student’s t-test for independent samples. At the doses recommended, epinephrine is safe for healthy patients as well as for those with controlled cardiovascular conditions. Conclusi o n es: La epinefrina puede ser utilizada de manera segura a las dosis recomendadas tanto en pacientes sin enfermedad cardiovascular, como en pacientes con compromiso cardiovascular en control.
Vasoconstrictors are substances that are added to local anesthetics to utilize their effect on the caliber internal diameter of blood vessels.
Adrenaline or epinephrine is the most widely used vasoconstricting agent associated with local anesthetics in odontology. Both the heart and the vessels have abundant alpha odobtologia beta adrenoceptors. In general, beta receptors tend to be more sensitive than alpha, therefore they respond to lower doses, so low concentrations actions predominantly betawhile in rapid intravascular injection also cause intense alpha actions.
Adrenaline has chrono and inotropic effect by activation of beta 1 receptors. It causes vasodilation of arterioles muscle area, coronary and other area of the organism for action on b2 receptors; as a result, increases blood flow and reduces the diastolic pressure, by reflex mechanism, causing tachycardia.
This effect is dominant at low doses of adrenaline. But high doses snestesia 0. This substances reduce blood vessel caliber in the mucosal membrane and the skin due to its effect on alpha adrenergic receptors, which counteracts the vasodilating effects of local anesthetics, while affecting beta 1 and beta 2 receptors by increasing arterial tension and vasodilation in muscles and internal odontologis, respectively.
The advantages of administering an anesthetic combined with a vasoconstrictor are the following: It is a widely held belief among doctors, dentists and even patients that epinephrine is not recommended for heart patients due to the possibility of increasing hart rate HR odontolkgia arterial tension AT.
Nevertheless, it is anestesix known that the amount of epinephrine contained in dental anesthesia cartridges 0. Other researchers agree with these findings and say that epinephrine dosages in cardiopathic patients should not exceed 0. If a ocontologia dosage of anesthesia is required, one might consider an additional infiltration using pure anesthetic.
ANESTESIA DENTAL : Técnicas de anestesia troncular en el maxilar superior
The use of vasoconstrictors is justifiable in cardiopathic znestesia, 9 provided that extra precautions are taken not to deliver the anesthetic by way of intravascular injection. While there has been some debate regarding the procedure, previous literature denotes that, vasoconstrictors can be administered in patients with hypertension. In a meta analysis and after analyzing 6 studies on the subject, the use of different vasoconstrictors in dental anesthesia has been found to be justified even in cardiopathic patients and in patients with hypertension, provided that such use is controlled.
Administering vasoconstrictors in combination with anesthetic solutions in odontological procedures allows for greater control over anxiety and pain without significantly impacting AT levels in any way, 13 and the quantities of adrenaline released endogenically are greater than those which are administered in dental anesthetics.
Studies on healthy patients conclude that the effects of adrenaline associated with local anesthetic do not cause significant increase in factors such troncu,ar AT and HR; rather, a potential increase in these factors is only due to the stress the patient is experiencing during the odontological procedure.
When the effects of administering pure Lidocaine and Mepivacaine odlntologia compared with those same substances combined with epinephrine in healthy orontologia, no significant changes to experimental factors observed such as HR, SAT, DAT, and other electrocardiographic levels were detected. Following the infiltration of local anesthetic with varying concentrations of adrenaline in healthy patients, hemodynamic changes in HR and AT were observed but without exhibiting any significant differences between the three levels of concentration administered 1: Due to the release of trncular endogenic catecholamines caused by stress on the patient during the odontological procedure, adverse cardiovascular effects tend to be greater than the dose of adrenaline in the anesthetic solution actually used.
The increase seen in hemodynamic factors such as HR, SAT, DAT is caused more by the anxiety patients experience during dental procedures subsequently leading to a release of endogenic catecholamines than the by the effect of vasoconstrictors administered in combination with local anesthetic. The objective of this study is to determine whether administering epinephrine has significant effects on the AT and Odontolpgia during dental procedures. An experimental study was carried out before and after under complete control of each patient using a convenience odontologgia of patients.
The universe were patients who attended the clinics of the Academic Unit of Dentistry of the Autonomous University of Guerrero in the period July-December who were undergoing periodontal treatments, dental extraction, mouth surgeries, and dental operative techniques.
The sample was fn into two groups of 60 patients. Patients were assigned to the groups based on the type of procedure they were about to undergo.
ANESTESIA DENTAL : Técnicas de anestesia troncular en el ma
Group A comprised of patients undergoing non-surgical treatments operative techniques and prothesiswhile group B was composed of patients undergoing invasive surgical procedures periodontal and mouth surgery, as well as dental extraction procedures to prevent excessive bleeding in the absence of the vasoconstrictor.
Group A was infiltrated with a dental cartridge containing 36 mg of Mepivacaine, while Group B was giving 36 mg of Mepivacaine combined with troncylar. The fact that Group B knew that they were going to be exposed to invasive procedures may have skewed the results of the study, as the resulting stress may have caused an elevation of the experimental factors.
A supraperiostic infiltration technique was used in procedures carried out on the upper maxillary, and tronculag troncular technique was used during procedures on the lower jaw.
Intravascular injection was not done in this study. The first measurement was taken 30 min after the patient arrived to the clinic, to eliminate the influence of fatigue on the experimental factors resulting from the patient having just climbed stairs or traversed other distances within the institutional facility on their way to the clinic.
The second measurement was taken 5 min after the first one, before initiating the procedure and following infiltration. In terms of the ethical aspects not new sn or new techniques odonfologia used in this study.
Informed consent was obtained from each participant in the trial, as a prerequisite for participating in the trial, in accordance with the ethical principles set forth in the Helsinki Declaration version. Student t statistical analysis for independent groups was used to analyze the differences between the two groups before after infiltration.
A value p less than 0. Of the patients included in the study, 60 were men and 60 were women, with an average age of Group A pure Mepivacaine were represented with an average age of Increased levels were recorded in all measured variables after infiltration, with the exception of DAT, which exhibited no change in odintologia groups table 1. Epinephrine is the vasoconstrictor most widely used as a supplement to local anesthetics in general medicine anestesla well as in odontology.
Findings related to variations of SAT levels coincide with previous study results that reported variations ofontologia this factor, none of which reached statistical significance. Our results showed that vasoconstrictors exert a positive influence on DAT, as changes in this factor reached statistical significance.
This result differs from those found by other similar studies that in contrast reported that DAT levels had no statistical significance.
In contrast to Mustafa’s results, we did in fact find statistically significant increased levels in this hemodynamic factor. Some elevated levels of the experimental factors observed in patients about to undergo surgical osontologia compared to patients who were about to receive other treatments were considered of little value, as any patient anestsia is aware that any kind of odontological treatment is imminent, surgical or not, experiences a certain degree of stress. Administering epinephrine in dental anesthesia cartridges does not produce significant changes to HR and SAT levels, even though our study did show significant changes to DAT levels.
Nevertheless, we do not consider it necessary to use pure anesteska on healthy patients. Pure anesthetics can be used on cardiopathic patients, but as long as the patient is controlled, they can also be administered safe doses of local anesthetics with vasoconstrictors.
The advantages of using vasoconstrictors in these cases still outweigh the disadvantages. Epinephrine can be odohtologia safely at recommended doses on both healthy patients and on those with cardiovascular e. According to American Heart Association the maximum dose of epinephrine in local anaesthesia for a healthy subject tronculxr 0. Therefore, if a dental anesthetic cartridge with epinephrine at a concentration of 1: We recommend conducting similar studies on a larger scale and odontklogia patients with cardiovascular disease to examine the effects of the pharmaceuticals on such patients, similar to studies done previous by other researchers.
The results obtained in this research coincide with results reported in other similar studies. Epinephrine can be used safely at anestezia doses on both healthy patients and on those with cardiovascular compromise under control, since administering epinephrine in anestezia anesthesia cartridges does not produce significant changes to HR and SAT levels.
No conflict of interest exists among the participants in the study, nor with any national or international institute.
A prospective randomized clinical trial compared the effect of various types of local anesthetics cartridges on hypertensive patients during dental extraction. J Clin Exp Dent. Local anesthesia with epinephrine is safe and effective for oral surgery in patients with type 2 diabetes mellitus and coronary disease: Hemodynamic changes following injection of local anesthetics with different concentrations of epinephrine during simple tooth extraction: A prospective randomized clinical trial.
A randomized double-blind experimental clinical trial. Editorial Masson SA; Use of anesthetics associated to vasoconstrictors for dentistry in patients with cardiopathies. Review of the literature published in the last decade.
A cross-over, randomized, single blinded study. Comparison of hemodynamic effects of lidocaine, prilocaine and mepivacaine solutions without vasoconstrictor in hypertensive patients. J Appl Oral Sci. Evaluation of haemodynamic changes in hypertensive patients during tooth extraction under local anaesthesia. West Indian Med J.
Felypressin increases blood pressure during dental procedures in hypertensive patients. Rev Univ Ind Santander, Salud. Clinical assessment of the tronclar use local anaesthesia with vasoconstrictor agents in cardiovascular compromised patients: Pharmacodynamic responses of exogenous epinephrine during mandibular third molar aneztesia.
J Pharm Bioall Sci. Local anesthetics and medically complex patients. J Calif Dent Assoc. It prolongs the anesthetic effect by slowing down the blood flow in the infiltrated zone, increasing the block quality. It slows down the absorption of the local anesthetic, reducing its systemic toxicity. It reduces secondary blood flow by diminishing the vascular caliber, which promotes hemostasis, allowing for better visibility and reducing excessive bleeding during invasive surgical procedures.
METHODS An experimental study was carried out before anestesiz after under complete control of each patient using a convenience sample of patients. Conflict of interest No conflict of interest exists among the participants in the study, nor with any national or international institute.