BACKGROUND: The routine use of local anesthetics associated to vasoconstrictors for the dental treatment of patients with cardiopathies is still controversial, due to the risk of adverse cardiovascular effects. OBJECTIVE: To evaluate and compare the hemodynamic effects of the use of local anesthetics with a non-adrenergic vasoconstrictor in patients with ventricular arrhythmia, when compared to the use of anesthetics without vasoconstrictor. METHODS: A prospective randomized study evaluated 33 patients with positive serology for Chagas' disease and 32 patients with coronary artery disease that presented complex ventricular arrhythmia at Holter monitoring (>10 EV/h and NSVT), of which 21 were females, aged 54.73 + 7.94 years, submitted to routine dental treatment with pterygomandibular anesthesia. These patients were divided in two groups: group I received prilocaine 3% associated with felypressin 0.03 IU/ml and group II received lidocaine 2% without vasoconstrictor. The number and complexity of extrasystoles were analyzed, as well as the heart rate and systemic arterial pressure of the patients on the day before, one hour before, during the procedure and one hour after the dental procedure. RESULTS: No hemodynamic alterations or increase in the number and complexity of the ventricular arrhythmia related to the anesthetic used in the dental procedure were observed in either group. CONCLUSION: The results suggest that prilocaine 3% associated to a felypressin 0.03 IU/ml can be safely used in patients with Chagas' disease or coronariopathy with complex ventricular arrhythmia.
RCT Entities:
BACKGROUND: The routine use of local anesthetics associated to vasoconstrictors for the dental treatment of patients with cardiopathies is still controversial, due to the risk of adverse cardiovascular effects. OBJECTIVE: To evaluate and compare the hemodynamic effects of the use of local anesthetics with a non-adrenergic vasoconstrictor in patients with ventricular arrhythmia, when compared to the use of anesthetics without vasoconstrictor. METHODS: A prospective randomized study evaluated 33 patients with positive serology for Chagas' disease and 32 patients with coronary artery disease that presented complex ventricular arrhythmia at Holter monitoring (>10 EV/h and NSVT), of which 21 were females, aged 54.73 + 7.94 years, submitted to routine dental treatment with pterygomandibular anesthesia. These patients were divided in two groups: group I received prilocaine 3% associated with felypressin 0.03 IU/ml and group II received lidocaine 2% without vasoconstrictor. The number and complexity of extrasystoles were analyzed, as well as the heart rate and systemic arterial pressure of the patients on the day before, one hour before, during the procedure and one hour after the dental procedure. RESULTS: No hemodynamic alterations or increase in the number and complexity of the ventricular arrhythmia related to the anesthetic used in the dental procedure were observed in either group. CONCLUSION: The results suggest that prilocaine 3% associated to a felypressin 0.03 IU/ml can be safely used in patients with Chagas' disease or coronariopathy with complex ventricular arrhythmia.
Authors: Ana Carolina Guimarães Oliveira; Itamara Lucia Itagiba Neves; Luciana Sacilotto; Natália Quintella Sangiorgi Olivetti; Marcela Alves Dos Santos-Paul; Tânia Cristina Pedroso Montano; Cíntia Maria Alencar Carvalho; Tan Chen Wu; Cesar José Grupi; Sílvio Alves Barbosa; Carlos Alberto Pastore; Nelson Samesima; Denise Tessariol Hachul; Maurício Ibrahim Scanavacca; Ricardo Simões Neves; Francisco Carlos Costa Darrieux Journal: J Am Heart Assoc Date: 2019-07-19 Impact factor: 5.501
Authors: Caio Chaves Guimaraes; Luciane Cruz Lopes; Cristiane de Cássia Bergamaschi; Juliana Cama Ramacciato; Marcus Tolentino Silva; Jimmy de Oliveira Araújo; Natalia Karol de Andrade; Rogério Heládio Lopes Motta Journal: BMJ Open Date: 2021-07-15 Impact factor: 2.692
Authors: María A Serrera Figallo; Rocío T Velázquez Cayón; Daniel Torres Lagares; Jose R Corcuera Flores; Guillermo Machuca Portillo Journal: J Clin Exp Dent Date: 2012-04-01