Effects of Mepivacaine 2% With Epinephrine in the Cardiovascular Activity of Patients Undergoing Third Molar Surgery

Scarparo, Henrique Clasen; Maia, Raimundo Nonato; Gois, Soraia Rodrigues de; Costa, Fábio Wildson Gurgel; Ribeiro, Thyciana Rodrigues; Soares, Eduardo Costa Studart

doi:10.1097/scs.0b013e3182a2ec06

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…the dental procedure proposed 14 . Moreover, the present study demonstrates that possible variations in systemic parameters (SaO 2 , HR, SBP and DBP) may be associated with the pain of anesthetic injection 30 . However, it is important to consider the limitation of this study by use of maximum 1 anesthetic cartridge (1.8ml), in respect to the literature data, which show that higher doses of local anesthetic with vasoconstrictor should be used sparingly 14 .…”

Section: Resultsmentioning

confidence: 51%

The Influence of Vasoconstritor Use in Local Anesthesia in Individuals with Chronic Renal Failure

Rosa

Silva

Segundo³

et al. 2019

J. Health Scie.

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Individuals with chronic renal failure (CRD) undergo hemodialysis to compensate for systemic-based disease and often develop systemic arterial hypertension (SAH). Such individuals, when needing dental treatment, carry with them the consideration of which type of anesthetic to be used in clinical and surgical interventions. The objective of this study was to evaluate the action of anesthetics with vasoconstrictor (AwV) and without vasoconstrictor (AoV) in individuals with chronic renal failure. Research subjects needed dental treatment, with dental restorations, on the right and left lower dental arch in premolars and / or molars, thus receiving the model of a split-mouth clinical study. In a randomized study, each side of the mandible was subjected to an anesthetic infiltration with only one 1.8 mL tube in two different moments with a minimum interval of 7 days (for one moment with AwV and another AoV moment). The parameters of oxygen saturation (SaO2), heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured 5 minutes before anesthesia, 5, 15 and 30 minutes after anesthesia. The results found in this study showed statistical difference only in SaO2 in the time of 5 minutes after the anesthesia in comparison of the AwV and AoV group, this same result was obtained when only those individuals who, besides nephropathies, had a diagnosis of SAH, were evaluated. The findings of this study highlight the safety of the use of anesthetics, with or without vasoconstrictors since in small amounts, in individuals with CRF with or without associated SAH.Keywords: Renal Insufficiency. Hypertension. Anesthetics, Local.ResumoIndivíduos com insuficiência renal crônica (IRC) em geral são submetidos à hemodiálise para compensação da doença de base sistêmica e frequentemente desenvolvem a hipertensão arterial sistêmica (HAS). Tais indivíduos, ao necessitarem de tratamento odontológico, levam consigo a ponderação de qual tipo de anestésico a ser utilizado em intervenções clínicas e cirúrgicas. O objetivo deste estudo foi avaliar a ação de anestésicos com vasoconstritor (ACV) e sem vasoconstritor (ASV) em indivíduos com insuficiência renal crônica. Os indivíduos da pesquisa tinham necessidade de tratamento odontológico, com restaurações dentárias, no arco dentário inferior direito e esquerdo em pré-molares e/ou molares, recebendo assim o modelo de estudo clínico de boca dividida. De forma aleatória, os hemiarcos inferiores foram submetidos, em dois diferentes momentos com intervalo mínimo de 7 dias, a infiltração anestésica com apenas um tubete de 1,8 mL (para um momento com ACV e outro momento ASV). Foi feita aferição dos parâmetros de saturação de oxigênio (SaO2), frequência cardíaca (FC), pressão arterial sistólica (PAS) e diastólicas (PAD), 5 minutos antes da anestesia, 5, 15 e 30 minutos após a anestesia. Os resultados encontrados neste estudo demonstraram diferença estatística apenas na SaO2 no tempo de 5 minutos após a anestesia em comparação do grupo ACV e ASV, esse mesmo resultado foi obtido quando avaliados apenas os indivíduos que, além de nefropatas, apresentavam diagnóstico de HAS. Os achados deste estudo ressaltam a segurança do uso de anestésicos, com ou sem vasoconstritores desde que em pequenas quantidades, em indivíduos com IRC com ou sem HAS associada.Palavras-chave: Insuficiência Renal. Hipertensão. Anestésicos Locais.

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Section: Resultsmentioning

confidence: 51%

The Influence of Vasoconstritor Use in Local Anesthesia in Individuals with Chronic Renal Failure

Rosa

Silva

Segundo³

et al. 2019

J. Health Scie.

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“…Despite their clinical success and availability, tooth extractions can cause morbidity and discomfort to the patient ( 17 ). In addition, changes in haemodynamic parameters may occur ( 18 , 19 ) and therefore it is paramount to carefully conduct a local anaesthetic procedure for surgery in order to minimise adverse events.…”

Section: Introductionmentioning

confidence: 99%

Volume and effectiveness assessment of articain 4% versus mepivacaine 2% used in third molar surgery: randomized, double-blind, split-mouth controlled clinical trial

Almeida¹,

Fv²,

Sato³

et al. 2020

Med Oral

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Background The different indications for extraction of the lower third molars, require resources to manage pain and discomfort, such as, for example, adequate anesthetic techniques, and the type of anesthetic used can influence the management of pain in tooth extractions. Few studies in the literature compare the anesthetics 4% articaine hydrochloride and 2% mepivacaine hydrochloride showing evidence that both allow for successful pain management. This study sought to compare the volume, efficacy and safety of these two anesthetic drugs, both associated with epinephrine at a ratio of 1:100,000, used in the extraction of lower third molars. Material and Methods A controlled, clinical, split-mouth compared these both local anesthetics in a sample of 20 patients requiring bilateral extraction of teeth. Pain was the main parameter to be assessed by means of the visual analogue scale (VAS) applied during and immediately after the surgery. Hemodynamic parameters, adverse events, presence of paresthesia and satisfaction of patients and surgeon were also analysed. Results Pain management was more effective with mepivacaine up to two hours after surgery ( p =0.014), whereas the surgeon was more satisfied with the use of articaine during divulsion and suture ( p <0.05). However no statistically significant differences were found between both anesthetics regarding pain perception. Conclusions It was observed that both anesthetics are efficient and safe in the management of pain for extraction of third molars, in which less amount of mepivacaine is needed. The satisfaction of patients and surgeon was the same for both anesthetics, with articaine being highlighted during divulsion and suture. Key words: Pain, third molar, local anaesthesia, paresthesia.

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Small doses of adrenaline contained in the local anaesthetic may result in prolonged increased cardiac function even after the vital signs return to normal

Wakita

Ito

Fukayama

2021

Advances in Oral and Maxillofacial Surgery

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Effects of Mepivacaine 2% With Epinephrine in the Cardiovascular Activity of Patients Undergoing Third Molar Surgery

Abstract: Blood pressure did not present significant alterations after a local injection of 54 or 108 µg of epinephrine during surgery to remove 2 or 4 third molars. Although without significance, HR was more elevated in the 108-µg dose of epinephrine during the removal of 4 third molars.

Cited by 4 publications

References 12 publications

The Influence of Vasoconstritor Use in Local Anesthesia in Individuals with Chronic Renal Failure

The Influence of Vasoconstritor Use in Local Anesthesia in Individuals with Chronic Renal Failure

Volume and effectiveness assessment of articain 4% versus mepivacaine 2% used in third molar surgery: randomized, double-blind, split-mouth controlled clinical trial

Small doses of adrenaline contained in the local anaesthetic may result in prolonged increased cardiac function even after the vital signs return to normal

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