心血管病患者拔牙阿替卡因肾上腺素局麻临床效果观察

摘要

目的 比较局部麻醉剂阿替卡因肾上腺素和利多卡因用于老年心血管疾病患者拔牙时,对患者血压和心率等变化的影响,探寻阿替卡因肾上腺素用于老年心血管疾病患者拔牙的安全性.方法 本研究包括 228 例老年心血管疾病患者的 239 颗牙齿,随机分组为阿替卡因肾上腺素组(实验组)和利多卡因组(对照组),分别记录麻醉注射前3min,麻醉注射即刻,麻醉注射后3min、拔牙手术中、拔牙手术后3min患者的血压、心率.对数据进行统计分析.结果 与利多卡因相比,阿替卡因肾上腺素在麻醉注射即刻、拔牙手术中心率明显加快,差异具有统计学意义(P<0.05).在麻醉注射后3min收缩压升高,差异具有统计学意义(P<0.05).在任何时点舒张压均无明显升高.两组在麻醉注射后、拔牙手术后血压、心率均回复到麻醉注射前水平.结论 局部麻醉剂阿替卡因肾上腺素对无心动过速、经过全身系统治疗的、病情稳定的心血管疾病患者拔牙是安全可行的.%Objective To compare the effect of local anesthesia articaine adrenaline and lidocaine on heart rate(HR) and blood pressure(BP) durng tooth extraction of patients with cardiovascular disease and evaluate the safety of tooth extraction in the cardiovascular disease patients under local anesthesia with articaine adrenaline.Methods A total of 228 cardiovascular diseases patients and 234 teeth were included in this study.The patients were randomly divided into articaine adrenaline group and lidocaine group.The changes of HR and BP were recorded at the time of 3 minutes before local anesthesia, during local anesthesia , 3 minutes after local anesthesia , during operating, 3 minute after operating.Results HR was significantly increased in articaine adrenaline group than that in lidocaine group(P<0.05).Systolic pressure was significantly increased at 3 minutes after local anesthesia of articaine adrenaline and diastolic pressure was not increased at any time point.HR and BP reverted to the level before local anesthesia after injection and operation.Conclusion Tooth extraction in the cardiovascular disease patients after properly treated is safe under local anesthesia with articaine adrenaline.