Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/588017d97f8c9d0a098b4939
Revista de Odontologia da UNESP
Original Article

Avaliação comparativa da latência e da duração do cloridrato de evobupivacaína 0,5% sem e com vasoconstritor em anestesia terminal infiltrativa

Comparative study of the latency period and duration of levobupicaine 0.5% plain and with vasoconstrictor in maxillary infiltrative anesthesia

Barros, E.G.; Marquez, I.M.; Zanetta-Barbosa, D.

Downloads: 0
Views: 1192

Resumo

Este estudo avaliou comparativamente o período de latência e a duração do cloridrato de levobupivacaína 0,5% sem vasoconstritor e com epinefrina 1:200.000 (NOVABUPI®) após anestesia terminal infiltrativa na maxila. As injeções com as duas soluções foram realizadas no mesmo canino superior escolhido previamente pelo voluntário, de forma aleatória, em um estudo triplo-cego, anestesia essa feita com intervalo de, no mínimo, 48 horas. O período de latência e a duração da anestesia pulpar foram analisados pelo teste de sensibilidade elétrico (Fabricante Analytic Technology, USA), e o tempo de duração em tecidos moles foi relatado pelo voluntário. Os resultados obtidos revelaram diferenças estatisticamente significantes (p < 0,05) em relação à adição do vasoconstritor, quanto à duração da anestesia pulpar (p = 0,0004) e a duração em tecidos moles (p = 0,0019), porém, com relação ao período de latência, não houve diferença estatisticamente significante (p = 0,6547). Concluiu-se que ambas as soluções foram eficazes na perda da sensibilidade dos tecidos duros e moles e a adição de epinefrina 1:200.000 prolongou o tempo de duração do cloridrato de levobupivacaína 0,5%.

Palavras-chave

Levobupivacaína, teste elétrico, vasoconstritor

Abstract

The purpose of this study was to comparatively evaluate the time of latency and duration of two types of levobupivacaine 0.5%: plain and with epinephrine 1:200.000, in maxillary infiltrative anesthesia. The infiltration anesthesias were perfomed in the vestibule in the upper caninine chosen at random by the volunteer in a triple-blind study. The chosen tooth was anesthetized with both anesthetic solution in two sessions with a minimum interval of 48 hours. The time of latency and duration of pulpar anesthesia were analysed by eletric pulp tester (Analytic Technology, USA) and the soft tissue duration was noted by the volunteer. The results showed statistical significant difference (p < 0.05) when there was vasoconstrictor addition in time of pulpar (p = 0.0004) and soft tissue (p = 0.0019) anesthesia; however, no significanct difference was obtained in latency period (p = 0.6547). It was concluded that both solutions were effective in obtaining anesthesia for hard and soft tissues and the addition of 1:200.000 epinephrine prolonged the duration of anesthesia.

Keywords

Levobupivacaine, eletric pulp tester, vasoconstrictor

References



1. Bjorn H. Electrical excitation of teeth. Swed Dent J. 1946;39(Suppl):6-100 apud Dreven LJ, Reader A, Beck M, Meyers WJ, Weaver J. Evaluation of an electric pulp tester as a major of analgesia in human vital teeth. J Endod. 1987;13:233-8.

2. Chambers IG. The role and methods of pulp testing in oral diagnosis: a review. Int Endod J. 1982;15:1-15.

3. Chang DHT, Ladd LA, Wilson KA, Gelgor L, Mather LE. Tolerability of large-dose intravenous levobupivacaine in sheep. Anesth Analg. 2000;91:671-9.

4. Cooley RL, Robison SF. Variables associated with electric pulp testing. Oral Surg Oral Med Oral Pathol. 1980;50:66-73.

5. Cooley RL, Stilley L, Lubow RM. Evaluation of digital pulp tester. Oral Surg Oral Med Oral Pathol. 1984;58:437-42.

6. Cristwood RW. Cardiac and CNS toxicity of levobupivacaine: strengths of evidence for advantage over bupivacaine. Drug Safety. 2002;25:153-63.

7. Dreven LJ, Reader A, Beck M, Meyers WJ, Weaver J. Evaluation of an electric pulp tester as a major of analgesia in human vital teeth. J Endod. 1987;13:233-8.

8. Feldmann G, Nordenran A. Marcaine in oral surgery, a clinical comparative study with carbocaine. Acta Anesthesiol Scand. 1966;23:410-3.

9. Foster RH, Markham A. Levobupivacaine: a review of its pharmacology and use as local anaesthetic Drugs. 2000;59:551-79.

10. Galindo MA. Levobupivacaina, anestésico local de acción prolongada, con menor cardio y neurotoxicidad. Col Anests. 2000;28:231-5.

11. Henry Neto MDE. Análise do efeito clínico do comportamento do cloridrato de levobupivacaína 0,5% sem vasoconstritor (NOVABUPI®) na extração de terceiros molares inferiores não irrompidos [Dissertação de Mestrado]. Uberlândia: Faculdade de Odontologia da UFU; 2003.

12. Ivani G, Borghi B, Van Oven H. Levobupivacaine. Minerva Anestesiol. 2001; 67(9):20-3.

13. Kopacz DJ, Allen HW. Accidental intravenous levobupivacaine. Anesth Analg. 1999;89:1027-9.

14. Malamed SF. Handbook of local anesthesia. 4th ed. St Louis: Mosby; 1997.

15. Mather LE, Chang DHT. Cardiotoxity with modern local anaesthetics – is there a safer choice? Drugs. 2001;61:333-42.

16. McClellan KJ, Spencer CM. Levobupivacaine. Drugs. 1998;56:355-62.

17. McLeod GA, Burke D. Levobupivacaine. Anaesthesia. 2001;56:331-41.

18. Morrison SG, Dominguez JJ, Frascarolo P, Reiz S. A comparasion of the eletrocardiographic cardiotoxic effects of racemic bupivacaine, levobupivacaine and ropivacaine in anesthetized swine. Anesth Analg. 2000;90:1308-14. 19 Pricco DF, Milwaukee W. An evaluation of bupivacaine for regional nerve block in oral surgery. J Oral Surg. 1977;35:126-9.

20. Rood JP, Coulthard P, Snowdon AT, Gennery BA. Safety and efficacy of levobupivacaine for postoperative pain relief after the surgical removal of impacted third molars: a comparison with lignocaine and adrenaline. Br J Oral Maxillofac Surg. 2002;40:491-6.

21. Santos AC, Karpel B, Noble G. The placental transfer and fetal effects of levobupivacaine, racemic bupivacaine, and ropivacaine. Aesthesiology. 1999;90:1698-703.

22. Shapiro SS, Wilk MB. An analysis of variance test normality. Biometrika. 1965; 52: 591-611.

23. Siegel S. Estatísticas não paramétrica, para as ciências do comportamento. São Paulo: Ed. McGraw-Hill do Brasil; 1975.

24. Soares PCO. Avaliação de parâmetros cardiovasculares pré, trans e pós anestesia local em pacientes normotensos [Dissertação de Mestrado]. Piracicaba: Faculdade de Odontologia da UNICAMP; 2002.
588017d97f8c9d0a098b4939 rou Articles
Links & Downloads

Rev. odontol. UNESP

Share this page
Page Sections