Efeito da mepivacaína 2% com adrenalina 1:100.000 sobre a pressão sanguínea
Effect of mepivacaine 2% with adrenaline 1:100.000 in blood pressure
Dantas, M.V.M.; Gabrielli, M.A.C.; Hochuli Vieira, E.
Rev. odontol. UNESP, vol.37, n3, p.223-227, 2008
Resumo
Na prática odontológica, a mepivacaína é o agente anestésico que vem sendo largamente utilizado, geralmente associada ao vasoconstritor adrenalina na proporção de 1:100.000. A questão a respeito de quanto e em quais circunstâncias os anestésicos locais com adrenalina são apropriados tem sido infindavelmente debatida há mais de 50 anos. Dessa forma, com o objetivo de se avaliar o efeito deste anestésico local associado à adrenalina (1:100.000) sobre a pressão arterial, 50 pacientes normotensivos foram selecionados e submetidos à exodontia na Clínica de Cirurgia e Traumatologia Buco-Maxilo-Facial da Faculdade de Odontologia de Araraquara - UNESP. A pressão arterial dos pacientes foi aferida antes e 5 minutos após a infiltração com o anestésico proposto. Os resultados obtidos foram analisados através do Teste t de Student pareado. Adotou-se o nível de 5% de significância (p < 0,05). O procedimento de anestesia local com o anestésico proposto não provocou alterações estatisticamente significantes na pressão sistólica (teste t pareado, p = 0,57) e a pressão diastólica sofreu um discreto aumento de 1,5 mmHg (teste t pareado, p = 0,02). Concluímos, dessa forma, que o anestésico local mepivacaína 2% com adrenalina (1:100.000) pode ser seguramente utilizado em pacientes normotensivos durante a realização de procedimentos cirúrgicos odontológicos, devido ao fato deste leve aumento na pressão diastólica poder estar relacionado à ansiedade e/ou ao estresse emocional dos pacientes.
Palavras-chave
Mepivacaína, epinefrina, pressão arterial.
Abstract
Mepivacaine with adrenaline is currently one of the most used local anesthetics for oral surgery. The question concerning how much and under which conditions local anesthetic with adrenaline vasoconstriction must be used has been debated for over 50 years. Thus, the aim of this study was to evaluate the effect of 2% mepivacaine with 1:100.000 adrenaline in cardiovascular system, particularly blood pressure. For this purpose, 50 normotensive patients were selected and submitted to a routine tooth extraction. Blood pressure measurements were recorded immediately prior to and 5 minutes after local anesthesia. Data were statistically analyzed by the paired Student’s t-test (p < 0.05). No significant differences in systolic blood pressure (p = 0.57) were demonstrated, nor before neither 5 minutes after local anesthesia with 2% mepivacaine with 1:100.000 adrenaline. On the other hand, a significantly increase (p = 0.02) in diastolic blood pressure was observed 5 minutes after local anesthesia with anesthetic solution tested. Despite the increase in diastolic blood pressure just after local anesthesia, 2% mepivacaine with 1:100.000 adrenaline might be safely indicated to dental surgery in normotensive patients due to the fact that the observed increase may be attributed to patient anxiety and emotional stress.
Keywords
Mepivacaine, epinephrine, blood pressure
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