Analysis of Hemodynamic Changes after Administration of Mepivacaine HCL 3% with Prilocaine 3% Solution + Felypressin

E. Aliabadi, Ahmad Homayoon, H. Eftekharian
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Abstract

Introduction: With regards to the usage of local anesthetic drugs in hypertensive patients, this study is designed for comparing the effects of mepivacaine 3% and prilocaine 3% + felypressin in hemodynamic changes after inferior alveolar nerve block to help dental practitioner select anesthetic solutions for hypertensive patients considering their hemodynamic effects in order to provide patient safety.Materials & Methods: In this double blind clinical trial 32 patients were referred to oral and maxillofacial surgery department of Shiraz dentistry school in 2021 were divided into 2 groups with 16 patients in each group. In first group, inferior alveolar nerve block was accomplished by mepivacaine 3% and in the other group, prilocaine 3% and felypressin. Then systolic and diastolic blood pressure, heart rate and oxygen saturation were measured at 4 different time points consisting of before injection, immediately after injection, 10 minutes after injection and 30 minutes after tooth extraction. The data were analyzed by ANOVA and T-test (p value < 0.05).Results: There were no statistically significant differences in systolic blood pressure, diastolic blood pressure, heart rate and oxygen saturation changes between mepivacaine and prilocaine groups during all four sampling time points. But in each group, individually there were significant differences in systolic and diastolic blood pressure, heart rate and oxygen saturation in different times. In addition mepivacaine causes a significant increase in systolic blood pressure immediately after injection but in contrast prilocaine + felypressin didn’t do so.Conclusion: We recommend prilocaine + felypressin in comparison with mepivacaine for local anesthesia in hypertensive patients.
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3%盐酸美哌卡因与3%普拉卡因溶液+ felypresin给药后血流动力学变化分析
前言:针对高血压患者局麻药的使用,本研究旨在比较3%甲哌卡因和3%丙洛卡因+ fely加压素对下牙泡神经阻滞后血流动力学变化的影响,帮助牙科医生根据血流动力学影响选择适合高血压患者的麻醉方案,以保障患者安全。材料与方法:本双盲临床试验选取设拉子牙科学校2021年口腔颌面外科转诊患者32例,分为2组,每组16例。第一组用3%的甲哌卡因完成下肺泡神经阻滞,另一组用3%的丙洛卡因和利尿素完成下肺泡神经阻滞。分别于注射前、注射后立即、注射后10分钟、拔牙后30分钟4个不同时间点测量收缩压、舒张压、心率、血氧饱和度。数据分析采用方差分析和t检验(p值< 0.05)。结果:甲哌卡因组与丙洛卡因组在4个采样时间点的收缩压、舒张压、心率、血氧饱和度变化均无统计学差异。但在每一组中,不同时间的收缩压、舒张压、心率和血氧饱和度都有显著差异。此外,甲哌卡因在注射后立即引起收缩压明显升高,而丙洛卡因+ fely加压素则没有。结论:与甲哌卡因相比,我们推荐普利卡因+ fely加压素用于高血压患者的局部麻醉。
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