HEMODYNAMIC CHANGES INDUCED BY LOCAL ANESTHETICS WITHOUT VASOCONSTRICTOR IN THE SURGICAL REMOVAL OF IMPACTED LOWER THIRD MOLARS

Yıl 2005, Cilt: 2005 Sayı: 1, 40 - 47, 01.01.2005

Yrd. Doç. Dr. Sinan Ay Yrd. Doç. Dr. H. Hüseyin Köşger Doç. Dr. Mustafa Öztürk Dr. Osman Yüksel Prof.dr. Derviş Yılmaz

Öz

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Anahtar Kelimeler

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ALT ÇENE GÖMÜLÜ 3. MOLAR DİŞ CERRAHİSİNDE VAZOKONSTRİKTÖR İÇERMEYEN LOKAL ANESTEZİK MADDELERE BAĞLI OLUŞAN HEMODİNAMİK DEĞİŞİKLİKLER

Öz

Bu çal$ mada, vazokonstriktör içermeyen dört farkl$ lokal anestezik maddeye ba8l$ olu an hemodinamik de8i ikliklerin incelenmesi amaçlanm$ t$r. Cumhuriyet Üniversitesi DiFakültesi, A8$z Di Çene Hastal$klar$ ve Cerrahisi AD. klini8indealt çene gömülü 3. molar di çekim endikasyonu bulunan 52 sa8l$kl$ eri kin hastaya lokal anestezi alt$nda cerrahi operasyon uygulanm$ t$r. 13’er ki ilik 4 gruba ayr$lan hastalara %2'lik artikain, %0,5'lik bupivakain, %2'lik lidokain ve %2'lik prilokain içeren lokal anestezik maddeler verilmi tir. Hastalar$n sistolik ve diastolik tansiyonlar$, solunum, nab$z ve oksijen saturasyonu de8erleri operasyon öncesinde, operasyon s$ras$nda ve sonras$nda monitörize edilerek kaydedilmi tir. Hemodinamik de8i iklikler aç$s$ndan incelenen dört farkl$ solüsyon için bazal de8erlere göre önemli bir de8i iklik olmad$8$ ve bu de8i kenlerin stabil kald$8$ görülmü tür

Anahtar Kelimeler

Lokal anestezik maddeler, artikain, bupivakain, lidokain, prilokain, hemodinamik de8i iklikler

Kaynakça

• Bennett CR. Monheim's Local Anesthesia and Pain Control in Dental Practice. 6th ed. St Louis, The C.V. Mosby Com, 1978: 63.
• Demiralp AS, Demiralp S. Di Hekimli8inde Anestezi. Ankara, AÜ Sa8l$k Bilimleri Enstitüsü Yay$nlar$ No:3, 1987: 17-8.
• Erengül A. Lokal Anestezi. Sstanbul, Nobel T$p Kitabevleri, 1992: 18.
• Kayhan Z. Klinik Anestezi. 2. Bask$, Logos Yay$nc$l$k Tic, 1997: 26.
• Bouloux GF, Punnia-Moorthy A. Bupivacaine versus lidocaine for third molar surgery: a double-blind, randomized, crossover study. J Oral Maxillofac Surg 1999; 57: 510-4.
• Danielsson K, Evers H, Holmlund A, Kjellman O, Nordenram A, Persson NE. Long-acting local anaesthetics in oral surgery. Clinical evaluation of bupivacaine and etidocaine for mandibular nerve block. Int J Oral Maxillofac Surg 1986; 15: 119-26.
• Delilba $ Ç, Keskin A. Gömülü yirmi ya di i cerrahisinde bupivakain ile lidokain etkilerinin kar $la t$r$lmas$. T Klin Di Hek Bil 2000; 6: 91- 5.
• Giovannitti JA, Bennett CR. The effectiveness of 1.5 % etidocaine HCl with epinephrine 1:200,000 and 2 % lidocaine HCl with epinephrine 1:100,000 in oral surgery: a clinical comparison. J Am Dent Assoc 1983; 107: 616-8.
• Malamed SF, Gagnon S, Leblanc D. Articaine hydrochloride: a study of the safety of a new amide local anesthetic. J Am Dent Assoc 2001; 132 : 177-85.
• Oertel R, Rahn R, Kirch W. Clinical pharmacokinetics of articaine. Clin Pharmacokinet 1997; 33: 417-25.
• Perusse R, Goulet JP, Turcotte JY. Contraindications to vasoconstrictors in dentistry: Part I. Cardiovascular diseases. Oral Surg Oral Med Oral Pathol 1992; 74: 679-86.
• Perusse R, Goulet JP, Turcotte JY. Contraindications to vasoconstrictors in dentistry: Part II. Hyperthyroidism, diabetes, sulfite sensitivity, cortico-dependent asthma, and pheochromocytoma. Oral Surg Oral Med Oral Pathol 1992; 74: 687-91.
• Goulet JP, Perusse R, Turcotte JY. Contraindications to vasoconstrictors in dentistry: Part III. Pharmacologic interactions. Oral Surg Oral Med Oral Pathol 1992; 74: 692-7.
• Malamed SF. Handbook of Local Anesthesia. 4th ed. St Louis, Mosby Inc, 1997: 304-5.
• Hupp JR. Preoperative Health Status Evaluation. In: Peterson LJ, Ellis III E, Hupp JR, Tucker MR. Contemporary Oral and Maxillofacial Surgery. 3th ed. St Louis, Mosby Year-Book, Inc. 1998: 9.
• Fernieini EM, Bennett JD, Silverman DG, Halaszynski TM. Hemodynamic assessment of local anesthetic administration by laser Doppler flowmetry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 91: 526-30.
• Knoll-Köhler E, Knöller M, Brandt K, Becker J. Cardiohemodynamic and serum catecholamine response to surgical removal of impacted mandibular third molars under local anesthesia: a randomized double-blind parallel group and crossover study. J Oral Maxillofac Surg 1991; 49: 957-62.
• Meyer FU. Hemodynamic changes of local dental anaesthesia in normotensive and hypertensive subjects. Int J Clin Pharmacol Ther Toxicol 1986; 24: 477-81.
• Niwa H, Sigumura M, Satoh Y, Tanimoto A. Cardiovascular response to epinephrine- containing local anesthesia in patients with cardiovascular disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 92: 610-6.
• Tolas AG, Pflug AE, Halter JB. Arterial plasma epinephrine concentrations and hemodynamic responses after dental injection of local anesthetic with epinephrine. J Am Dent Assoc 1982; 104: 41-3.
• Yagiela JA. Adverse drug interactions in dental practice: interactions associated with vasoconstrictors. Part V of a series. J Am Dent Assoc 1999; 130: 701-9.
• Blinder S, Manor Y, Shemesh J, Taicher S. Electrocardiographic changes in cardiac patients having dental extractions under a local anesthetic containing a vasopressor. J Oral Maxillofac Surg 1998; 56: 1399-402.
• Matsumura K, Miura K, Kurokawa H, Abe I, Takata Y. Lack of association between QT dispersion and blood pressure response during dental surgery. Clin Exp Pharmacol Physiol 2001; 28: 748-51.
• Salonen M, Forssell H, Scheinin M. Local dental anaesthesia with lidocaine and adrenaline. Effects on plasma catecholamines, heart rate and blood pressure. Int J Oral Maxillofac Surg 1988; 17: 392-4.
• Katibo8lu AB, Keskin C, Soley S, Korkut F, Ayhan N, Özyuvac$ H. Damar büzücü katk$ içeren ve içermeyen lokal anesteziklerin kan bas$nc$ ve kalp at$m say$s$ üzerine etkilerinin ara t$r$lmas$. Di hek Derg 1996; 20: 100-3.
• Mollao8lu N, Yücel E, Çevik C. The effects of five different dental local anaesthetics on plasma potassium level and heart rate in healty volunteers undergoing third molar operation. HÜ Di Hek Fak Derg 2000; 3-4: 44-8.
• Saysel M, ener C, Ta ar F, Ertu8 E, Ba al N. Comparison of cardiovascular and anesthetic effectiveness of lidocaine and articaine in impacted mandibular third molar surgery. J MU Dental Faculty 1998; 3: 830-3.
• Güngörmü M, Day$ E, Büyükkurt C. Normal ve hipertansiyonlu hastalarda kullan$lan farkl$ lokal anestezik solusyonun kan bas$nc$ ve nab$z üzerine etkilerinin klinik olarak ara t$r$lmas$. OMÜ Di hek Fak Derg 2002; 3: 94-7. .leti6im Adresi: Yrd.Doç.Dr. Sinan AY Cumhuriyet Üniversitesi, Di Hekimli8i Fakültesi ADÇ. Hastal$klar$ ve Cerrahisi AD. 58140, Kampüs / Sivas Tel: [phone] / 2756 Faks: 0 346 2191237 e-posta: [e-mail]