Banca de DEFESA: MARCELO LEITE MACHADO DA SILVEIRA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : MARCELO LEITE MACHADO DA SILVEIRA
DATE: 06/09/2022
TIME: 14:00
LOCAL: DEPARTAMENTO DE ODONTOLOGIA - SALA DE REUNIÕES DA COORDENAÇÃO
TITLE:

Evaluation of cardiovascular alterations and catecholamines serum concentration after oral surgery in patients receiving local anesthetics with adrenergic vasoconstrictor.

KEY WORDS:

Local anesthetics; Epinephrine; Heart diseases; Vasoconstrictor agents; Oral surgery.

PAGES: 44
BIG AREA: Ciências da Saúde
AREA: Odontologia
SUBÁREA: Cirurgia Buco-Maxilo-Facial
SUMMARY:

Objectives: A randomized controlled clinical trial was developed to evaluate the cardiovascular effects of local anesthetics with vasoconstrictors (LAVC) in healthy and hypertensive patients undergoing teeth extraction with lidocaine 2% with epinephrine 1:100.000. Materials and methods: 20 patients were divided into control (CG – normotensive patients) and experimental groups (EG – hypertensive patients). The variables analyzed were heart rate (HR), oxygen saturation (O2S), systolic and diastolic blood pressure (sysBP and diasBP), serum catecholamines concentration (dopamine, epinephrine, and norepinephrine), ventricular and supraventricular extrasystoles (VES and SVES respectively), and ST segment depression. Data was obtained in three different moments (initial, trans and final). Blood samples were taken to measure the catecholamines and a Holter device was used to measure data from the electrocardiogram including a 24-hour postoperative evaluation period. The Mann-Whitney test was used to identify differences between the two groups and the Friedman test with the adjusted Wilcoxon post test were used for intragroup evaluation for repeated measures. Results:  The EG presented a lower O2S in the initial period (p = 0,001) while the sysBP showed a statistical difference for the three evaluation periods with the EG presenting the highest values. The VES where higher for the EG during the 24-hour postoperative evaluation period (p = 0,041). The SVES and the serum catecholamines showed were similar between the groups. The intragroup analysis revealed significant statistical difference for the sysBP in the EG with the trans period presenting the highest measurements. The extrasystoles evaluation showed that the 24-hour postoperative period presented most events with only the CG not presenting statistical difference for the variable VES during this period (p = 0,112). No ST segment depression was noticed for both groups. Conclusions: Teeth extraction with LAVC can be safely executed in hypertensive patients. Blood pressure should be monitored in these patients since the sysBP presented significant differences during the surgical procedures. Cardiac arrhythmia and the serum catecholamines concentration levels seem not to be altered by the surgical procedure. Also, serum catecholamines to not influence cardiovascular changes in this type of surgery.

COMMITTEE MEMBERS:
Interno - 2379951 - ADRIANO ROCHA GERMANO
Externo ao Programa - 1221550 - WAGNER RANIER MACIEL DANTAS - UFRNExterno à Instituição - EDUARDO DIAS DE ANDRADE - UNICAMP
Externo à Instituição - FRANCISCO SAMUEL RODRIGUES CARVALHO - UFC
Externo à Instituição - RICARDO JOSÉ HOLANDA VASCONCELOS - UPE