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Variação da pressão arterial no uso de anestésicos locais com e sem vasoconstritor
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| PPG_24165 | 379.94 KB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Introdução: A anestesia local é imprescindível à prática da medicina dentária no que diz
respeito ao controlo e prevenção da dor. É cada vez mais importante que os médicos
dentistas possuam bons conhecimentos de base acerca dos anestésicos locais, bem como
dos vasoconstritores tão usualmente combinados com estes. É também importante que o
clinico esteja alertado dos efeitos diretos e secundários dos anestésicos locais,
reconhecendo-os, nomeadamente na hemodinâmica do paciente e, especialmente as suas
repercussões na pressão arterial.
Objetivo: Este trabalho teve como objetivo uma recolha e revisão bibliográfica sobre
anestésicos locais com e sem vasoconstritor e qual o efeito destes no comportamento da
pressão arterial. Abordam-se ainda as principais vantagens e limitações das soluções
anestésicas mais utilizadas em medicina dentária, com ênfase nos efeitos na pressão
arterial.
Materiais e métodos: Para tal, realizou-se uma pesquisa bibliográfica nos principais
motores de busca (PubMed, Scielo, B-On e Science Direct), como também em vários
livros científicos, utilizando palavras-chave como: “Anestésicos Locais”,
“Vasoconstritores” e “Pressão Arterial”, que foram associadas de várias formas. Desta
pesquisa, efetuada entre Maio e Julho de 2015, foram escolhidos 40 artigos, dos quais
foram utilizados 25. Além dos artigos, foram analisados 7 livros, dos quais foram
utilizados 4.
Resultados: Foram analisados vários estudos, dos quais é possível verificar que a
pressão arterial sofre variações quando são administrados anestésicos locais, quer estes
se apresentem combinados ou não com vasoconstritores. Porém estas alterações não são
estatística e clinicamente significantes.
Conclusões: O uso de anestésicos locais com ou sem vasoconstritores não demonstrou
uma variação significativa relativamente a pressão arterial. Contudo, deve ser respeitada
a técnica adequada, as doses máximas de vasoconstritor associado, assim como as
situações de contra-indicação relativa e absoluta. O stress do paciente é um fator a ser considerado na prática de medicina dentária assim como, o eficiente controlo da dor.
Foi demonstrando que a associação a vasoconstritores na anestesia local é uma mais
valia.
Introduction: Local anesthesia is essential to the practice of dentistry regarding the control and prevention of pain. It is increasingly important that dentists possess good basic knowledge of the local anesthetics, as well as the vasoconstrictor usually combined with these. It is also important that the clinician is alerted to the direct and secondary effects of local anesthetics, recognizing them, particularly in the patient's hemodynamic and its impact on blood pressure. Objective: This study aimed to a bibliographic research and revision of local anesthetics with and without vasoconstrictor and the effect of these on the blood pressure's behavior. It were also addressed the main advantages and limitations of the anesthetics commonly used in dentistry, emphasizing the effect on blood pressure. Methods: For this purpose, was carried out a literature search on the major search engines (PubMed, Scielo, B-On and Science Direct), as well as in several scientific books, using keywords such as "local anesthetics", " Vasoconstrictors "and" blood pressure, "that have been associated in various ways. From this research, conducted between May and July 2015, were chosen 40 articles of which 25 were used. In addition to the articles, 7 books were analyzed, of which 4 were used. Results: Were analyzed several studies, in which is possible to verify that blood pressure suffers variations with the administration of local anesthetics either if combined or not with vasoconstrictor. However, these changes are not statistically and clinically significant. Conclusions: The use of local anesthetics with or without vasoconstrictor showed no significant variation regarding the blood pressure. However, it should be respected the proper technique and the maximum doses of the associated vasoconstrictor, as well as the situations of relative or absolute contraindication. The patient stress is a factor to be considered in clinical dentistry and therefore the efficient management of pain. It was shown that the combination of vasoconstrictor in local anesthesia is an asset.
Introduction: Local anesthesia is essential to the practice of dentistry regarding the control and prevention of pain. It is increasingly important that dentists possess good basic knowledge of the local anesthetics, as well as the vasoconstrictor usually combined with these. It is also important that the clinician is alerted to the direct and secondary effects of local anesthetics, recognizing them, particularly in the patient's hemodynamic and its impact on blood pressure. Objective: This study aimed to a bibliographic research and revision of local anesthetics with and without vasoconstrictor and the effect of these on the blood pressure's behavior. It were also addressed the main advantages and limitations of the anesthetics commonly used in dentistry, emphasizing the effect on blood pressure. Methods: For this purpose, was carried out a literature search on the major search engines (PubMed, Scielo, B-On and Science Direct), as well as in several scientific books, using keywords such as "local anesthetics", " Vasoconstrictors "and" blood pressure, "that have been associated in various ways. From this research, conducted between May and July 2015, were chosen 40 articles of which 25 were used. In addition to the articles, 7 books were analyzed, of which 4 were used. Results: Were analyzed several studies, in which is possible to verify that blood pressure suffers variations with the administration of local anesthetics either if combined or not with vasoconstrictor. However, these changes are not statistically and clinically significant. Conclusions: The use of local anesthetics with or without vasoconstrictor showed no significant variation regarding the blood pressure. However, it should be respected the proper technique and the maximum doses of the associated vasoconstrictor, as well as the situations of relative or absolute contraindication. The patient stress is a factor to be considered in clinical dentistry and therefore the efficient management of pain. It was shown that the combination of vasoconstrictor in local anesthesia is an asset.
Description
Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária
Keywords
Anestésicos Locais Vasoconstritores Pressão Arterial Local anesthetics Vasoconstrictors Blood pressure