Effects of Implant Surgery on Blood Pressure and Heart Rate During Sedation with Propofol and Midazolam

被引:0
作者
Ueno, Daisuke [1 ]
Sato, Junichi [1 ]
Nejima, Jun [2 ]
Maruyama, Keisuke [1 ]
Kobayashi, Mariko [1 ]
Iketani, Toshikazu [1 ]
Sekiguchi, Rei [4 ]
Kawahara, Hiroshi [3 ]
机构
[1] Tsurumi Univ, Unit Oral & Maxillofacial Implantol, Sch Dent Med, Yokohama, Kanagawa, Japan
[2] Tsurumi Univ, Dept Internal Med, Sch Dent Med, Yokohama, Kanagawa, Japan
[3] Tsurumi Univ, Dept Dent Anesthesiol, Sch Dent Med, Yokohama, Kanagawa, Japan
[4] Univ Rochester, Div Periodont, Eastman Inst Oral Hlth, Rochester, NY USA
关键词
angiotensin II receptor blockers; dental implant; hemodynamics; midazolam; moderate sedation; oral surgery propofol; RECEPTOR ANTAGONISTS; HEMODYNAMIC-CHANGES; SURGICAL REMOVAL; DENTAL TREATMENT; DOUBLE-BLIND; 3RD MOLARS; ANESTHESIA; HYPERTHYROIDISM; HYPOTENSION; INDUCTION;
D O I
暂无
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Purpose: Intravenous (IV) sedation is commonly used in dentistry. However, no report has yet been published regarding age, hypertension, and antihypertensive drugs during implant surgery and their relationship with changes in blood pressure (BP) and heart rate in implant surgery under IV sedation with propofol and midazolam. Materials and Methods: Medical records of 252 patients who underwent implant surgery were retrospectively analyzed. Patients were classified into four groups according to their age (in years) and hypertension status: A = <= 64, no hypertension; B = >= 65, no hypertension; C = <= 64, hypertension; or D = >= 65, hypertension. Hypertensive patients were further characterized by their antihypertensive medications: E = calcium channel blockers (CCBs), F = angiotensin II receptor blockers (ARBs), G = CCBs+ARBs, or H = no medication. IV sedation was administered in two stages. After midazolam injection to prevent angialgia, propofol was infused at the rate of 4 mg/kg/h, followed by a dose reduction. Systolic and diastolic BP and heart rate were recorded before, during, and after surgery. Results: Systolic BP increased significantly after patients were draped in groups A, C, and D, with group D showing the most pronounced increase. Sedatives decreased BP in all groups. Diastolic BP in group F decreased significantly compared to group H after induction and before infiltration of local anesthetic. After infiltration, systolic BP decreased more significantly in group G than in group H. Intraoperative hypotension was observed in 25% of patients. The incidence of intraoperative hypertension in group D was markedly higher than in group A (23% vs 4%). Conclusion: IV sedation using midazolam and propofol reduces hypertensive risks during implant surgery. Nevertheless, care must be taken, especially in older hypertensive patients and in hypertensive patients on ARBs or ARBs+CCBs. INT J ORAL MAXILLOFAC IMPLANTS 2012;27:1520-1526
引用
收藏
页码:1520 / 1526
页数:7
相关论文
共 25 条
[1]   Hemodynamic changes during the surgical removal of lower third molars [J].
Alemany-Martinez, Aurelia ;
Valmaseda-Castellon, Eduard ;
Berini-Aytes, Leonardo ;
Gay-Escoda, Cosme .
JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, 2008, 66 (03) :453-461
[2]   BLOOD-PRESSURE AND HEART-RATE RESPONSES TO ANTICIPATED HIGH-STRESS DENTAL TREATMENT [J].
BECK, FM ;
WEAVER, JM .
JOURNAL OF DENTAL RESEARCH, 1981, 60 (01) :26-29
[3]  
Bertrand M, 2001, ANESTH ANALG, V92, P26
[4]   The hemodynamic effects of anesthetic induction in vascular surgical patients chronically treated with angiotensin II receptor antagonists [J].
Brabant, SM ;
Bertrand, M ;
Eyraud, D ;
Darmon, PL ;
Coriat, P .
ANESTHESIA AND ANALGESIA, 1999, 89 (06) :1388-1392
[5]   Refractory hypotension after induction of anesthesia in a patient chronically treated with angiotensin receptor antagonists [J].
Brabant, SM ;
Eyraud, D ;
Bertrand, M ;
Coriat, P .
ANESTHESIA AND ANALGESIA, 1999, 89 (04) :887-888
[6]   Cardiovascular responses induced by dental treatment [J].
Brand, HS ;
AbrahamInpijn, L .
EUROPEAN JOURNAL OF ORAL SCIENCES, 1996, 104 (03) :245-252
[7]  
CHERASKIN E., 1959, JOUR AMER DENTAL ASSOC, V58, P61
[8]   HEMODYNAMIC-CHANGES DURING ANESTHESIA INDUCED AND MAINTAINED WITH PROPOFOL [J].
CLAEYS, MA ;
GEPTS, E ;
CAMU, F .
BRITISH JOURNAL OF ANAESTHESIA, 1988, 60 (01) :3-9
[9]   A sedation technique for implant and periodontal surgery [J].
Craig, DC ;
Boyle, CA ;
Fleming, GJP ;
Palmer, P .
JOURNAL OF CLINICAL PERIODONTOLOGY, 2000, 27 (12) :955-959
[10]  
Frabetti L, 1992, Quintessence Int, V23, P19