A study on hemodynamic effects accompanied with local anesthesia: Applications of the pulsed doppler echocardiography and laser doppler blood flowmetry

Sudou, T.

Shikwa Gakuho 94(1): 1-22

1994


Accession: 008080886

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Abstract
In this study, hemodynamic effects during local anesthesia were observed systemic and peripheral circulation, because of hemodynamic changes may have a influence significantly on mental stress and pain during the dental treatment. Methods: In patients requiring dental treatment under local anesthesia, 16 normal subjects for 16 cases, and 15 hypertension patients for 38 cases, were examined using 2% lidocaine with 1:80000 epinephrine. The applications were used for pulsed doppler echocardiography and laser doppler blood flowmetry. The observation was made by heart rate, blood pressure, stroke volume index, cardiac index, left ventricle outflow, digital blood flow volume, total peripheral resistance, left ventricular work index and rate-pressure-product. Results and Conclusions: 1. Preoperative echocardiograms in both groups indicated no abnormalities. 2. At the start of local anesthesia, heart rate and blood pressure were remarkably increased in the hypertensive group. In 3 minutes following local anesthesia, heart rate showed maximum values for both groups, but blood pressure was recovered preoperative level for both groups. 3. Stroke volume index and cardiac index for both groups changed slightly at the start of local anesthesia, and maximum values were observed in 3 minutes following local anesthesia. 4. Left ventricle outflow showed high value preoperative level for the hypertensive group. For both groups, however, flow rate decreased slightly at the start of local anesthesia, and increased following local anesthesia, and these changes were thought to be affected total peripheral resistance. 5. Digital blood flow volume showed minimum value at the start of local anesthesia for both groups and 3 minutes following local anesthesia was recovered preoperative level. 6. Total peripheral resistance showed high value preoperative level for the hypertensive group and more increased at the start of anesthesia. For both groups showed decreased 3 minutes following local anesthesia. 7. At the start of local anesthesia, blood pressure increased was affected with total peripheral resistance. In 3 minutes following local anesthesia, blood pressure recovered preoperative level, but stroke volume and total peripheral resistance were changing. Thus it was thought that measurement of stroke volume grasped of detailed hemodynamic effects, and measurement of digital blood flow volume observed the involvement of the autonomic nervous activity in the circulation.