Key result
Phenylephrine raises trans-operative SBP by ~12 mmHg vs felypressin, though changes remain well tolerated.
Why the study?
The study evaluated the cardiovascular effects of infiltrating epinephrine or phenylephrine with lidocaine compared with felypressin with prilocaine during third molar surgery in ASA I patients.
Do epinephrine or phenylephrine with lidocaine compared to felypressin with prilocaine alter cardiovascular parameters during third molar surgery in ASA I patients?
RCT (n=18)
Randomly divided into two groups
No
Do epinephrine or phenylephrine with lidocaine compared to felypressin with prilocaine alter cardiovascular parameters during third molar surgery in ASA I patients?
Absolute Event Rate: 127.3% vs 114.9%
p-value: p=<0.05
In healthy patients undergoing third molar surgery, local anesthesia with phenylephrine increases blood pressure while felypressin reduces heart rate and oxygen saturation, though these hemodynamic changes are well tolerated.
OBJECTIVE: Evaluate the cardiovascular effects by infiltration of 1:100.000 epinephrine and 1:2.500 phenylephrine associated with 2% lidocaine compared with the effects by infiltration of 0.03 IU/ml felypressin with 3% prilocaine, during surgery of third molars in ASA I patients.METHODS: Eighteen patients were divided into two groups. In group I (GI), the effects of epinephrine vs felypressin were evaluated and in group II (GII), the effects of phenylephrine vs felypressin. Cardiovascular parameters: systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and oxygen saturation (SatO2) were measured in pre, trans and post-operative periods.RESULTS: Statistical analysis (T-TEST) on the cardiovascular parameters demonstrated with significance that, GI: felypressin presented HR average reduction in the postoperative period and SatO2 average reduction in trans and postoperative periods. For GII: felypressin presented SatO2 average reduction in the postoperative period; SBP averages for patients submitted to phenylephrine increased in trans and postoperative periods; and DBP averages for patients submitted to phenylephrine increased in pre and trans-operative periods.COCLUSION: We can conclude that phenylephrine may lead to increased SBP and DBP and felypressin generated a reduction in HR and SatO2. All these changes were well tolerated by ASA I patients.
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Costa et al. (2018) conducted an RCT in Healthy patients requiring third molar extraction (n=18). 2% lidocaine with 1:2,500 phenylephrine vs. 3% prilocaine with 0.03 IU/ml felypressin was evaluated on Trans-operative systolic blood pressure (SBP) in mmHg (p=<0.05). In healthy patients undergoing third molar extraction, phenylephrine significantly increased trans-operative systolic blood pressure compared to felypressin (127.3 vs 114.9 mmHg, p<0.05), though all cardiovascular changes were well tolerated.
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