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Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2011, vol. 17, book 2
Subject Collection:Oral and Dental Medicine
Page: 101 - 103
DOI: 10.5272/jimab.2011172.101
Online date: September 3, 2011

J of IMAB 2011; 17(2):101-103
CONTINUOUS HOLTER MONITORING OF PATIENTS WITH CARDIOVASCULAR DISEASES IN ORAL SURGERY
Hristo Daskalov*, Lyudmila Vladimirova-Kitova** F. Nikolov**, E. Sarachev*
* Department of Oral surgery, Faculty of Dental medicine,
** Department of Cardiology, Faculty of Medicine,
MedicalUniversity - Plovdiv, Bulgaria

ABSTRACT:
Introduction. Pain control and anxiety management are important aspects of modern dental treatment. Although many local anesthetics and anesthesia techniques have so far been studied, there is still no clarity as to what anesthetic should be used in cardiovascularly compromised patients.
This anesthetic and its dosage should be very carefully chosen to achieve optimal effective pain control; the possible side effects occurring mainly in morbidly compromised patients should also be well studied.
Methods. The aim of this study was to study the effect of vasoconstrictors on local anesthetics in 18 patients with heart diseases.
The study contingent was recruited from the patients visiting often their general dental practitioners and diagnosed with the following heart diseases:
Heart failure (after 6 months); ischemic heart disease, including mild angina pectoris.
Articaine was used as local anesthetic.
Results. The ST segment on the ECG was used to detect myocardial ischemia and to study the effect of the administered local anesthesia.
Conclusion. The study results suggest that pain control in a cardiovascularly compromised patient subjected to oral surgery should be carried out only after thorough analysis is conducted of the specific condition and current status of the patient. Additional hematological tests shoud be done to enable the dentist to build a viable treatment plan.

Key words: cardiovascular diseases, Holter, vasoconstrictors.

REFERENCES:
1. Michan G. Local anesthesia in dentistry. Medicine publishers Sharov 2003;1-133. (in Bulgarian)
2. Tomov I, L. Tomov. Clinical electrocardiography and vector cardiography. Medicine and Physical culture. Sofia 1981:392. (in Bulgarian)
3. Anisimova EN, Zorian EV, Shugaĭlov IA. [The action of Carpule-delivered local anesthetics and their combinations with vasoconstrictors]. Stomatologiia (Mosk). 1998;77(2):19-22. [in Russian] [PubMed]
4. Alemany-Martinez A, Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C. Hemodynamic changes during the surgical removal of lower third molars. J Oral Maxillofac Surg 2008 Mar;66(3):453-61. [PubMed
5. Arrigoni J, Lambrecht JT, Filippi A. Cardiovascular monitoring and its consequences in oral surgery. Schweiz Monatsschr Zahnmed. 2005; 115(3):208-13. [in German] [PubMed]
6. Buric N, Tijanic M. Review and analysis of vasoconstrictors in local anesthetics applied in orofacial surgery. Acta Stomatologica Naissi 2003;19(43):315-319.
7. Campbell RL, Langston WG. A comparison of cardiac rate-pressure product and pressure-rate quotient in healthy and medically compromised patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995 Aug;80(2):145-52. [PubMed]
8. Glick M, Greenberg BL. The potential role of dentists in identifying patients risk of experiencing coronary heart disease events. J Am Dent Assoc 2005 Nov;136(11);1541-1546. [PubMed]
9. Jowett NI, Cabot LB. Patients with cardiac disease: considerations for the dental practitioner. Br Dent J. 2000 Sep 23;189(6):297-302. [PubMed]
10. Karp JM, Moss AJ. Dental treatment of patients with long QT-syndrome. J Am Dent Assoc 2006 May;137(5);630-637. [PubMed]
11. Malamed S, Gagnon S, Leblanc D. Efficacy of articaine: new amide local anesthetic. J Am Dent Assoc 2000 May;131(5);635-642. [PubMed]
12. Malamed SF, Gagnon S, Leblanc D. Articaine hydrochloride: a study of the safety of a new amide local anesthetic. J Am Dent Assoc. 2001 Feb;132(2):177-85. [PubMed]
13. Malamed S. What's new in local anaesthesia? SAAD Dig. 2009 Jan;25:4-14. [PubMed]
14. Vanderheyden PJ, Williams RA, Sims TN. Assessment of ST segment depression in patients with cardiac disease after local anesthesia. J Am Dent Assoc. 1989 Sep;119(3):407-12. [PubMed].

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Please cite this article as: Daskalov Hr., Vladimirova-Kitova L, Nikolov F., Sarachev E. CONTINUOUS HOLTER MONITORING OF PATIENTS WITH CARDIOVASCULAR DISEASES IN ORAL SURGERY. J of IMAB 2011; 17(2):101-103. doi:10.5272/jimab.2011172.101

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