Comparative Studies of Electrocardiographic Changes with Local Anesthesia in Oral Surgery with the Use of Holter Monitoring

Introduction: Patients with heart diseaseoften do not get adequate surgical interventions because doctors fear the complications that may develop after the use of vasoconstrictors in local anesthetics. The purposeof the study is to determine the kind ofinfluence that Adrenalin has in the local anesthetic Unistesin in outpatient service of surgical patients that suffer from controlled forms of hypertension, coronary artery disease – angina and myocardial infarction, abnormalities of heart rhythm, through a 24 hour Holter monitoring of the cardiogram (before, during and after administering anesthesia), along with analyzing the values of the hemodynamic indicators. Studydesign:The object of the study is a group of 60 people with heart diseases, selected by admission criteria, that have had an oral surgical intervention with the use of local anesthesia. They have been randomly divided into two groups: First group30 patients that have been given an anesthetic with corrigent (Ubistesin, 1: 200 000, 3M-ESPE), Second group30 patients that have been given an anesthetic without corrigent (UltracainD, Aventis). The ST segment and QT interval were observed. An analysis of the hemodynamic indicators was done. Results: The results show a direct influence of the vasoconstrictors on the cardiac activity. The cardiogram showed no statistically significant difference in the changes of the studied markers (ST-segment and QTinterval), along with the main hemodynamic indicators (mean arterial pressure, pulse pressure, double product) in the patient groups that have used a different anesthetic(with and without corrigent). (Р>0.05) Conclusion:It can be concluded that the risk of using an anesthetic that contains 1:200 000 vasoconstrictors is minimal, while at the same time the quality of the anesthesia is sufficiently good so that the main stress component, that leads to the release of a large amount endogenous adrenalin, can be eliminated.