Electrocardiographic changes in cardiac patients undergoing dental extractions under local anesthesia

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
D BlinderS Taicher

Abstract

The purpose of this study was to identify which group of cardiac patients is most at risk when dental extractions are performed under local anesthesia. Forty cardiac patients who had dental extraction under local anesthesia (Mepivacain HCl three percent) were connected to a Holter monitor for 24 hours starting 1 hour before the procedure. Of the 40 patients, 24 had coronary artery disease, 12 had valvular disease, 3 were being treated with antiarrhythmic drugs, and 1 had malignant arterial hypertension. Sixteen patients were being treated with digoxin. The electrocardiogram was analyzed for the number of premature beats, ST depression, and cardiac rhythm. A mean rate was calculated for the first 2 hours after injecting the local anesthetic and surgical procedure, and for the subsequent 22 hours. All electrocardiographic changes occurred during the first 2 hours after injecting the local anesthetic. When the mean rate of that period was compared with the remaining 22 hours, new pathologic signs of arrhythmia, tachycardia, or ST depression were seen in 14 patients (35%). Of these, 12 were being treated with digoxin. Patients being treated with digoxin for atrial fibrillation or congestive heart failure are more prone to complicat...Continue Reading

References

Dec 12, 1990·JAMA : the Journal of the American Medical Association·A S DajaniS T Shulman
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Citations

Sep 5, 2002·Journal of Periodontology·UNKNOWN Research, Science and Therapy Committee, American Academy of Periodontology.
Feb 14, 2006·Vojnosanitetski pregled. Military-medical and pharmaceutical review·Mirjana Zivotić-Vanović, Marjan Marjanović
Dec 5, 2013·Restorative Dentistry & Endodontics·Youngjune Jang, Euiseong Kim
Apr 21, 2018·British Dental Journal·N J RansfordH Singh
Jul 20, 2019·Journal of the American Heart Association·Ana Carolina Guimarães OliveiraFrancisco Carlos Costa Darrieux
Nov 4, 2000·British Dental Journal·N I Jowett, L B Cabot
Feb 8, 2019·Journal of Maxillofacial and Oral Surgery·Ashish SharmaManoj Chaudhary
Apr 5, 2011·Clinical Oral Implants Research·Marcelo Munhóes RomanoCarlos Alberto Adde

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