Effects of dental local anesthesia with epinephrine in patients with cardiac channelopathies

• Grant number: 13/24283-1
• Support Opportunities: Regular Research Grants
• Start date: June 01, 2015
• End date: May 31, 2017
• Field of knowledge: Health Sciences - Dentistry - Dental Clinics
• Principal Investigator: Francisco Carlos da Costa Darrieux
• Grantee: Francisco Carlos da Costa Darrieux
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated researchers: Ana Carolina Guimarães Oliveira ; Itamara Lucia Itagiba Neves ; Luciana Sacilotto

Abstract

Potentially lethal ion channel disorders such as Brugada syndrome, long QT syndrome and catecholaminergic polymorphic ventricular tachycardia may account for at least one-third of the unexplained cases of sudden cardiac death (30%), although structural cardiovascular abnormalities explain most of them (70%). Diagnosis of channelopathy is performed according to clinical criteria and genetic tests. Dental care in patients with channelopathies and ventricular arrhythmias is controversial due to lack of information in the literature regarding the use of appropriate dose and type of local anesthetic recommended. The use of vasoconstrictors in patients with structural heart disease is restrict due to anesthetic complications described in the literature, most caused by adrenergic stimulation on the cardiovascular system, keeping the discussion on the choice of the ideal anesthetic during dental procedures. Objectives: To investigate the occurrence of cardiac arrhythmias in patients with channelopathies after local dental anesthesia with two cartridges (3,6 mL) of lidocaine 2% without epinephrine and lidocaine with epinephrine 1:100,000 previous to restorative dental treatment. Methods: Thirty to 50 patients diagnosed with channelopathy will undergo restorative dental treatment in two sessions, performed with an interval of seven days (wash-out) both them, and the patient will be self-control. In the first session, for randomization, patients will receive one of the anesthetics: lidocaine 2% without epinephrine (LSA) or lidocaine 2% with epinephrine 1:100,000 (LCA) (cross-over), yielding two groups: LSAàLCA e LCAàLSA. The anesthetic randomization will be held by the researcher responsible, being blind to the researcher performer and to the patient, who will be under ambulatory electrocardiographic monitoring (Holter) for 28 hours, counting from one hour before the procedure, in the two study sessions. To record changes in blood pressure will be used digital sphygmomanometer and facial image scale will be applied for measuring anxiety, both three times. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

GUIMARAES OLIVEIRA, ANA CAROLINA; ITAGIBA NEVES, ITAMARA LUCIA; SACILOTTO, LUCIANA; SANGIORGI OLIVETTI, NATALIA QUINTELLA; DOS SANTOS-PAUL, MARCELA ALVES; PEDROSO MONTANO, TANIA CRISTINA; ALENCAR CARVALHO, CINTIA MARIA; WU, TAN CHEN; GRUPI, CESAR JOSE; BARBOSA, SILVIO ALVES; et al. Is It Safe for Patients With Cardiac Channelopathies to Undergo Routine Dental Care? Experience From a Single-Center Study. JOURNAL OF THE AMERICAN HEART ASSOCIATION, v. 8, n. 15, AUG 6 2019. (13/24283-1)

ANA CAROLINA GUIMARÃES OLIVEIRA; ITAMARA LUCIA ITAGIBA NEVES; LUCIANA SACILOTTO; NATÁLIA QUINTELLA SANGIORGI OLIVETTI; SAVIA CHRISTINA PEREIRA BUENO; GABRIELLE DAREZZO PESSENTE; MARCELA ALVES DOS SANTOS-PAUL; TÂNIA CRISTINA PEDROSO MONTANO; CÍNTIA MARIA ALENCAR DE CARVALHO; CESAR JOSÉ GRUPI; et al. Favorable Safety Experience of Local Dental Anesthesia in ICD Recipients with Cardiac Channelopathies. International Journal of Cardiovascular Sciences, v. 36, 2023-04-03. (13/24283-1)