| Summary: | 碩士 === 國立臺灣大學 === 臨床牙醫學研究所 === 92 === ABSTRACT
Local anesthetics are frequently used in dentistry. Its use makes the dental therapy easier and allows reassurance of patient to whom some painful techniques will be applied. This study attempted to examine the physiological changes during and after injection of local anesthetics containing different concentrations of epinephrine, and to evaluate the safety of local anesthetics with epinephrine for patients with underlying diseases. Two hundred and three patients who came to NTUH for dental extraction under local anesthesia were chosen randomly. Informed consent was given and questionnaire was obtained for patients’ psychologic response to dental treatment. Anxiety was measured by using Corah’s Dental Anxiety Scale, which has been translated into local language. Pulse rate, blood pressure, electrocardiograms, O2 saturation and symptoms are monitored before, during and after the local anesthesia. Then we distribute the data into several criteria to observe: according to the subjects’ past medical history, type of injection, Corah’s DAS, and type of local anesthesia solution that we employed. Hypertensive subjects and subjects with severe dental anxiety are hyperreactors to epinephrine. The mean DAS score were 9.3 (± 2.5), female appeared to have a higher dental anxiety level than male. Patients with a high score were younger than those with a low score. Infiltration anesthesia were produced an increased in heart rate, while PSA and mandibular block produced a reduction in heart rate, but these findings were insignificant. In this study, overall incidences of positive aspirations were 3%, and most of the incidences were occurred when giving the mandibular block anesthesia. .None adverse events had shown up on those subjects in this study during the entire procedure, even in the subjects with positive aspiration. It seems that the tachycardia were the main EKG changes during the entire procedure. We concluded that limited dental anesthetics with epinephrine were well tolerated by the subjects in our study, even those with underlying diseases. Therefore, a local anesthetic with epinephrine may be selected to obtain adequate levels of anesthesia.
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