Studies on the effects of minor dental surgery on oxygen consunption and myocardial function.

我们观察了牙科局部麻醉和小手术对氧消耗(VO2)、二氧化碳产生(VCO2)、分钟容量(Ve)、潮气量(Vt)、呼吸频率(RR)和心肌功能(STI)的影响。结果表明：1)肾上腺素与利多卡因联合应用可使VO2、Vco2、Ve增加，并具有正性变力作用。然而，这些变化对健康的成年人来说是轻微的。因此，口腔内注射利多卡因和肾上腺素对氧耗量和心肌功能的影响很小。2)健康成人小手术引起VO2、VCO2、Ve升高，具有正性肌力作用。然而，这些变化是轻微的，通过安定静脉镇静可以最大限度地减少这些变化。因此，我们认为这些变化主要是由于牙科治疗的心理应激所致。3)在高血压患者中，在手术加静脉镇静的情况下，VO2、Vco2、Ve和心功能有增加的趋势，但无明显变化。这一结果与健康成年人的结果相似。因此，从耗氧量或心肌功能的角度来看，高血压患者的牙科小手术应采用镇静技术。

we investigated the effects of dental local anesthesia and minor dental surgery on oxygen consunption(Vo2),carbon dioxide production(Vco2),minute volume(Ve),tidal volume(Vt),respiratory rate (RR) and myocardial function(STI).We found that:1) Epinephrine used concomitantly with lidocaine for dental local anesthesia caused an increase in Vo2,Vco2,Ve, and had positive inotropic effect. However, these changes were slight on healthy adults. Therefore, it was concluded that intraoral injections of lidocaine and epinephrine for dental procedures had minimal clinical effects on oxygen consumption and myocardial function.2) Minor dental surgery on healthy adults caused an increase in Vo2, Vco2, Ve and had positive inotropic effect. However, these changes were slight and were minimized by intravenous sedation by diazepam. Therefor, we believe that these changes were mainly due to the psychological stress of the dental treatment.3) In the patients with hypertension, it was observed that Vo2, Vco2, Ve and myocardial function tended to increase but with no significant changes under the surgical procedures with intravenous sedation. The results was similar to that in healthy adults. Therefor, one implication from the viepoint of oxygen consumption or myocardial function is that sedation technique should be used for minor dental surgery in the patients with hypertension.