Evaluation of blood glucose in type II diabetic patients submitted to local anesthesia with different vasoconstrictors

ABSTRACT Objective: In the dental clinic, the use of local anesthetics containing vasoconstrictors in diabetic patients are still controversial raising some doubts. Thus, the objective of this randomized crossover clinical trial was to evaluate blood glucose, pulse oximetry and heart rate of type 2 diabetic patients when submitted to local anesthesia using prilocaine 3% associated to felypressin 0,03UI / ml (G1) and 2% lidocaine associated to epinephrine 1: 100,000 (G2). Methods: The sample consisted of 20 compensated type 2 diabetic patients (both genders) who were taking oral hypoglycemic drugs. The volunteers underwent two periodontal sessions (scaling) and one of the solutions tested was used in each visit. The cited parameters were evaluated at three different times: before the procedure (T1), 10 minutes after anesthesia (T2) and after 20 minutes (T3). Results: Regarding the blood glucose levels, no statistically significant difference was found in different times between G1 and G2 (p> 0.05). Similarly, regarding pulse oximetry and heart rate, no statistically significant differences were observed in intervals assessed between groups (p> 0.05), presenting values within normal limits. Conclusion: Considering the vasoconstrictors and the volume of anesthetic solution used, the results suggest that the evaluated vasoconstrictors do not alter significantly blood glucose, pulse oximetry and heart rate in compensated type 2 diabetic patients.

摘要 目的：牙科临床中，对糖尿病患者使用含血管收缩剂的局部麻醉药物仍存在争议，引发诸多疑虑。本随机交叉临床试验旨在评估2型糖尿病患者分别接受3%丙胺卡因（prilocaine）联合0.03UI/ml加压素（felypressin，G1组）、2%利多卡因（lidocaine）联合1:100000肾上腺素（epinephrine，G2组）局部麻醉时的血糖、脉搏血氧饱和度及心率水平。方法：本研究样本纳入20名接受口服降糖药物治疗的代偿性2型糖尿病患者（性别不限）。受试者完成两次牙周刮治疗程，每次就诊使用一种受试麻醉溶液。分别在3个时间点对上述指标进行检测：操作前（T1）、麻醉后10分钟（T2）及麻醉后20分钟（T3）。结果：就血糖水平而言，G1组与G2组在各时间点均未检出具有统计学意义的组间差异（p>0.05）。类似地，两组间各评估区间的脉搏血氧饱和度及心率亦未观察到统计学差异（p>0.05），且相关指标均处于正常参考范围内。结论：综合所用血管收缩剂类型及麻醉溶液剂量，本研究结果提示，受试血管收缩剂不会对代偿性2型糖尿病患者的血糖、脉搏血氧饱和度及心率产生显著影响。