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Comparison of two vasoconstrictors on glycemic levels in diabetic patients

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Abstract

Objectives

The aim of this study was to evaluate glycemic levels in diabetic patients before, during, and after extractions using 2% lidocaine with 1:100,000 epinephrine (Lido/Epi) and 3% prilocaine with 0.03 IU/mL felypressin (Prilo/Fely).

Materials and methods

A double-blind, randomized clinical trial was conducted to evaluate changes in body parameters and glycemic levels in diabetic patients undergoing two anesthetic protocols during dental extractions. During surgery, we evaluated blood pressure (BP), heart rate (HR), saturation (SpO2), and capillary glycemic levels (Gly). These parameters were measured at the following surgical moments: basal, 30 min after medication, incision, tooth removal, suture, and 30 and 60 min after anesthesia.

Results

Data analysis showed no differences between the groups considering age, weight, and time spent in surgery. Increased systolic BP and decreased diastolic BP were observed in the lido/epi group. No difference was observed in the prilo/fely group among the surgical moments or between the groups regarding BP. No difference was observed in HR and SpO2 between the groups at any surgical moment. However, differences were found when compared the differences in glycemic and basal levels in both groups with greater decreases in blood glucose values for the lido/epi group. In anxiety level evaluation, there was no difference between the different surgical moments.

Conclusion

Thus, both lido/epi and prilo/fely (maximum 3.6 mL) can be safely used in controlled diabetic patients

Clinical relevance

The use of lidocaine associated with epinephrine did not increase glycemic levels but leads to decrease over time when associated with an anxiety reduction protocol, offering some advantage over prilocaine plus felypressin for diabetic patients.

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Acknowledgments

The Federal University of Sergipe, through the Pro-Rector of Post-Graduation and Research (Posgrap), and the Coordination of Research (Copes) awarded a scholarship to this work. The Nova DFL donated the local anesthetics and needles used in the research.

Funding

The work was supported by Coordination of Research (Copes), Department of Dentistry of the Federal University of Sergipe.

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Authors and Affiliations

  1. Oral surgery and anesthesiology area of Dentistry Department, Federal University of Sergipe, St Cláudio Batista, s/n. Bairro Sanatório, Cidade Nova, Aracaju, Sergipe, 49060-108, Brazil

    Daniela Meneses-Santos, Anne Caroline Gercina Carvalho Dantas, Ricardo Pedro da Silva & Liane Maciel Almeida Souza

  2. Pharmacology, Anesthesiology and Therapeutics Department of the Piracicaba Dental School, University of Campinas, 901 Limeira Avenue, Piracibaba, São Paulo, 13414-903, Brazil

    Klinger Souza Amorim, Jaiza Samara Macena de Araújo & Francisco Carlos Groppo

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  1. Daniela Meneses-Santos
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  2. Klinger Souza Amorim
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  3. Anne Caroline Gercina Carvalho Dantas
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  7. Liane Maciel Almeida Souza
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Correspondence to Daniela Meneses-Santos.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Meneses-Santos, D., Amorim, K.S., Dantas, A.C.G.C. et al. Comparison of two vasoconstrictors on glycemic levels in diabetic patients. Clin Oral Invest 24, 4591–4596 (2020). https://doi.org/10.1007/s00784-020-03327-z

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  • DOI: https://doi.org/10.1007/s00784-020-03327-z

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