Monitorização materno-fetal durante procedimento odontológico em portadora de cardiopatia valvar

• Autor(a) principal: Neves, Itamara Lucia Itagiba
• Data de Publicação: 2009
• Outros Autores: Avila, Walkiria Samuel, Neves, Ricardo Simões, Giorgi, Dante Marcelo Artigas, Santos, Jorge Francisco Kuhn dos [UNIFESP], Oliveira Filho, Ricardo Martins, Grupi, Cesar José, Grinberg, Max, Ramires, José Antonio Franchini
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0066-782X2009001100005; http://repositorio.unifesp.br/handle/11600/5324
• topic: Electrocardiography, ambulatory; blood pressure monitoring, ambulatory; cardiotocography; anesthesia, local; pregnant women; rheumatic heart disease; Eletrocardiografia ambulatorial; monitorização ambulatorial da pressão arterial; cardiotocografia; anestesia local; gestantes; cardiopatia reumática

BACKGROUND: The effects of local dental anesthesia with lidocaine and epinephrine on cardiovascular parameters of pregnant women with heart valve diseases and their fetuses are not fully understood. OBJECTIVES: To assess and analyze cardiotocographic, blood pressure and electrocardiographic parameters of pregnant women with rheumatic heart valve disease undergoing local anesthesia with 1.8mL of lidocaine 2% with or without epinephrine 1:100,000 during restorative dental treatment. METHODS: Maternal ambulatory blood pressure and electrocardiographic monitoring as well as cardiotocography of 31 patients with rheumatic heart disease were performed between the 28th and 37th week of gestation. The patients were divided into two groups, those with or without vasoconstrictor. RESULTS: A significant reduction in maternal heart rate was shown in both groups during the procedure in comparison with the other periods (p<0.001). Cardiac arrhythmia was observed in nine (29.0%) patients, of which seven (41.8%) were from the group of 17 pregnant women who received anesthesia plus epinephrine. No difference in maternal blood pressure was observed when periods or groups were compared (p>0.05). The same occurred (p>0.05) with the number of uterine contractions, baseline level and variability, and number of accelerations of fetal heart rate. CONCLUSION: The use of 1.8mL of lidocaine 2% in combination with epinephrine was safe and efficient in restorative dental procedures during pregnancy in women with rheumatic heart valve disease.