Electrocardiographic alterations during endosseous implant placement performed with local anesthetic agents.
OBJECTIVE
The purpose of this study was to analyze electrocardiographic alterations during dental implant surgeries when local anesthetic agents were used.


METHODS
Twenty implants were placed in 18 healthy patients. An electrocardiogram and Wincardio software were used to gather recordings from 12 static leads every 2 minutes, continuously record coronary artery (D2) derivations, and automatically measure the following electrocardiographic parameters: heart rate, duration and amplitude of the P wave, PR segment duration, ST segment deviation, QRS complex duration, and duration of the RR, QT, and corrected QT (QTc) intervals.


RESULTS
Analysis of variance of the values obtained at the different stages showed significant differences (P<.05) for the heart rate and for the duration of the RR and QT intervals. The heart rate increased during the anesthesia, incision, and bone drilling stages, reaching a peak during drilling. Duration of the RR and QT intervals decreased during the incision and drilling stages. Among the electrocardiographic parameters individually assessed, several altered values were found for the duration of the P wave, the QRS complex, and the QT and QTc intervals. Sinusal tachycardia and bradycardia, sinusal arrhythmia, supraventricular extrasystole, ventricular extrasystole, and T-wave inversion were detected.


CONCLUSIONS
Dental implant placement surgery may induce electrocardiographic alterations. The most frequently found arrhythmias were extrasystole and sinusal tachycardia. The anesthesia, incision, and bone drilling stages exhibited the highest heart rate values and the shortest durations of the RR and QT intervals.
Romano
Marcelo Munhóes
MM
Integrated Clinic, School of Dentistry, University of São Paulo, and Graphics Recording Services, Heart Institute, Clinics Hospital, São Paulo, Brazil. mmromano@usp.br
Soares
Mario Sergio
MS
Pastore
Carlos Alberto
CA
de Oliveira Guaré
Renata
R
Adde
Carlos Alberto
CA
D000328:Adult; D000367:Age Factors; D000779:Anesthetics, Local / Q000494:pharmacology; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D003758:Dental Implantation, Endosseous / Q000009:adverse effects; D004562:Electrocardiography; D004837:Epinephrine / Q000494:pharmacology; D006329:Heart Conduction System / Q000187:drug effects / Q000502:physiology*; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D008619:Mepivacaine / Q000494:pharmacology; D008875:Middle Aged; D013315:Stress, Psychological / Q000150:complications; D014662:Vasoconstrictor Agents / Q000494:pharmacology; D055815:Young Adult
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008619:Mepivacaine; D004837:Epinephrine