2019 Fiscal Year Final Research Report
A developmental study of the prediction system for cardiovascular accidents in dental treatment of the medically compromised elderly
| Project/Area Number |
17K11915
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Surgical dentistry
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| Research Institution | Kyushu Dental College |
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Principal Investigator |
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Keywords | 心電図再分極過程 / アドレナリン / フェリプレシン / 高齢者 / 局所麻酔薬 / 致死的不整脈 / TdP / 心電図 |
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| Outline of Final Research Achievements |
Cardiovascular accident is common in dental care of medically compromised elderly. In order to prevent cardiovascular accident, it is necessary to identify the cause and reveal the mechanism. Vasoconstrictor in local anesthetics is considered to be an important cause of cardiovascular accident, however, the causal relationship between those is unknown. Therefore, we investigated the effect of adrenaline (AD) and feripressin (FP), which are representative vasoconstrictors in dental anesthetics, on blood pressure (BP), heart rate (HR) and repolarization process in electrocardiogram, which is important in the occurrence of arrhythmia, with double blind crossover study design.
As a result, FP showed significant increase in BP compared to AD, and HR was significantly higher in AD than in FP. In addition, AD showed prolongation of QTc but FP did not. AD may be desirable for hypertensive elderly patients and FP is desirable for the elderly with arrhythmia.
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| Free Research Field |
歯科麻酔学
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| Academic Significance and Societal Importance of the Research Achievements |
本研究結果は、「有病高齢者の安心安全な歯科治療を実現するための循環器系偶発症の予測システム」のkeyとなる局所麻酔薬選択における有力な指標となるものである.すなわち、アドレナリン添加局所麻酔薬使用は心拍数上昇により心筋虚血ならびにTdPリスクを高めるために頻脈性不整脈患者には望ましくなく、フェリプレシンは、TdPリスクを上昇させず、心筋虚血リスクも低いが、血圧は上昇させる可能性が高いため、高血圧患者には望ましくないといえる。ますます増加する有病高齢者の安全・安心な歯科治療における安全な局所麻酔薬の選択を可能にするという点で社会的にも学術的にも大きな意義がある.
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