Московский государственный медико-стоматологический университет им. А.И. евдокимова, Москва, россия В данной статье авторским коллективом представлены основные принципы выбора местного обезболивания у пациентов с сопутствующей патологией на основании данных анамнеза, анализа взаимодействия фармакологических препаратов со средствами местной анестезии и седации, определения функционального состояния пациента и возможности проведения лечения в амбулаторных условиях, коррекции тревожности и боли, а также оказания стоматологической помощи с непрерывным контролем гемодинамических показателей. Было показано, что соблюдение данного алгоритма является профилактикой неотложных состояний у пациентов с фактором риска в условиях амбулаторного стоматологического приема. Ключевые слова: выбор местного обезболивания, сбор анамнеза, контентный анализ, коррекция тревожности пациента. Local anesthesia selection algorithm in patients with concomitant disease. Part 2. e.N. aNiSiMOva, S.T. SOkhOv, N.Y. LeTuNOva, i.v. OrekhOva, M.v. grOMOvik, e.a. eriLiN, N.a. rYazaNTSev Moscow State university of Medicine and Dentistry named after a.i. evdokimov, Moscow, russia A group of authors presents the rationale for local anesthesia selection in patients with concomitant disease based on case history; interaction analysis of drugs with local anesthetic and sedation agents; estimation of patient functional status; patient anxiety correction; dental care with hemodynamics monitoring. It was found that adhering to this algorithm promotes the prevention of urgent conditions in outpatient settings.
The aim of the study was to improve dental treatment quality in patients with arterial hypertension. The study included 256 patients with arterial hypertension (153 females, 103 males) aged 35 to 60 years. Anesthesia efficacy was assessed by visual analog scale after treatment. Oral adverse effects caused by regular intake of antihypertensive drugs and interrelation with articaine and mepivacaine were described. The study proved high efficacy of 4% articaine 1:200 000. The efficacy of 3% mepivacaine with no vasoconstriction agents was 86.4±2.3% but may be enhanced to 93.3±2.3% by preventive non-steroid anti-inflammatory agents taken 25-30 minutes before treatment in maximal daily dosage.
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