Evaluation of Cardiovascular Parameters of ASA I and ASA II Patients Undergoing Dental Implant Surgery Under Intravenous Sedation with Midazolam: A Retrospective Analysis

The purpose of this research was to compare the vital signs of ASA II patients undergoing dental implant surgery under intravenous anesthesia to those of ASA I patients. From a specialist course in Implant Dentistry, 41 medical records (22 ASA I and 19 ASA II patients) were analyzed. Age, gender, ASA classification, blood pressure, heart rate, and oxygen saturation were all measured. Pre-surgery, following the onset of local anesthetic, at the end of the initial implant insertion, and at the end of surgery were all used to collect vital signs. Student's t-test (p<0.05) was used to determine inter- and intra-group data associations. The crossing of operative moments pre-surgical and installation of the first implant in both systolic (p<=0.01) and diastolic (p<=0.03) pressure was statistically significant in ASA I patients. In contrast, there was only a statistical difference in the verification of peripheral oxygen saturation data at preoperative and local anesthesia times in ASA II patients (p<=0.04). When comparing the time of installation of the first implant (p<=0.03) and at the end of surgery (p<=0.02), with respect to systolic pressure, ASA II presented statistically higher, while variable oxygen saturation at the beginning of local anesthesia in ASA I was statistically higher (p<=0.04). It is proposed that intravenous sedation acts in a compensatory manner in patients with systemic disease, leading both groups' behavior to be similar.

El propósito de esta investigación fue comparar los signos vitales de pacientes ASA II sometidos a cirugía de implante dental bajo anestesia intravenosa con los de pacientes ASA I. Se analizaron 41 historias clínicas de un curso de especialista en Implantología (22 pacientes ASA I y 19 ASA II). Se midieron la edad, el sexo, la clasificación ASA, la presión arterial, la frecuencia cardíaca y la saturación de oxígeno. Se tomarn los signos vitales antes de la cirugía, después del inicio de la anestesia local, al final de la inserción inicial del implante y al final de la cirugía. Se utilizó la prueba t de Student (p<0,05) para determinar las asociaciones de datos entre e intragrupos. El cruce de los momentos operatorios prequirúrgicos y de instalación del primer implante tanto en la presión sistólica (p<=0,01) como en la diastólica (p<=0,03) fue estadísticamente significativo en los pacientes ASA I. En contraste, solo hubo diferencia estadística en la verificación de los datos de saturación periférica de oxígeno en el momento preoperatorio y de anes- tesia local en los pacientes ASA II (p<=0,04). Al comparar el tiempo de instalación del primer implante (p<=0,03) y al final de la cirugía (p<=0,02), con respecto a la presión sistólica, el ASA II se presentó estadísticamente mayor, mientras que la variable saturación de oxígeno al inicio de la anestesia local en El ASA I fue estadísticamente mayor (p<0,4). Se propone que la sedación intravenosa actúa de forma compensatoria en pacientes con enfermedad sistémica, lo que hace que el comportamiento de ambos grupos sea similar.

Severe oral mucositis relating to pain and worse oral condition among patients with solid tumors undergoing treatment with FOLFIRI and 5-FU: a retrospective study

ABSTRACT BACKGROUND: There is a need for studies that correlate the severity of oral mucositis (OM) with chemotherapy protocols, transient myelosuppression and oral health. OBJECTIVE: To analyze the severity of OM among individuals with solid tumors during hospitalization and its correlation with the type of chemotherapy, myelosuppression and oral health condition. DESIGN AND SETTING: Retrospective study at a public hospital in Bauru, state of São Paulo, Brazil, that is a regional referral center. METHODS: Individuals diagnosed with solid malignant tumors who received chemotherapy during hospitalization for completion of the antineoplastic treatment cycle or who presented complications resulting from this were assessed. RESULTS: Twenty-eight individuals (24.3%) manifested some degree of OM. The most prevalent degrees of OM according to the World Health Organization (WHO) and modified WHO classification were grades 2 (11.3%) and 5 (4.3%), respectively. It was observed that the higher the OM-WHO (P < 0.001; r = 0.306) and modified OM-WHO (P < 0.001; r = 0.295) classifications were, the greater the oral pain reported by the individuals was. Presence of mucositis in the upper lip and buccal mucosa contributed to increased severity of OM and worsening of swallowing during hospitalization. Thus, severe OM was associated with use of the FOLFIRI protocol (folinic acid, fluorouracil and irinotecan). CONCLUSION: Individuals with tumors who presented severe OM had greater severity of oral pain and worse oral health. Use of the FOLFIRI protocol was associated with higher prevalence of severe OM, while use of 5-fluorouracil (5-FU) was correlated with worse oral condition.

Oral Manifestation COVID-19 and the Rapid Resolution of Symptoms Post-Phtalox Treatment: a Case Series

ABSTRACT: The mouth plays a critical role in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) owing to the fact that both the tongue and salivary glands are conducive environments for the storage and spread of the virus. This case series aimed to describe the oral manifestations of coronavirus disease (COVID-19) and report the rapid response to Phtalox® treatment in all patients who tested positive for the virus. The patients were grouped based on whether according to convenience as soon as they tested positive for COVID-19. All patients had mouth ulcers and were advised to use 5 mL of Phtalox® mouthwash for 1 min, five times daily, in addition to standard COVID-19 treatment. Complete healing of mouth ulcers occurred in all patients diagnosed with COVID-19, and the mean duration for complete healing was 2.37 days. General improvement of COVID-19 symptoms was also observed. Based on the rapid recovery of mouth ulcers observed, we suggest that Phtalox® is effective as a complementary oral treatment for ulcers associated with COVID-19.

RESUMEN: La cavidad oral juega un papel fundamental en la transmisión del síndrome respiratorio agudo severo coronavirus 2 (SARS-CoV-2) debido al hecho de que tanto la lengua como las glándulas salivales son entornos propicios para el almacenamiento y la propagación del virus. Esta serie de casos tuvo como objetivo describir las manifestaciones orales de la enfermedad por coronavirus (COVID-19) e informar la rápida respuesta al tratamiento con Phtalox® en todos los pacientes que dieron positivo al virus. Los pacientes se agruparon en función de su conveniencia tan pronto como dieron positivo a COVID-19. Todos los pacientes tenían úlceras en la boca y se les recomendó utilizar 5 ml de enjuague oral Phtalox® durante 1 minuto, cinco veces al día, además del tratamiento estándar de COVID-19. La curación completa de las úlceras orales ocurrió en todos los pacientes diagnosticados con COVID-19, y la duración media para la curación completa fue de 2,37 días. También se observó una mejoría general de los síntomas de COVID-19. Con base en la rápida recuperación de las úlceras orales observadas, sugerimos que Phtalox® es eficaz como tratamiento oral complementario para las úlceras asociadas con COVID-19.

Prevalência de Manifestações Bucais em Pacientes com Câncer Assistidos em um Programa de Atenção Domiciliar na Cidade de Pelotas-RS / Prevalence of Oral Manifestations in Cancer Patients Assisted in a Home Care Program in the City of Pelotas-RS / Prevalencia de Manifestaciones Orales en Pacientes com Câncer Asistidos en un Programa de Atención Domiciliaria en la Ciudad de Pelotas-RS

Introdução: O município de Pelotas-RS dispõe do Programa de Internação Domiciliar Interdisciplinar (PIDI) implantado no Hospital Escola da Universidade Federal de Pelotas com a presença de cirurgiões-dentistas em sua equipe. O PIDI atende a pacientes oncológicos em cuidados paliativos. Objetivo: Avaliar a prevalência de manifestações bucais em pacientes assistidos por esse programa, as características epidemiológicas da referida população e verificar a associação das manifestações com o tipo de câncer e tratamento antineoplásico recebido. Método: Estudo transversal retrospectivo, com dados secundários coletados dos prontuários odontológicos de pacientes atendidos no período de abril de 2018 a setembro de 2019. O teste qui-quadrado foi aplicado com um nível de 5% de significância (p≤0,05) atribuído aos resultados significativos. Resultados: As manifestações bucais foram encontradas 47 vezes nos 61 pacientes avaliados, sendo que alguns apresentaram mais de uma ocorrência. Pacientes que apresentavam câncer primário no sistema digestivo foram os mais acometidos por manifestações bucais. As mais prevalentes foram xerostomia (26,2%); candidíase (18%); mucosite (13,1%); disfagia e disgeusia, que apresentaram o mesmo percentual (9,8%); nenhum paciente desenvolveu cárie de radiação. A xerostomia mostrou significância estatística (p≤0,05) na associação com o tipo de câncer. Ao correlacionar as manifestações bucais com o tipo de tratamento recebido, estas não apresentaram significância estatística. Conclusão: Este estudo demonstrou alta prevalência de manifestações bucais na população estudada, reafirmando a importância do cirurgião-dentista na equipe multiprofissional de cuidados paliativos.

Introduction: The municipality of Pelotas-RS has the Interdisciplinary Home Internment Program (PIDI) implemented at the Teaching Hospital of the Federal University of Pelotas with the presence of dental surgeons on its team. PIDI assists oncology patients in palliative care. Objective:To evaluate the prevalence of oral manifestations in patients assisted by this program, the epidemiological characteristics of that population and to verify the relationship of the manifestations with the type of cancer and antineoplastic treatment received. Method: Retrospective cross-sectional study with secondary data collected from the dental records of patients seen from April 2018 to September 2019. The Chi-square test was applied, with a 5% significance level (p≤0.05) attributed to significant results. Results:Oral manifestations were found 47 times in the 61 patients evaluated, with some having more than one occurrence. Patients who had primary cancer in the digestive system were the most affected by oral manifestations. The most prevalent oral manifestations were xerostomia (26.2%), followed by candidiasis (18%), mucositis (13.1%), dysphagia and dysgeusia that presented the same percentage (9.8%), no patient developed radiation caries. Xerostomia showed statistical significance (p≤0.05) in relation to the type of cancer. When correlating oral manifestations with the type of treatment received, they were not statistically significant. Conclusion:This study demonstrated a high prevalence of oral manifestations in the population investigated, reaffirming the importance of the dental surgeon in the palliative care multidisciplinary team.

Introducción: El municipio de Pelotas-RS cuenta con el Programa Interdisciplinario de Internación Domiciliaria (PIDI) implementado en el Hospital Docente de la Universidad Federal de Pelotas con la presencia de cirujanos dentistas en su equipo. PIDI atiende a pacientes oncológicos en cuidados paliativos. Objetivo: Evaluar la prevalencia de manifestaciones bucales en pacientes atendidos por este programa, las características epidemiológicas de esa población y verificar la relación de las manifestaciones con el tipo de cáncer y tratamiento antineoplásico recibido. Método: Estudio transversal retrospectivo con datos secundarios recolectados de los registros dentales de los pacientes atendidos desde abril de 2018 a septiembre de 2019. Se aplicó la prueba de chi-cuadrado, con un nivel de significancia del 5% (p≤0,05) atribuido a resultados significativos. Resultados: Las manifestaciones orales se encontraron 47 veces en los 61 pacientes evaluados, algunos con más de una ocurrencia. Los pacientes que tenían cáncer primario en el sistema digestivo fueron los más afectados por las manifestaciones orales. Las más prevalentes fueron xerostomía (26,2%); candidiasis (18%); mucositis (13,1%); disfagia y disgeusia, que presentaron el mismo porcentaje (9,8%); ningún paciente desarrolló caries de radiación. La xerostomía mostró significancia estadística (p≤0,05) en relación con el tipo de cáncer. Al correlacionar las manifestaciones orales con el tipo de tratamiento recibido, no resultaron estadísticamente significativas. Conclusión: Este estudio demostró una alta prevalencia de manifestaciones bucales en la población estudiada, reafirmando la importancia del cirujano dentista en el equipo multidisciplinario de cuidados paliativos.