Cardiovascular and haemodynamic changes in healthy and cardiac patient undergoing dental extraction

ABSTRACT

A clinical study was performed to investigate the role of Midazolam as sedative agent on the possible incidence of ischemic changes which occur during dental extraction for ambulatory patients receiving local anaesthesia and also to identify which group of cardiac patients is mostly at risk during minor oral surgical procedures. Forty patients aged between 20- 50 year represent the materials of this work, of the forty patients, ten healthy patients act as a control group. The thirty patients had a cardiac disease. All patient were monitored for recording [HR], [SBP], [DBP] and [MAP] by automatic non invasive blood pressure monitor. Midazolam 1 mg was given IV. to all patients and the previous parameters were recorded after 5 minutes, at 1 and 5 minutes post injection of local anaesthetic [Mepicaine] and at 1 and 5 minutes after tooth extraction. The threshold for myocardial ischemia used in this study includes RPP values more than 12.000 and PRQ values less than 1.0. Sedation produced significant decrease in the RPP values in all groups [P < 0.05]. Whereas, it produced insignificant change in PRQ values. This beneficial effect of sedation would be recommended for cardiac patients, especially hypertensive patients who have more risk than the other patients to develop myocardial ischemia during dental extraction under local anaesthesia