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Master's Dissertation
DOI
10.11606/D.23.2006.tde-16082007-104018
Document
Author
Full name
Anna Carolina Ratto Tempestini Horliana
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2006
Supervisor
Committee
Borsatti, Maria Aparecida (President)
Pereira, Paulo Zarate
Perez, Flávio Eduardo Guillin
Title in Portuguese
"Avaliação da duração anestésica sob influência da hialuronidase injetada isoladamente no bloqueio pterigomandibular"
Keywords in Portuguese
Anestésicos Locais
Hialuronogluconaminidase
Odontologia
Abstract in Portuguese
A associação do anestésico local (AL) com hialuronidase é muito utilizada em oftalmologia melhorando a eficácia anestésica. Foi demonstrado que uma fração muito pequena das moléculas de AL injetadas atingem o feixe nervoso e o restante se difunde para os tecidos ao redor. O objetivo deste estudo foi verificar se a hialuronidase 75 UTR é capaz de prolongar a duração de ação anestésica quando injetada antes da regressão do efeito AL. Foram realizadas 40 cirurgias de terceiros molares inferiores bilaterais e simétricos, pelo mesmo operador, utilizando-se mepivacaína 2% com epinefrina para bloqueio pterigomandibular, em 20 pacientes saudáveis. Para cada cirurgia foi injetada aos 40 minutos, hialuronidase ou placebo, de modo duplo-cego. Utilizou-se estímulo elétrico na polpa para a avaliação da anestesia pulpar e estímulo mecânico (picada) na gengiva. Os testes foram feitos no pré-molar inferior, colateral à cirurgia. Em ambos tecidos avaliados, a duração da anestesia com hialuronidase foi maior (p<0,01) do que com o placebo. Indiretamente, estes resultados são um indício de que a hialuronidase redireciona as moléculas de AL para a fibra nervosa, prolongando o tempo de bloqueio nervoso. Nestas condições experimentais, pode-se concluir que, a hialuronidase prolonga a duração de ação anestésica local.
Title in English
Evaluation of duration of anaesthesic action influenced by plain hyaluronidase in pterigomandibular block
Keywords in English
Dentistry
Hyaluronoglicosaminidase
Local Anesthetics
Abstract in English
The association of local anaesthetic (LA) with hyaluronidase is widely used in ophthalmic anaesthesia improving its efficacy. It was demonstrated that a fraction of molecules of the LA applied reached the nerve and the others spreads out to the tissues around. Our purpose was to verify if hyaluronidase (75 TRU) is able to prolong the duration of anaesthesic action when it was injected immediately before the end of pulpal anesthesia. It was realized 40 bilateral and symmetrical third inferior molar surgeries by the same operator, with 2% mepivacaine with epinephrine to block inferior alveolar nerve , in 20 healthy patients. In each surgeries was injected at 40 minutes hyaluronidase or placebo, in a double blinded manner. It was used electrical stimulus to evaluate pulpal anesthesia, and was done mechanical stimulus (pick) to evaluated gingival anaesthesia. The tests were done in the inferior premolar, collateral side to the surgery. In both tissues, the duration of action with hyaluronidase was longer (p<0.01) than placebo. Indirectly, these outcomes indicate that hyaluronidase redirects the molecules of LA to the nervous fiber. Regarding these experimental conditions, it is possible to conclude that hyaluronidase induce long-term local anesthesia.
 
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Publishing Date
2008-02-22
 
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