Peri-operative Hemodynamic changes and Anxiety in patients undergoing surgical and LASER assisted periodontal therapies- A randomised clinical trial
Abstract
Objectives: Hemodynamic changes, such as changes in blood pressure, heart rate, and hypoxia, are observed during surgical procedures and may be related to pre-operative anxiety. As a result, the current study aims to compare the hemodynamic changes, hypoxia, and anxiety in LASER assisted periodontal therapy and surgical periodontal therapy for pocket reduction.
Methods: This single blinded randomized controlled observational clinical trial included 30 patients with Stage II,III and Grade B,C periodontitis randomly allocated to surgical periodontal therapy (SurPT) and LASER assisted periodontal therapy(LAPT) groups. The systolic blood pressure(SBP), diastolic blood pressure(DBP), Pulserate(PR), oxygen saturation (SpO2) were assessed before injection of local anaesthesia (LA), after LA, during and at the end of procedure. Pre-operative anxiety(POA) was assessed using Amsterdam pre-operative anxiety and information scale(APOAI) before starting the procedure. Statistical analysis was done using student t-test for intergroup and repeated measures of ANOVA for intragroup analysis.
Results: SBP and HR were significantly greater in SurPT group at all time intervals compared to LAPT group (P<0.05). SpO2 levels reduced significantly in LAPT group at T2(P-0.002) with no significant intergroup differences. POA especially anxiety scorewas significantly higher in SurPT(P-0.017)groupwith no difference in information scores(P-0.100).
Conclusion: Greater pre-operative anxiety was observed in SurPT group and significant increase in SBP, HR at all time intervals compared to LAPT.
References
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Abstract
References
- 1. Pohjola V, Lahti S, Vehkalahti MM, Tolvanen M, Hausen H. Association between dental fear and dental attendance among adults in Finland. Acta Odontol Scand. 2007;65(4):224–230.
- 2. Klinberg G. Dental anxiety and behaviour management problems in paediatric dentistry--a review of background factors and diagnostics. Eur Arch Paediatr Dent. 2008;9:11-15.
- 3. Agras S, Sylvester D, Oliveau D. The epidemiology of common fears and phobia. Compr Psychiatry 1969;10:151-156.
- 4. Klingberg G, Broberg AG. Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. Int J Paediatr Dent. 2007;17(6):391-406.
- 5. Gedik RG, Marakoğlu I, Demirer S. Blood pressure, heart rate and temperature variability during periodontal surgery. West Indian Med J. 2005;54(5):329-333.
- 6. Meng L, Yu W, Wang T, Zhang L, Heerdt PM, Gelb AW. Blood Pressure Targets in Perioperative Care. Hypertension. 2018;72(4):806-817.
- 7. Lizano-Díez I, Poteet S, Burniol-Garcia A, Cerezales M. The burden of perioperative hypertension/hypotension: A systematic review. PLoS One. 2022;17(2):e0263737.
- 8. Gill R, Goldstein S. Evaluation and Management of Perioperative Hypertension. 2022 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
- 9. Wolfsthal SD. Is blood pressure control necessary before surgery? Med Clin North Am. 1993;77(2):349-363.
- 10. Sanz M, Marco Del Castillo A, Jepsen S, Gonzalez-Juanatey JR, D'Aiuto F, Bouchard P et al. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol. 2020;47(3):268-288.
- 11. Schwarz F, Aoki A, Becker J, Sculean A. Laser application in non-surgical periodontal therapy: a systematic review. J Clin Periodontol. 2008;35:29-44.
- 12. Ugurlu F, Cavus O, Kaya A, Sener CB. Evaluation of dental anxiety in patients undergoing dentoalveolar surgery with laser treatment. Photomed Laser Surg. 2013;31(4):169-173.
- 13. Mikami R, Mizutani K, Sasaki Y, Iwata T, Aoki A. Patient-reported outcomes of laser-assisted pain control following non-surgical and surgical periodontal therapy: A systematic review and meta-analysis. PLoS One. 2020;15(9):e0238659.
- 14. Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89(1):S173-S182.
- 15. Moerman N, van Dam FS, Muller MJ, Oosting H. The Amsterdam Preoperative Anxiety and Information Scale (APAIS). AnesthAnalg. 1996;82(3):445-451.
- 16. Matsumura K, Miura K, Takata Y, Kurokawa H, Kajiyama M, Abe I, Fujishima M. Changes in blood pressure and heart rate variability during dental surgery. Am J Hypertens. 1998;11:1376-1380.
- 17. Amoian B, Rabíee M, Aghvami M, Milani S. Evaluation of hemodynamic and SpO2 variability during different stages of periodontal surgery. J Indian Soc Periodontol. 2013;17(5):612-616.
- 18. Alqahtani AS, Sharanesha RB, Gufran K, Alqhtani NR, Abushanan A, Alasqah M, Alsakr AM, Alkharaan H. Variation in Hemodynamic Characteristics during Periodontal Crown-Lengthening Surgical Procedure: An Uncontrolled Cohort Study. Healthcare (Basel). 2022;10(5):919.
- 19. Alemany-Martínez A, Valmaseda-Castellón E, Berini-Aytés L, Gay-Escoda C. Hemodynamic changes during the surgical removal of lower third molars. J Oral Maxillofac Surg. 2008;66(3):453-461.
- 20. Shakeel AM, Christopher PJ, Kengasubbiah S, Kumar S, Shenoy V. Hemodynamic Changes Associated with Two Different Concentrations of Adrenaline in Lignocaine Solution: A Comparative Analysis. Cureus. 2019;11(4):e4434.
- 21. Kämmerer PW, Seeling J, Alshihri A, Daubländer M. Comparative clinical evaluation of different epinephrine concentrations in 4% articaine for dental local infiltration anesthesia. Clin Oral Investig. 2014;18(2):415-421.
- 22. Elad S, Admon D, Kedmi M, Naveh E, Benzki E, Ayalon S, Tuchband A, Lutan H, Kaufman E. The cardiovascular effect of local anesthesia with articaine plus 1:200,000 adrenalin versus lidocaine plus 1:100,000 adrenalin in medically compromised cardiac patients: a prospective, randomized, double blinded study. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2008;105(6):725-730.
- 23. Neves RS, Neves IL, Giorgi DM, Grupi CJ, César LA, Hueb W, Grinberg M. Effects of epinephrine in local dental anesthesia in patients with coronary artery disease. Arq Bras Cardiol. 2007;88(5):545-551.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research Articles |
| Authors | |
| Publication Date | June 23, 2023 |
| Submission Date | January 11, 2023 |
| Published in Issue | Year 2023Volume: 26 Issue: 2 |
Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.
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