Use of Phentolamine Mesylate in Implant Surgery: Analysis of Adverse Effects and Haemodynamic Changes.

Clara Vintanel-Moreno,Isabel Leco-Berrocal,José María Martínez-González,Cristina Meniz-García,Natalia Martínez-Rodríguez

doi:10.3390/jcm10173875

Clara Vintanel-Moreno, Isabel Leco-Berrocal + Show 3 more

Open Access

https://doi.org/10.3390/jcm10173875

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Abstract

The clinical application of phentolamine mesylate (PM) as an anaesthetic reversal agent has been documented in the paediatric population and in conservative dentistry, but no studies have been conducted regarding dental implant surgery. A prospective randomised study was conducted on 60 patients eligible for mandibular implant treatment, randomly divided between a control group (CG) and an experimental group (EG), to whom PM was administered. Haemodynamic changes, adverse effects and patient satisfaction were assessed. No statistically significant differences in haemodynamic changes and postoperative pain were found between CG and EG (p < 0.05), except for systolic blood pressure (SBP), which increased slightly in EG, without posing a risk to patients. There were no differences in the occurrence of adverse effects between the two groups, except for greater difficulty in chewing and biting (p < 0.05) in CG and greater pain in the injection area (p = 0.043) in EG. Among EG patients, 83.3% reported that they would request PM again for future dental treatment. The use of PM offers an alternative to implant surgery, thereby increasing patients’ quality of life without increasing the risks.

Highlights

Patients whose questionnaire was incomplete; patients with ASA class II, III or IV; patients for whom more than 2 carpules of anaesthetic were necessary for treatment; patients with arterial hypertension (AHT) or alterations in heart rate (HR); patients who chronically take anti-inflammatory and/or analgesic drugs; patients who take any other type of medication; and those who did not wish to participate in the study were excluded
A total of 60 patients were included in the present study, 30 in control group (CG) and 30 in experimental group (EG)
Laviola et al [10] observed in their study that the most frequent adverse effect, in both patients injected with phentolamine mesylate (PM) and a control group injected with placebo in similar proportions, was tachycardia, which in most cases occurred 10 min after the injection

Summary

Introduction

All anaesthetic techniques used produce total or partial loss of soft tissue sensitivity for 3 to 5 h [1,2,3,4], which is often longer than the working time plus the time needed for pain control after a restorative or periodontal procedure [5,6] This duration is most often associated with difficulty in eating, drinking, speaking and smiling [7,8,9,10,11], and can cause biting injuries to the lips, tongue and cheeks, in children and disabled people [12,13]. Some patients consider it to be a temporary decrease in their quality of life [7,12,14], affecting their normal daily activity in three areas: perceptual (altered perception of physical appearance), sensory (lack of sensation) and functional (impaired ability to speak, smile, drink and control salivation) [5,14,15,16]

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