Safety of Local Dental Anesthesia in Patients With Cardiac Channelopathies

Not Applicable

Completed

• Conditions: Brugada Syndrome; Ventricular, Tachycardia; Channelopathies; Long QT Syndrome
• Interventions: Procedure: Dental restorative procedure

• Registration Number: NCT03182777
• Lead Sponsor: University of Sao Paulo General Hospital

Brief Summary

Patients with cardiac channelopathies needing restorative dental treatment will be included in two sessions of the study, using local dental anesthetic: lidocaine 2% with epinephrine and lidocaine 2% without vasoconstrictor. The safety of the use of two cartridges (3.6 mL) will be evaluated. The patients will be their own control and will be assessed by Holter monitoring for 28 hours, blood pressure measurement and anxiety measuring.

Detailed Description

Patients of Heart Institute of the University of São Paulo with inherited cardiac channelopathies will be included, considering the criteria for inclusion and non-inclusion, after reading and signing the informed consent.

They will undergo dental restorative treatment in two sessions, in the morning period, with an interval of at least seven days (wash-out) between them, and the patients will be their own control.

In the first session, after randomization, patients will receive lidocaine 2% without vasoconstrictor (LSA) or lidocaine 2% with 1: 100,000 epinephrine (LCA) (cross-over), resulting in two conditions: with adrenaline and without adrenaline.

The randomization of the anesthetic solution will be performed by the main researcher, being blind to the performer researcher and to the patient.

The injected volume will be 3.6 mL (2 cartridges) of the anesthetic solution, using blocking technique of the inferior alveolar nerve.

The patients will be monitored by Holter for 28 hours starting one hour before the procedure, for registration and analysis of cardiac electrical activity during the two sessions. Blood pressure will be monitored with digital sphygmomanometer and anxiety will be measured with Facial Image Scale, both on three occasions: at the beginning of the baseline periods, before starting application of anesthesia and at the end of the proceedings. The results will be analyzed statistically.

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study Start: 2015-05
• Study First Submitted: 2015-10-15
• Study First Submitted QC: 2017-06-07
• Study First Posted: 2017-06-09
• Primary Completion: 2018-08
• Study Completion: 2018-08
• Status Verified: 2024-04
• Last Update Submitted: 2024-04-08
• Last Update Posted: 2024-04-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 31

Inclusion Criteria

• Patients with any channelopathies below, kept on optimal drug therapy, with or without ICD:

Brugada Syndrome, Long QT Syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia

• Dental caries or unsatisfactory restorations in the mandible, indicating restorative dental treatment

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Exclusion Criteria

• Patients allergic to lidocaine
• Patients undergoing ICD therapy for less than three months
• Patients with recurrent syncope in the last three months
• Patients with sustained arrhythmias documented for less than 3 months
• Have received epinephrine in the last 24 hours

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Lidocaine	Dental restorative procedure	Application of local dental anesthesia with two cartridges (3,6 mL) of lidocaine 2% without vasoconstrictor for dental restorative procedures in patients with cardiac channelopathies.
Lidocaine with epinephrine	Dental restorative procedure	Application of local dental anesthesia with two cartridges (3,6 mL) of lidocaine 2% with epinephrine 1:100.000 for dental restorative procedures in patients with cardiac channelopathies.

Primary Outcome Measures

Name	Time	Method
No sustained ventricular tachycardia	during dental procedures	No life-threatening arrhythmias and clinical signs and symptoms

Trial Locations

Locations (1)

Heart Institute of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo; 🇧🇷 São Paulo, Brazil