Local anaesthetics combined with vasoconstrictors in patients with cardiovascular disease undergoing dental procedures: systematic review and meta-analysis protocol

IntroductionThe use of vasoconstrictors combined with local anaesthetics (LAs) in dentistry for patients with cardiovascular disease (CVD) is still controversial in the scientific literature. It raises concerns regarding the possibility of transient episodes, triggering negative cardiovascular outco...

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Bibliographic Details
Published in:BMJ open 2017-11, Vol.7 (11), p.e014611
Main Authors: Guimaraes, Caio Chaves, Lopes Motta, Rogério Heládio, Bergamaschi, Cristiane de Cássia, Araújo, Jimmy de Oliveira, Andrade, Natalia Karol de, Figueiró, Mabel Fernandes, Ramacciato, Juliana Cama, Lopes, Luciane Cruz
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia, Local - methods
Anesthetics, Local - administration & dosage
Anxiety
Arthritis
Cardiac arrhythmia
Cardiovascular disease
Cardiovascular Diseases - mortality
Clinical trials
Dentistry
Dentistry and Oral Medicine
Dentistry, Operative - methods
Evidence-based medicine
Heart attacks
Humans
Hypertension
Inflammatory diseases
Local anesthesia
Meta-analysis
Mortality
Pain
Quality of life
Stress
Systematic review
Systematic Reviews as Topic
Vasoconstrictor Agents - adverse effects
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Summary:IntroductionThe use of vasoconstrictors combined with local anaesthetics (LAs) in dentistry for patients with cardiovascular disease (CVD) is still controversial in the scientific literature. It raises concerns regarding the possibility of transient episodes, triggering negative cardiovascular outcomes.Method/designTrials eligible for our systematic review will enrol patients with CVD who have undergone dental treatments carried out with the use of LAs by comparing two arms: LAs with vasoconstrictors and LAs without vasoconstrictors. The research will be conducted in the electronic databases, namely Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Healthstar (via Ovid), Cumulative Index to Nursing and Allied Health Literature and Web of Science, from their inception to December 2017, without any restrictions in terms of language and status of publication. A team of reviewers will independently assess titles, abstracts and complete text to determine eligibility. For eligible studies, the same reviewers will perform data extraction and evaluate the risk of bias in the selected articles. The selected outcomes comprise death, mortality by a specific cause, stroke, acute myocardial infarction, hospitalisation, pain, bleeding, arrhythmias, ischaemic episodes, anxiety, adverse effects, changes in blood pressure, changes in heart rate, anxiety and results obtained via oximetry. Whenever possible, we will conduct a meta-analysis to establish the effects of LAs with and without vasoconstrictors in the patients with CVD, and the overall quality of evidence for each outcome will be determined using the Grading of Recommendations Assessment, Development and Evaluation classification system.Ethics and disseminationEthics committee approval was not necessary because this is a protocol of systematic review. This systematic review will be submitted for presentation at conferences and for publication in a peer-reviewed journal. Our review will assess the risks of cardiovascular events when using LAs with and without vasoconstrictors in patients with CVD, focusing on important clinical outcomes.PROSPERO registration numberCRD42016045421.
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2016-014611