Jorkjend L, Skoglund L A
Section of Dental Pharmacology and Pharmacotherapy, University of Oslo, Norway.
Anesth Prog. 1999 Spring;46(2):71-6.
A controlled, randomized, double-blind, within-patient, crossover study was made with 50 patients (28 women and 22 men) of mean age 47 years (range, 32-69 years) who were subjected to identical bilateral gingivectomies. On one occasion, lidocaine 2% was infiltrated as the local anesthetic. On the other occasion, lidocaine 2% with epinephrine 1:80,000 was given. Postoperative pain intensity was recorded by the patients on a 100-mm visual analogue scale every hour during an 11-hour observation period. The mean pain intensity was numerically higher after lidocaine 2% at 0 hours and 1 hour postoperatively. Then the mean pain intensity after lidocaine 2% was lower than that after lidocaine 2% with epinephrine 1:80,000 throughout the remaining observation period. The difference in pain intensity was statistically significant (P < .05) at 2, 4, 5, 6, and 7 hours after surgery. Mean sum (SEM) pain intensity over the 11-hour observation period was lower (P = .03) after lidocaine 2%, 66.5 (13.4) mm than after lidocaine 2% with epinephrine 1:80,000, 92.6 (15.4) mm. The study shows that high epinephrine concentration (1:80,000) increases the postoperative pain after dental soft tissue surgery with mild pain.
对50例患者(28名女性和22名男性)进行了一项对照、随机、双盲、患者自身交叉研究,这些患者平均年龄47岁(范围32 - 69岁),均接受了相同的双侧牙龈切除术。一次,采用2%利多卡因浸润作为局部麻醉剂。另一次,采用含1:80,000肾上腺素的2%利多卡因。在11小时的观察期内,患者每小时用100毫米视觉模拟量表记录术后疼痛强度。术后0小时和1小时,2%利多卡因后的平均疼痛强度在数值上更高。然后在剩余的观察期内,2%利多卡因后的平均疼痛强度低于含1:80,000肾上腺素的2%利多卡因后的平均疼痛强度。术后2、4、5、6和7小时,疼痛强度差异具有统计学意义(P < .05)。在11小时观察期内,2%利多卡因后的平均疼痛强度总和(标准误)较低(P = .03),为66.5(13.4)毫米,低于含1:80,000肾上腺素的2%利多卡因后的92.6(15.4)毫米。该研究表明,高肾上腺素浓度(1:80,000)会增加牙科软组织手术术后轻度疼痛的程度。