Yonchak T, Reader A, Beck M, Clark K, Meyers W J
The Ohio State University, Columbus 43218-2357, USA.
Anesth Prog. 2001 Spring;48(2):55-60.
The purpose of this prospective, randomized, double-blind study was to measure the degree of anesthesia obtained with a labial infiltration of either 2% lidocaine with 1:50,000 or 2% lidocaine with 1:100,000 epinephrine in mandibular anterior teeth. Another objective was to measure the degree of anesthesia obtained with a lingual infiltration of 2% lidocaine with 1:100,000 epinephrine in mandibular anterior teeth. Through use of a repeated-measures design, 40 subjects randomly received a labial infiltration at the lateral incisor apex of either 1.8 mL of 2% lidocaine with 1:100,000 epinephrine or 1.8 mL of 2% lidocaine with 1:50,000 epinephrine at 2 separate appointments. An additional 40 subjects received a lingual infiltration at the lateral incisor apex of 1.8 mL of 2% lidocaine with 1:100,000 epinephrine. The mandibular anterior teeth were blindly pulp tested at 4-minute cycles for 60 minutes postinjection. No response from the subject to the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Anesthesia was considered successful when 2 consecutive 80 readings were obtained. For the 3 infiltrations, success rates for the lateral incisor ranged from 43 to 50%. Adjacent teeth had success rates of 27 to 63%. There was no significant difference (P > 0.05) in success between the labial infiltration of 2% lidocaine with 1:100,000 epinephrine and 2% lidocaine with 1:50,000 epinephrine or the lingual infiltration of 2% lidocaine with 1:100,000 epinephrine when compared with the labial infiltration of 2% lidocaine with 1:100,000 epinephrine. Duration of pulpal anesthesia declined steadily for all solutions over the 60 minutes. In conclusion, the success rate of 43-50% and declining duration of pulpal anesthesia over an hour indicates that a labial infiltration of 1.8 mL of either 2% lidocaine with 1:100,000 epinephrine or 1: 50,000 epinephrine or a lingual infiltration of 2% lidocaine with 1:100,000 epinephrine over the lateral incisor apex cannot be recommended clinically to provide profound pulpal anesthesia.
这项前瞻性、随机、双盲研究的目的是测量在下颌前牙唇侧浸润2%利多卡因加1:50000肾上腺素或2%利多卡因加1:100000肾上腺素所获得的麻醉程度。另一个目的是测量在下颌前牙舌侧浸润2%利多卡因加1:100000肾上腺素所获得的麻醉程度。通过重复测量设计，40名受试者在两次单独的就诊中，随机在下颌侧切牙根尖处接受1.8毫升2%利多卡因加1:100000肾上腺素或1.8毫升2%利多卡因加1:50000肾上腺素的唇侧浸润。另外40名受试者在下颌侧切牙根尖处接受1.8毫升2%利多卡因加1:100000肾上腺素的舌侧浸润。注射后60分钟内，以4分钟为周期对下颌前牙进行盲法牙髓测试。受试者对牙髓测试仪的最大输出值（80次读数）无反应被用作牙髓麻醉的标准。当连续获得2次80次读数时，麻醉被认为成功。对于这三种浸润方法，侧切牙的成功率在43%至50%之间。相邻牙齿的成功率在27%至63%之间。在下颌侧切牙唇侧浸润2%利多卡因加1:100000肾上腺素与2%利多卡因加1:50000肾上腺素之间，或在下颌侧切牙唇侧浸润2%利多卡因加1:100000肾上腺素与舌侧浸润2%利多卡因加1:100000肾上腺素之间，成功率无显著差异（P>0.05）。在60分钟内，所有溶液的牙髓麻醉持续时间均稳步下降。总之，43%-50%的成功率以及一小时内牙髓麻醉持续时间的下降表明，临床上不推荐在下颌侧切牙根尖处唇侧浸润1.8毫升2%利多卡因加1:100000肾上腺素或1:50000肾上腺素，或舌侧浸润2%利多卡因加1:100000肾上腺素来提供深度牙髓麻醉。
