Hersh Elliot V, DeRossi Scott S, Ciarrocca Katharine N, Secreto Stacey A, Ghassemi Annahita
University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA.
J Clin Dent. 2003;14(1):1-6.
In this randomized, double-blind, placebo-controlled clinical trial, the effectiveness and tolerability of a novel intraoral benzocaine patch was evaluated in 60 patients who presented to the Dental School's emergency clinic with spontaneous toothache pain of at least a moderate intensity.
Mucoadhesive patches, containing either 12 mg of benzocaine or a matching placebo, were applied approximately two millimeters apical to the mucogingival junction of the symptomatic tooth and remained in place for 60 minutes. Pain intensity (0-4 scale) and pain relief (0-4 scale) were recorded every five minutes through 30 minutes, and then every ten minutes through the 90-minute time point. The onset times of first perceptible and meaningful relief were recorded using two stopwatches. The occurrence of adverse events was also monitored.
While the benzocaine patches were numerically superior to the placebo patches at all time points with respect to pain relief, PID (pain intensity difference) and their summed measures (TOTPAR and SPID scores), an analysis of covariance revealed no significant differences between treatments. Survival analysis indicated that the percentage of patients reporting meaningful pain relief by 30 minutes was significantly (p < 0.05) greater in the benzocaine group than in the placebo group (77% for benzocaine and 47% for placebo). The median onset times to first perceptible and meaningful relief were 5.4 and 18.1 minutes in the benzocaine group, and 7.8 and 30.4 minutes in the placebo group. Only two side effects (headache) were reported in the entire study.
Although the results of the present study were promising, further research on this novel delivery system of benzocaine is warranted to firmly establish efficacy in patients with spontaneous toothache pain.
在这项随机、双盲、安慰剂对照的临床试验中,对60名因至少中度强度的自发性牙痛而前往牙科学院急诊诊所就诊的患者,评估一种新型口腔内苯佐卡因贴片的有效性和耐受性。
将含有12毫克苯佐卡因或匹配安慰剂的粘膜粘附贴片,贴于患牙粘膜牙龈交界处以根尖约两毫米处,并保持60分钟。在30分钟内每五分钟记录一次疼痛强度(0 - 4级)和疼痛缓解程度(0 - 4级),然后在90分钟时间点前每十分钟记录一次。使用两个秒表记录首次可察觉缓解和显著缓解的起效时间。同时监测不良事件的发生情况。
虽然在所有时间点,苯佐卡因贴片在疼痛缓解、疼痛强度差异(PID)及其综合指标(TOTPAR和SPID评分)方面在数值上优于安慰剂贴片,但协方差分析显示各治疗组之间无显著差异。生存分析表明,苯佐卡因组在30分钟时报告有显著疼痛缓解的患者百分比显著高于安慰剂组(苯佐卡因为77%,安慰剂为47%,p < 0.05)。苯佐卡因组首次可察觉缓解和显著缓解的中位起效时间分别为5.4分钟和18.1分钟,安慰剂组分别为7.8分钟和30.4分钟。整个研究中仅报告了两例副作用(头痛)。
尽管本研究结果令人鼓舞,但仍需对这种新型苯佐卡因给药系统进行进一步研究,以明确其在自发性牙痛患者中的疗效的确立。