Nusstein John, Berlin Jeffrey, Reader Al, Beck Mike, Weaver Joel M
Department of Graduate Endodontics, College of Dentistry, The Ohio State University, Columbus, Ohio 43218, USA.
Anesth Prog. 2004;51(4):126-33.
The purpose of this prospective, randomized, double-blind study was to compare the pain of injection, heart rate increase, and postinjection pain of the intraligamentary injection of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:100,000 epinephrine administered with a computer-controlled local anesthetic delivery system. Using a crossover design, intraligamentary injections of 1.4 mL of 4% articaine with 1:100,000 epinephrine and 1.4 mL of 2% lidocaine with 1:100,000 epinephrine were randomly administered on the mesial and distal aspects of the mandibular first molar with a computer-controlled local anesthetic delivery system in a double-blind manner at 2 separate appointments to 51 subjects. The results demonstrated the incidence of moderate pain was 14%-27% with needle insertion, with 0%-4% reporting severe pain. For solution deposition, moderate pain was reported 8%-18% of the time, with no reports of severe pain. There were no significant differences between the articaine and lidocaine solutions. Regarding heart rate changes, neither anesthetic solution resulted in a significant increase in heart rate over baseline readings. On day 1 postinjection, there was a 31% incidence of moderate/severe pain with the articaine solution and 20% incidence of moderate/severe pain with the lidocaine solution. The moderate/severe pain ratings decreased over the next 2 days. There were no significant differences between the articaine and lidocaine solutions. We concluded that the intraligamentary injection of 4% articaine with 1:100,000 epinephrine was similar to 2% lidocaine with 1:100,000 epinephrine for injection pain and postinjection pain in the mandibular first molar when administered with a computer-controlled local anesthetic delivery system. For both anesthetic solutions, heart rate did not significantly increase with the intraligamentary injection using the computer-controlled local anesthetic system.
这项前瞻性、随机、双盲研究的目的是比较使用计算机控制局部麻醉药输送系统给予含1:100,000肾上腺素的4%阿替卡因韧带内注射与含1:100,000肾上腺素的2%利多卡因韧带内注射时的注射疼痛、心率增加情况及注射后疼痛。采用交叉设计，在2次单独的就诊时，使用计算机控制局部麻醉药输送系统以双盲方式在51名受试者下颌第一磨牙的近中和远中面随机给予1.4 mL含1:100,000肾上腺素的4%阿替卡因和1.4 mL含1:100,000肾上腺素的2%利多卡因韧带内注射。结果显示，进针时中度疼痛的发生率为14% - 27%，0% - 4%报告有重度疼痛。溶液注射时，8% - 18%的时间报告有中度疼痛，无重度疼痛报告。阿替卡因溶液和利多卡因溶液之间无显著差异。关于心率变化，两种麻醉溶液均未导致心率相对于基线读数显著增加。注射后第1天，阿替卡因溶液中度/重度疼痛的发生率为31%，利多卡因溶液为20%。在接下来的2天中，中度/重度疼痛评分降低。阿替卡因溶液和利多卡因溶液之间无显著差异。我们得出结论，当使用计算机控制局部麻醉药输送系统时，含1:100,000肾上腺素的4%阿替卡因韧带内注射在下颌第一磨牙的注射疼痛和注射后疼痛方面与含1:100,000肾上腺素的2%利多卡因相似。对于两种麻醉溶液，使用计算机控制局部麻醉系统进行韧带内注射时心率均未显著增加。
