Abu Al-Melh Manal, Andersson Lars, Behbehani Ebraheem
Faculty of Dentistry, Health Sciences Centre, Kuwait University, Kuwait.
J Clin Dent. 2005;16(2):53-6.
The aim of the study was to compare the analgesic effect of a topical benzocaine gel with that of a topical gel mixture of lidocaine/prilocaine (L/P).
Forty individuals took part in the study. Topical anesthetics were applied bilaterally in the maxillary vestibule lateral to the canine. On one side, a mixture of 2.5% lidocaine/2.5% prilocaine (EMLA) was applied. On the opposite side, 20% benzocaine (Topex) was applied as control. The patients had no knowledge as to which side each gel was applied. A 27-gauge needle was inserted through the mucosa to bone contact every minute during a seven-minute period in each area of application. The subjects recorded which side was the least painful, and also registered the grade of pain on a 100 mm VAS scale. Comparisons were made estimating the group difference using the Wilcoxon rank sum test.
After one minute, 87.5% of the subjects reported the L/P side being the least painful. After two to four minutes, 97.5-100% reported the L/P side least painful. After five to seven minutes, 90-95% reported the L/P side least painful. The VAS grading of the pain showed that L/P was significantly (p < 0.05) better in eliminating or reducing the pain.
Topical anesthetics based on a combination of lidocaine 2.5% + prilocaine 2.5% are significantly more effective than 20% benzocaine in reducing pain from needle stick in the maxillary vestibular mucosa.
本研究旨在比较外用苯佐卡因凝胶与利多卡因/丙胺卡因（L/P）外用凝胶混合物的镇痛效果。
40名个体参与了本研究。在上颌犬齿外侧前庭双侧涂抹局部麻醉剂。一侧涂抹2.5%利多卡因/2.5%丙胺卡因的混合物（复方利多卡因乳膏）。另一侧涂抹20%苯佐卡因（妥塞敏）作为对照。患者不知道每侧涂抹的是哪种凝胶。在每个涂抹区域，在7分钟内每分钟通过黏膜插入一根27号针头直至与骨接触。受试者记录哪一侧疼痛最轻，并在100毫米视觉模拟量表上记录疼痛等级。使用Wilcoxon秩和检验对组间差异进行评估比较。
1分钟后，87.5%的受试者报告L/P侧疼痛最轻。2至4分钟后，97.5 - 100%的受试者报告L/P侧疼痛最轻。5至7分钟后，90 - 95%的受试者报告L/P侧疼痛最轻。疼痛的视觉模拟量表分级显示，L/P在消除或减轻疼痛方面显著更好（p < 0.05）。
2.5%利多卡因 + 2.5%丙胺卡因组合的局部麻醉剂在减轻上颌前庭黏膜针刺疼痛方面比20%苯佐卡因显著更有效。
