Stoltenberg Jill L, Osborn Joy B, Carlson Jeffrey F, Hodges James S, Michalowicz Bryan S
Department of Primary Dental Care, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA.
J Clin Periodontol. 2007 Oct;34(10):892-6. doi: 10.1111/j.1600-051X.2007.01128.x.
Compare the efficacy of topical benzocaine gel to injected lidocaine during scaling and root planing.
In each of 21 participants undergoing root planing, two dental quadrants were randomly assigned to receive topical 20% benzocaine gel delivered subgingivally (TOP) or injection anaesthesia using 2% lidocaine (INJ). Baseline, intra- and immediate post-operative pain was assessed using the Heft-Parker pain scale. Intra-subject differences (INJ-TOP) were analysed using paired t-tests and mixed models.
Baseline and post-operative pain did not differ between treatments (p>0.50). The injected anaesthetic, however, was associated with less intra-operative pain than the topical (INJ-TOP=-24.9 mm, p=0.005) Six participants required rescue (injected) anaesthesia during treatment with the topical. Eleven participants (52%) preferred topical over injected anaesthetic. Among these 11, intra-operative pain scores did not differ significantly (TOP=38.6 mm, INJ=28.4 mm, p=0.23). Among those who preferred the injected anaesthetic, intra-operative pain scores differed significantly (TOP=84.7 mm, INJ=43.8 mm, p=0.03).
Intra-pocket benzocaine gel is less effective than injected lidocaine in controlling pain during scaling and planing. Anaesthetic preference was related to the level of pain experienced during treatment with the topical. Larger studies are needed to confirm these findings.
比较在龈下刮治和根面平整过程中局部应用苯佐卡因凝胶与注射利多卡因的疗效。
21名接受根面平整的参与者，每个参与者的两个牙象限被随机分配，分别接受龈下局部应用20%苯佐卡因凝胶（TOP）或注射2%利多卡因进行麻醉（INJ）。使用赫夫特 - 帕克疼痛量表评估基线、术中及术后即刻疼痛。采用配对t检验和混合模型分析受试者内差异（INJ - TOP）。
两种治疗方法的基线和术后疼痛无差异（p>0.50）。然而，注射麻醉剂在术中引起的疼痛比局部应用的少（INJ - TOP = -24.9 mm，p = 0.005）。6名参与者在局部应用治疗期间需要追加（注射）麻醉。11名参与者（52%）更喜欢局部应用而非注射麻醉剂。在这11名参与者中，术中疼痛评分无显著差异（TOP = 38.6 mm，INJ = 28.4 mm，p = 0.23）。在那些更喜欢注射麻醉剂的参与者中，术中疼痛评分有显著差异（TOP = 84.7 mm，INJ = 43.8 mm, p = 0.03）。
在龈下刮治和根面平整过程中，袋内应用苯佐卡因凝胶在控制疼痛方面不如注射利多卡因有效。麻醉剂的偏好与局部应用治疗期间所经历的疼痛程度有关。需要更大规模的研究来证实这些发现。
