Kohler Bernhard Rolf, Castellón Loreto, Laissle Germán
Oral Surgery Clinic, Faculty of Dentistry, University Mayor, Santiago, Chile.
Anesth Prog. 2008 Spring;55(1):2-8. doi: 10.2344/0003-3006(2008)55[2:GTAPSF]2.0.CO;2.
The aim of this study was to compare the effectiveness of 2 different volumes of anesthetic solution for a premolar-molar extraction, and to determine the onset of complete mandibular conduction anesthesia via a Gow-Gates mandibular block. One operator performed 32 blocks with a 27-gauge needle on patients who required a dental extraction: 16 blocks using 1.8 mL of anesthetic solution, and 16 blocks using 3.6 mL of anesthetic solution. The parameters evaluated were frequency of successful anesthesia and onset of complete anesthesia. Significant differences (P < .005) were observed in the evaluation of volume: the 3.6 mL group yielded a higher success rate (82.5%) than the 1.8 mL group (17.5%). The onset of complete conduction anesthesia was achieved in 8 minutes by 56% of the subjects (9 of 16) with 3.6 mL and only one subject in 16 (6%) with 1.8 mL. A larger volume of anesthetic solution (3.6 mL) is required to achieve a higher success rate and a faster onset of action for a dental extraction without the use of reinforcement anesthesia. The volume of anesthetic solution is indirectly proportional to the onset of complete anesthesia. A premolar-molar extraction can be done, with 3.6 mL of anesthetic solution, in more than 50% of the patients 8 minutes after injection.
本研究的目的是比较两种不同体积麻醉溶液用于前磨牙-磨牙拔除术的效果,并通过Gow-Gates下颌阻滞确定完全下颌传导麻醉的起效时间。一名操作人员使用27号针头对需要拔牙的患者进行了32次阻滞:16次阻滞使用1.8 mL麻醉溶液,16次阻滞使用3.6 mL麻醉溶液。评估的参数为麻醉成功率和完全麻醉的起效时间。在体积评估中观察到显著差异(P <.005):3.6 mL组的成功率(82.5%)高于1.8 mL组(17.5%)。使用3.6 mL麻醉溶液时,56%的受试者(16名中的9名)在8分钟内实现了完全传导麻醉,而使用1.8 mL麻醉溶液时,16名受试者中只有1名(6%)在8分钟内实现了完全传导麻醉。在不使用强化麻醉的情况下,需要更大体积的麻醉溶液(3.6 mL)才能获得更高的成功率和更快的起效时间。麻醉溶液的体积与完全麻醉的起效时间成反比。注射后8分钟内,超过50%的患者使用3.6 mL麻醉溶液即可完成前磨牙-磨牙拔除术。