Lindemann Matthew, Reader Al, Nusstein John, Drum Melissa, Beck Mike
Private practice limited to endodontics, Flint, Michigan, USA.
J Endod. 2008 Oct;34(10):1167-70. doi: 10.1016/j.joen.2008.07.013. Epub 2008 Aug 23.
The purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of the administration of sublingual triazolam on the success of the inferior alveolar nerve (IAN) block in patients experiencing irreversible pulpitis. Fifty-eight emergency patients diagnosed with irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, an identical sublingual tablet of either 0.25 mg of triazolam or a placebo 30 minutes before administration of a conventional IAN block. Access was begun 15 minutes after completion of the IAN block, and all patients had profound lip numbness. Success was defined as no or mild pain (visual analog scale recordings) on access or initial instrumentation. The success rate for the IAN block was 43% with triazolam and 57% with the placebo, with no significant difference (P = .43) between the 2 groups. For mandibular posterior teeth, triazolam in a sublingual dose of 0.25 mg did not result in an increase in success of the IAN block in patients with irreversible pulpitis. Therefore, when using conscious sedation, profound local anesthesia is still required to eliminate the sensation of pain during endodontic treatment for patients with irreversible pulpitis.
这项前瞻性、随机、双盲、安慰剂对照研究的目的是确定舌下含服三唑仑对患有不可逆性牙髓炎患者下牙槽神经（IAN）阻滞成功率的影响。58例被诊断为下颌后牙不可逆性牙髓炎的急诊患者，在进行常规IAN阻滞前30分钟，以双盲方式随机接受一片0.25mg三唑仑或安慰剂的相同舌下片。在IAN阻滞完成15分钟后开始开髓，所有患者均有明显的唇部麻木。成功定义为开髓或初次器械操作时无疼痛或轻度疼痛（视觉模拟量表记录）。三唑仑组IAN阻滞成功率为43%，安慰剂组为57%，两组间无显著差异（P = 0.43）。对于下颌后牙，舌下含服0.25mg三唑仑并未使患有不可逆性牙髓炎患者的IAN阻滞成功率增加。因此，在使用清醒镇静时，对于患有不可逆性牙髓炎的患者，在牙髓治疗期间仍需要深度局部麻醉以消除疼痛感觉。
