Fan Song, Chen Wei-liang, Yang Zhao-hui, Huang Zhi-quan
Department of Oral and Maxillofacial Surgery, the Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Mar;107(3):359-63. doi: 10.1016/j.tripleo.2008.08.025. Epub 2008 Nov 8.
The aim of the present study was to demonstrate whether articaine/HCl administered alone as a single buccal infiltration in maxillary tooth removal provided favorable palatal anesthesia as compared to buccal and palatal injection, for a surgical procedure.
In total, 71 patients for removal of bilateral permanent maxillary teeth were enrolled in the present study. For the experimental side, 1.7 mL of 4% articaine/HCl was injected into the buccal vestibule of the tooth. After 5 minutes, tooth extraction was performed. On the control side a similar protocol was applied with the addition of a palatal injection. All patients completed a 100-mm Visual Analogue Scale (VAS), Verbal Response Scale (VRS) after both injection and then extraction, respectively.
According to the VAS scores, the pain of injection between buccal infiltration without a separate palatal injection and routine administration with additional palatal injection was statistically significant (P < .05). However, the VAS scores for permanent maxillary tooth removal showed no significant difference between the 2 types of injection (P > .05). All patients described both extractions as "acceptable" and no patient requested an additional palatal injection to ensure comfortable extraction.
The routine use of a palatal injection for the removal of permanent maxillary teeth may not be required when articaine/HCl is used as the local anesthetic.
本研究旨在证明,在上颌牙拔除手术中,与颊侧和腭侧注射相比,单独使用盐酸阿替卡因进行单次颊侧浸润麻醉是否能提供良好的腭侧麻醉效果。
本研究共纳入71例需要拔除双侧上颌恒牙的患者。在试验侧,将1.7 mL 4%的盐酸阿替卡因注射到患牙的颊侧前庭。5分钟后进行拔牙。在对照侧,采用相同方案并额外增加腭侧注射。所有患者在注射后和拔牙后分别完成100 mm视觉模拟量表(VAS)和语言反应量表(VRS)。
根据VAS评分,单纯颊侧浸润麻醉(不进行单独的腭侧注射)与常规增加腭侧注射的给药方式在注射疼痛方面具有统计学差异(P < .05)。然而,两种注射方式在上颌恒牙拔除时的VAS评分无显著差异(P > .05)。所有患者均表示两次拔牙均可“接受”,且没有患者要求额外进行腭侧注射以确保拔牙过程舒适。
当使用盐酸阿替卡因作为局部麻醉剂时,拔除上颌恒牙可能无需常规进行腭侧注射。