罗哌卡因上颌浸润麻醉用于上颌第三磨牙手术。
Maxillary infiltration anaesthesia by ropivacaine for upper third molar surgery.
机构信息
Clinic of Oral Surgery, Faculty of Dentistry, University of Belgrade, Belgrade, Serbia.
出版信息
Int J Oral Maxillofac Surg. 2010 Jan;39(1):36-41. doi: 10.1016/j.ijom.2009.11.009. Epub 2009 Dec 14.
The main purpose of this study was to assess the clinical efficacy and haemodynamic effects of ropivacaine for infiltration anaesthesia in patients undergoing surgical removal of upper third molars. The safety profile of ropivacaine was also studied by investigating the maximal venous plasma concentration of ropivacaine and the reactivity to ropivacaine of isolated human infraorbital arteries. Ropivacaine in concentrations of 0.5, 0.75 and 1% achieved dose-dependent parameters of maxillary infiltration aneasthesia, clinically relevant in concentrations 0.75 and 1%. Postoperative needs for analgesics were observed in 67-100% of patients. Haemodynamic parameters were stable during surgery with significant changes occuring 10 min after surgery. After maxillary infiltration of 2.0 ml 1% ropivacaine, the maximum venous plasma concentration (Cmax) was 82+/-15 microg/l. On isolated human infraorbital artery, ropivacaine (10(-4)M) induced endothelium-independent contraction. This study suggests that 0.75 and 1% ropivacaine offers adequate and safe intraoperative analgesia but not successful postoperative pain control for the surgical removal of upper third molars.
本研究的主要目的是评估罗哌卡因用于行上第三磨牙切除术患者浸润麻醉的临床疗效和血液动力学效应。通过检测罗哌卡因的最大静脉血浆浓度以及分离的人眶下动脉对罗哌卡因的反应性，研究了罗哌卡因的安全性。罗哌卡因在 0.5%、0.75%和 1%的浓度下达到了上颌浸润麻醉的剂量依赖性参数，在 0.75%和 1%的浓度下具有临床相关性。67-100%的患者术后需要镇痛。术中血流动力学参数稳定，术后 10 分钟出现显著变化。在上颌浸润 2.0 ml 1%罗哌卡因后，最大静脉血浆浓度（Cmax）为 82+/-15 microg/l。在分离的人眶下动脉上，罗哌卡因（10(-4)M）诱导内皮非依赖性收缩。本研究表明，0.75%和 1%的罗哌卡因可提供足够和安全的术中镇痛，但对上第三磨牙切除术的术后疼痛控制无效。
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