Kashyap Vinay Mohan, Desai Rajendra, Reddy Praveen B, Menon Suresh
Oral and Maxillofacial Surgery, Vydehi Institute of Dental Sciences, Bangalore, India.
Br J Oral Maxillofac Surg. 2011 Dec;49(8):e72-5. doi: 10.1016/j.bjoms.2011.04.068. Epub 2011 May 18.
Injections of lignocaine as local anaesthetic for pain control in oral and maxillofacial surgery can themselves be painful. The time of onset of anaesthesia is from 3 to 5 min. Sodium bicarbonate has been used worldwide to reduce both these drawbacks to the injection, so making procedures more acceptable. This randomised prospective trial of 100 patients aged 18-55 years who were given 3 nerve blocks (inferior alveolar, lingual, and long buccal) was designed to assess the effect of alkalinisation of the lignocaine solution with sodium bicarbonate. All patients were given 2% lignocaine hydrochloride with adrenaline 1:80,000 and 50 patients were randomly allocated to be given 8.4% sodium bicarbonate in a 1/10 dilution. Pain was measured on a visual analogue scale (VAS). No patient given the injection with sodium bicarbonate complained of pain, compared with 39/50 (78%) not given sodium bicarbonate (p<0.0001). The mean (SD) time (seconds) to onset of local anaesthesia in the group given sodium bicarbonate was 34.4 (9.8) compared with 109.8 (31.6) in the control group (p<0.001). Our results have confirmed the efficacy of the alkalinised local anaesthetic solution in reducing pain on injection and resulting in quicker onset of anaesthesia.
在口腔颌面外科手术中，注射利多卡因作为局部麻醉剂来控制疼痛本身可能会很疼。麻醉起效时间为3至5分钟。碳酸氢钠已在全球范围内用于减少注射带来的这两个缺点，从而使手术更容易被接受。这项随机前瞻性试验纳入了100名年龄在18至55岁之间的患者，他们接受了3种神经阻滞（下牙槽神经、舌神经和颊长神经），旨在评估用碳酸氢钠碱化利多卡因溶液的效果。所有患者均接受含1:80,000肾上腺素的2%盐酸利多卡因，50名患者被随机分配接受1/10稀释的8.4%碳酸氢钠。疼痛通过视觉模拟量表（VAS）进行测量。与未接受碳酸氢钠的39/50（78%）患者相比，接受碳酸氢钠注射的患者均未抱怨疼痛（p<0.0001）。接受碳酸氢钠组局部麻醉起效的平均（标准差）时间（秒）为34.4（9.8），而对照组为109.8（31.6）（p<0.001）。我们的结果证实了碱化局部麻醉溶液在减轻注射疼痛和加快麻醉起效方面的有效性。
