0.5%布比卡因与 4%阿替卡因用于下颌第三磨牙拔除的比较：一项交叉随机对照试验。
Bupivacaine 0.5% versus articaine 4% for the removal of lower third molars. A crossover randomized controlled trial.
机构信息
School of Dentistry, University of Barcelona, Spain.
出版信息
Med Oral Patol Oral Cir Bucal. 2012 May 1;17(3):e462-8. doi: 10.4317/medoral.17628.
Abstract
OBJECTIVE
To compare the anesthetic action of 0.5% bupivacaine in relation to 4% articaine, both with 1:200,000 epinephrine, in the surgical removal of lower third molars. As a secondary objective hemodynamic changes using both anesthetics were analyzed.
STUDY DESIGN
Triple-blind crossover randomized clinical trial. Eighteen patients underwent bilateral removal of impacted lower third molars using 0.5% bupivacaine or 4% articaine in two different appointments. Preoperative, intraoperative and postoperative variables were recorded. Differences were assessed with McNemar tests and repeated measures ANOVA tests.
RESULTS
Both solutions exhibited similar latency times and intraoperative efficacy. Statistical significant lower pain levels were observed with bupivacaine between the fifth (p=0.011) and the ninth (p=0.007) postoperative hours. Bupivacaine provided significantly longer lasting soft tissue anesthesia (p<0.5). Systolic blood pressure and heart rate values were significantly higher with articaine.
CONCLUSIONS
Bupivacaine could be a valid alternative to articaine especially due to its early postoperative pain prevention ability.
摘要
目的
比较 0.5%布比卡因和 4%阿替卡因（均含 1:200000 肾上腺素）在拔除下颌第三磨牙手术中的麻醉作用。次要目的是分析两种麻醉剂的血液动力学变化。
研究设计
三盲交叉随机临床试验。18 例患者在两次不同的就诊中接受双侧下颌第三磨牙阻生的手术，使用 0.5%布比卡因或 4%阿替卡因。记录术前、术中及术后的变量。采用 McNemar 检验和重复测量方差分析评估差异。
结果
两种溶液的潜伏期和术中效果相似。布比卡因在术后第 5 小时（p=0.011）和第 9 小时（p=0.007）时的疼痛水平明显较低。布比卡因提供的软组织麻醉持续时间明显更长（p<0.05）。阿替卡因的收缩压和心率值明显较高。
结论
布比卡因可能是阿替卡因的有效替代药物，特别是因为它具有早期预防术后疼痛的能力。
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