Tijanić Milos, Burić Nikola, Jovanović Goran, Stojanović Simona, Spasić Milan
Odeljenje oralne hirurgije, Klinika za stomatologiju, Medicinski fakultet, Univerzitet u Nisu, Nis, Srbija.
Vojnosanit Pregl. 2012 May;69(5):405-8. doi: 10.2298/vsp1205405t.
BACKGROUND/AIM: Ropivacaine is a relatively new long-acting local anesthetic. The aim of this study was to compare the postoperative analgesic effect of topical anesthetics ropivacaine 0.75% and lidocaine 2% with adrenaline in the postoperative treatment of periapical lesions in the maxilla.
The study was conducted on 60 subjects, divided into two groups. The study-group received 0.75% ropivacaine without a vasoconstrictor, while the control group was treated with 2% lidocaine with adrenaline (1 : 80.000). Block anesthesia for n. infraorbitalis was used and local anesthetics were applied also on the palatine side for the end branches of n. nasopalatinus. The following parameters were observed: time elapsed from the application of an anesthetic until the first occurrence of pain after the surgery and first intake of an analgesic, the intensity of initial pain, pain intensity 6 h after the application of anesthetics and the total number of analgesics taken within 24 h after the completion of surgery.
The pain appeared statistically significantly earlier in the patients who had been given lidocaine with adrenaline (p < 0.001), while statistically significantly higher mean values of initial postoperative pain (p < 0.05) and pain intensity 6 h after the intervention (p < 0.01) were also registered in the same group of patients. In the period of 24 h upon the intervention, the study-group patients were taking less analgesics as compared to the control-group subjects (46.6% vs 73.3%), who were given analgesics earlier, although no statistically significant differences were observed related to the number of analgesic doses taken.
The results of our study indicate a better postoperative analgesic effect of ropivacaine as compared to lidocaine with adrenaline.
背景/目的：罗哌卡因是一种相对较新的长效局部麻醉剂。本研究的目的是比较0.75%罗哌卡因和2%利多卡因加肾上腺素这两种局部麻醉剂在上颌根尖周病变术后治疗中的镇痛效果。
对60名受试者进行研究，分为两组。研究组接受不含血管收缩剂的0.75%罗哌卡因，而对照组接受含肾上腺素（1:80000）的2%利多卡因。采用眶下神经阻滞麻醉，同时在腭侧对鼻腭神经终末支应用局部麻醉剂。观察以下参数：从应用麻醉剂到术后首次出现疼痛和首次服用镇痛药的时间、初始疼痛强度、应用麻醉剂6小时后的疼痛强度以及术后24小时内服用的镇痛药总数。
使用利多卡因加肾上腺素的患者疼痛出现的时间在统计学上显著更早（p<0.001），同一组患者术后初始疼痛的平均数值（p<0.05）和干预后6小时的疼痛强度（p<0.01）在统计学上也显著更高。在干预后的24小时内，研究组患者服用的镇痛药比对照组患者少（46.6%对73.3%），对照组患者更早服用镇痛药，尽管在服用的镇痛药物剂量数量方面未观察到统计学上的显著差异。
我们的研究结果表明，与利多卡因加肾上腺素相比，罗哌卡因的术后镇痛效果更好。
