Medvedev D V, Petrikas A Zh, Diubaĭlo M V, Kuritsyna I Iu
Stomatologiia (Mosk). 2013;92(2):19-21.
The authors conducted a prospective, randomized, crossover study of positive aspiration frequency in intraligamentous anesthesia (ILA). The aims of the study were (1) to determine the frequency of positive aspiration in ILA and (2) to evaluate the depth of the pulp anesthesia in lower first molar (L6) by means of electrotesting in positive or negative aspiration. Intraligamentous injections with 4% articaine with epinephrine in L6 were carried out with computer syringe in 36 dental students. Anesthesia of these 36 molars was obtained in 114 injections, with 3.2 injections on average. Each injection was controlled by electrotesting. During each ILA the last 1-2 injections were accompanied by positive aspiration and simultaneously by pulpal analgesia (testing values 100-200 mka). In 34 of 36 (94.4%) subjects intraligamentous anesthesia was accompanied by positive aspiration test (AT). In 2 cases (2/36/5.6%) successful but slowed anesthesia had negative AT in all 5 injections. The phenomenon of aspiration in ILA was studied for the first time. Positive aspiration (94.4%) is a precursor of effective anesthesia. This phenomenon is presented as an evidence of vascular mechanism of ILA.
作者进行了一项关于韧带内麻醉（ILA）时阳性回抽频率的前瞻性、随机、交叉研究。该研究的目的是：（1）确定ILA时阳性回抽的频率；（2）通过对阳性或阴性回抽进行电测试来评估下颌第一磨牙（L6）牙髓麻醉的深度。对36名牙科学生的L6牙进行韧带内注射4%含肾上腺素的阿替卡因，使用计算机注射器。这36颗磨牙共注射114次，平均每颗牙注射3.2次。每次注射后均进行电测试。在每次ILA过程中，最后1 - 2次注射伴有阳性回抽且同时出现牙髓镇痛（测试值为100 - 200 mA）。36名受试者中有34名（94.4%）韧带内麻醉伴有阳性回抽试验（AT）。2例（2/36，5.6%）患者在所有5次注射中，麻醉成功但起效缓慢且AT为阴性。首次对ILA中的回抽现象进行了研究。阳性回抽（94.4%）是有效麻醉的先兆。这一现象是ILA血管机制的证据。
