Gutenberg Lauren L, Chen Jung-Wei, Trapp Larry
Former graduate student/resident, Loma Linda University School of Dentistry, Loma Linda, California.
Anesth Prog. 2013 Fall;60(3):99-108. doi: 10.2344/0003-3006-60.3.99.
The purpose of this study was to measure and compare peak methemoglobin levels and times to peak methemoglobin levels following the use of prilocaine and lidocaine in precooperative children undergoing comprehensive dental rehabilitation under general anesthesia. Ninety children, 3-6 years of age, undergoing dental rehabilitation under general anesthesia were enrolled and randomly assigned into 3 equal groups: group 1, 4% prilocaine plain, 5 mg/kg; group 2, 2% lidocaine with 1:100,000 epinephrine, 2.5 mg/kg; and group 3, no local anesthetic. Subjects in groups 1 and 2 were administered local anesthetic prior to restorative dental treatment. Methemoglobin levels (SpMET) were measured and recorded throughout the procedure using a Masimo Radical-7 Pulse Co-Oximeter (Masimo Corporation, Irvine, Calif, RDS-1 with SET software with methemoglobin interface). Data were analyzed using chi-square, one-way analysis of variance (ANOVA), and Pearson correlation (significance of P < .05). Group 1 had a significantly higher mean peak SpMET level at 3.55% than groups 2 and 3 at 1.63 and 1.60%, respectively. The mean time to peak SpMET was significantly shorter for group 3 at 29.50 minutes than that of group 1 at 62.73 and group 2 at 57.50 minutes. Prilocaine, at 5 mg/kg in pediatric dental patients, resulted in significantly higher peak SpMET levels than lidocaine and no local anesthetic. In comparison to no local anesthetic, the administration of prilocaine and lidocaine caused peak SpMET levels to occur significantly later in the procedure.
本研究的目的是测量并比较在全身麻醉下接受综合牙科修复的不合作儿童使用丙胺卡因和利多卡因后高铁血红蛋白的峰值水平以及达到峰值水平的时间。90名3至6岁在全身麻醉下接受牙科修复的儿童被纳入研究，并随机分为3组，每组人数相等：第1组，4%丙胺卡因原液，5mg/kg；第2组，2%利多卡因加1:100,000肾上腺素，2.5mg/kg；第3组，不使用局部麻醉剂。第1组和第2组的受试者在进行修复性牙科治疗前给予局部麻醉剂。在整个过程中，使用Masimo Radical-7脉搏血氧饱和度仪（Masimo公司，加利福尼亚州欧文市，RDS-1，配备带有高铁血红蛋白接口的SET软件）测量并记录高铁血红蛋白水平（SpMET）。数据采用卡方检验、单因素方差分析（ANOVA）和Pearson相关性分析（显著性P<0.05）。第1组的平均高铁血红蛋白峰值水平显著高于第2组和第3组，分别为3.55%、1.63%和1.60%。第3组达到高铁血红蛋白峰值的平均时间显著短于第1组和第2组，分别为29.50分钟、62.73分钟和57.50分钟。在儿科牙科患者中，5mg/kg的丙胺卡因导致的高铁血红蛋白峰值水平显著高于利多卡因和不使用局部麻醉剂的情况。与不使用局部麻醉剂相比，丙胺卡因和利多卡因的使用使高铁血红蛋白峰值水平在手术过程中出现的时间显著延迟。
