El-Kholey Khalid E
Lecturer, Oral Surgery, Ain-Shames University Hospitals; Assistant Professor, Oral Surgery, Dentistry Program, Ibn-Sina College for Medical Studies, Jeddah, Saudi Arabia.
J Oral Maxillofac Surg. 2013 Oct;71(10):1658.e1-5. doi: 10.1016/j.joms.2013.06.203.
Profound anesthesia for mandibular molars by buccal infiltration has been tried in recent years, with promising results. This prospective, randomized, single-blinded, crossover study investigated the clinical anesthetic efficacy obtained with 1:100,000 epinephrine plus 4% articaine (A100) 1.8 versus 3.6 mL as mandibular first molar buccal infiltration during removal of impacted lower third molars.
Thirty adult patients underwent removal of symmetrically positioned impacted lower third molars in 2 separate appointments. The patients randomly received mandibular buccal first molar infiltration of A100 1.8 or 3.6 mL during surgery. For assessment of anesthetic efficacy, any pain during surgery was rated using the visual analog scale. Also, the onset, duration, and total amount of anesthetic used were recorded.
Compared with the 1.8-mL volume of A100, the 3.6-mL volume showed a statistically higher success rate (93% vs 56%).
Infiltration in the buccal vestibule opposite the mandibular first molar by A100 3.6 mL may be a good option for extraction of mandibular third molars, with supplemental lingual anesthesia.
近年来尝试通过颊侧浸润对下颌磨牙进行深度麻醉,取得了令人满意的效果。这项前瞻性、随机、单盲、交叉研究调查了在拔除下颌阻生第三磨牙时,1:100,000肾上腺素加4%阿替卡因(A100)1.8毫升与3.6毫升作为下颌第一磨牙颊侧浸润麻醉的临床麻醉效果。
30名成年患者分两次就诊,拔除对称位置的下颌阻生第三磨牙。患者在手术过程中随机接受1.8毫升或3.6毫升A100在下颌第一磨牙颊侧的浸润麻醉。为评估麻醉效果,使用视觉模拟量表对手术过程中的任何疼痛进行评分。此外,记录麻醉起效时间、持续时间和所用麻醉剂的总量。
与1.8毫升A100相比,3.6毫升A100的成功率在统计学上更高(93%对56%)。
3.6毫升A100在下颌第一磨牙相对的颊前庭进行浸润麻醉,可能是拔除下颌第三磨牙并辅以舌侧麻醉的一个不错选择。