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丁丙诺啡联合2%利多卡因(1:80000)用于口腔小手术后镇痛的疗效。

Efficacy of buprenorphine added 2 % lignocaine 1:80000 in postoperative analgesia after minor oral surgery.

作者信息

Kumar S Praveen, Suryavanshi R K, Kotrashetti S M

机构信息

Department of OMFS, Goa Dental College and Hospital, Bambolim, 403002 Goa India.

Al-Badar Rural Dental College and Hospital, Gulbarga, Karnataka.

出版信息

J Maxillofac Oral Surg. 2013 Mar;12(1):30-4. doi: 10.1007/s12663-012-0360-z. Epub 2012 Apr 24.

Abstract

PURPOSE

Recent studies have demonstrated that opioid analgesia cannot be exclusively attributed to effects within central nervous system. Peripheral opioid receptors exist that can be activated by locally applied opioid agonists which mediate analgesic effects that are particularly prominent in painful inflammatory conditions. Patients who present themselves with conditions requiring minor surgery in the maxillo-facial region usually have associated ongoing inflammatory process. The aim of our study was to apply the concept of peripheral opioid analgesia in minor oral surgery and evaluate its effectiveness in managing postoperative pain. The present study was designed to evaluate the efficacy of buprenorphine added lignocaine 2 % in providing postoperative analgesia after minor oral surgery.

MATERIALS AND METHODS

Hundred consenting adult patients who were scheduled to undergo various minor oral surgeries were enrolled in this double blinded study. Patients were randomly assigned into one of the two groups based on whether they received buprenorphine added 2 % lignocaine 1:80000 (Group I) or (Group II) lignocaine 2 % with adrenaline 1:80000 alone. Visual analog scale method was used for evaluation of the postoperative analgesia.

RESULTS

The duration of analgesia in Group I was found to be 36 ± 1.5 h and the average consumption of NSAIDs was found to be 1.86 as compared to Group II mean value of 4.4 (P < 0.0001).

CONCLUSION

Addition of small amounts of buprenorphine to 30 ml lignocaine with adrenaline 1:80000 for minor oral surgery results in significant improvement in postoperative analgesia up to 36 h and markedly reduces the need for excessive analgesic intake. Thus reducing the adverse effects associated with excessive use of NSAIDs.

摘要

目的

近期研究表明,阿片类药物的镇痛作用不能完全归因于中枢神经系统内的效应。外周存在阿片受体,可被局部应用的阿片类激动剂激活,这些激动剂介导的镇痛作用在疼痛性炎症状态下尤为突出。因上颌面部区域需要进行小手术而前来就诊的患者通常伴有持续的炎症过程。我们研究的目的是将外周阿片类镇痛的概念应用于小口腔手术,并评估其在管理术后疼痛方面的有效性。本研究旨在评估添加丁丙诺啡的2%利多卡因在小口腔手术后提供术后镇痛的疗效。

材料与方法

100名同意接受各种小口腔手术的成年患者参与了这项双盲研究。根据患者是接受添加了丁丙诺啡的1:80000 2%利多卡因(第一组)还是仅接受1:80000肾上腺素的2%利多卡因(第二组),将患者随机分为两组。采用视觉模拟评分法评估术后镇痛效果。

结果

发现第一组的镇痛持续时间为36±1.5小时,非甾体抗炎药的平均消耗量为1.86,而第二组的平均值为4.4(P<0.0001)。

结论

在30毫升含1:80000肾上腺素的利多卡因中添加少量丁丙诺啡用于小口腔手术,可使术后镇痛效果显著改善长达36小时,并显著减少过量镇痛药物摄入的需求。从而减少与过度使用非甾体抗炎药相关的不良反应。

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