Moradi Saeed, Naghavi Neda
1. Department of Endodontics, Dental School, Dental Research Center, Mashad University of Medical Sciences, Mashad, Iran.
Iran Endod J. 2010 Winter;5(1):31-5. Epub 2010 Feb 20.
Many patients suffer from mild, moderate or severe pain during or after root canal therapy. Theoretically, post-operative pain control can be achieved by using long-acting local anesthetics. The aim of this study was to evaluate the efficacy of a long acting anesthesia, bupivacaine, on preventing post-operative pain associated with endodontic treatment, and to compare it with lidocaine.
This study was a double blind and randomized clinical trial on 30 patients' anterior maxillary teeth. The patients were divided into two groups of fifteen. One group was administered lidocanine (2% with 1:100000 epinephrine) local anesthesia and the other group was given bupivacaine (0.5% without epinephrine). The pain in patients were compared using the visual analogue scale (VAS) at definite times i.e. before treatment, during treatment and 2,4,6,8,10,12,24,36 and 48 hours after operation. Data were analyzed using One-way ANOVA tests.
Bupivacaine significantly decreased postoperative pain compared to lidocaine. Postoperative pain was directly related to preoperative pain. Women reported more pain, though significant difference in postoperative pain report was not found between different ages.
In conclusion, a single dose of bupivacaine 0.5% used in infiltration anesthesia could be more effective in reduction or prevention of post-operative endodontic pain compared with lidocaine.
许多患者在根管治疗期间或之后会遭受轻度、中度或重度疼痛。从理论上讲，使用长效局部麻醉剂可以实现术后疼痛控制。本研究的目的是评估长效麻醉剂布比卡因对预防与牙髓治疗相关的术后疼痛的疗效，并将其与利多卡因进行比较。
本研究是一项针对30例患者上颌前牙的双盲随机临床试验。患者被分为两组，每组15人。一组给予利多卡因（2%加1:100000肾上腺素）局部麻醉，另一组给予布比卡因（0.5%不加肾上腺素）。在特定时间，即治疗前、治疗期间以及术后2、4、6、8、10、12、24、36和48小时，使用视觉模拟量表（VAS）比较患者的疼痛情况。数据采用单因素方差分析进行分析。
与利多卡因相比，布比卡因显著降低了术后疼痛。术后疼痛与术前疼痛直接相关。女性报告的疼痛更多，不过不同年龄之间术后疼痛报告未发现显著差异。
总之，与利多卡因相比，浸润麻醉中使用单剂量0.5%的布比卡因在减轻或预防牙髓术后疼痛方面可能更有效。
