Managutti Anil, Prakasam Michael, Puthanakar Nagraj, Menat Shailesh, Shah Disha, Patel Harsh
Professor and Head, Vice Principal, Department of Oral & Maxillofacial Surgery, Narsinhbhai Patel Dental College and Hospital, Visnagar, Gujarat, India.
Reader, Department of Oral & Maxillofacial Surgery, Modern Dental College and Hospital, Indore, Madhya Pradesh, India.
J Int Oral Health. 2015 Mar;7(3):24-7.
Local anesthetic agents are more commonly used in dentistry to have painless procedure during surgical intervention in bone and soft tissue. There are many local anesthetic agents available with the wide selection of vaso-constrictive agents that improve the clinical efficacy and the duration of local anesthesia. Most commonly lignocaine with adrenaline is used in various concentrations. Systemically adrenaline like drugs can cause a number of cardiovascular disturbances while most are short lived, permanent injury or even death may follow in drug induced ventricular fibrillation, myocardial infarction or cerebro-vascular accidents. This study compared the efficacy and cardiovascular effects with the use of 2% lignocaine with two different concentrations.
Forty patients underwent extractions of mandibular bilateral teeth using 2% lignocaine with two different concentrations - one with 1:80000 and the other with 1:200000.
There was no significant difference in the efficacy and duration with the 2% lignocaine with 2 different concentrations. 2% lignocaine with 1:80000 adrenaline concentration has significantly increased the heart rate and blood pressure especially systolic compared with the lignocaine with 1:200000.
Though 2% lignocaine with 1:80000 is widely used in India, 1:200000 adrenaline concentrations do not much affect the cardiovascular parameters. So it is recommended to use 2% lignocaine with 1:200000 for cardiac patients.
在牙科手术中,局部麻醉剂更常用于在骨骼和软组织手术干预期间实现无痛操作。有许多局部麻醉剂可供选择,同时还有多种血管收缩剂,可提高临床疗效和局部麻醉的持续时间。最常用的是不同浓度的利多卡因加肾上腺素。像肾上腺素这样的全身性药物会导致许多心血管紊乱,虽然大多数是短暂的,但药物诱发的心室颤动、心肌梗死或脑血管意外可能会导致永久性损伤甚至死亡。本研究比较了两种不同浓度的2%利多卡因的疗效和心血管效应。
40例患者使用两种不同浓度的2%利多卡因进行下颌双侧牙齿拔除,一种浓度为1:80000,另一种浓度为1:200000。
两种不同浓度的2%利多卡因在疗效和持续时间上没有显著差异。与1:200000的利多卡因相比,1:80000肾上腺素浓度的2%利多卡因显著提高了心率和血压,尤其是收缩压。
虽然1:80000的2%利多卡因在印度广泛使用,但1:200000肾上腺素浓度对心血管参数影响不大。因此,建议心脏病患者使用1:200000的2%利多卡因。