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可乐定和肾上腺素与利多卡因在上颌浸润麻醉拔牙术中的比较效果

Comparative Effects of Clonidine and Adrenaline with Lignocaine during Maxillary Infiltration Anaesthesia for Dental Extraction.

作者信息

Jimson Samson, Ranjani Sree S, Lenka Sthithaprajna, Jimson Sudha

机构信息

Professor and Head, Department of Oral & Maxillofacial Surgery, Tagore Dental College & Hospital, Chennai Research Scholar, Bharath University , Chennai, India .

Assistant Professor, Department of Anesthesiology, Tagore Medical College & Hospital , Chennai, India .

出版信息

J Clin Diagn Res. 2015 May;9(5):ZC85-8. doi: 10.7860/JCDR/2015/11066.5968. Epub 2015 May 1.

Abstract

INTRODUCTION

Lignocaine is a commonly used local anaesthetic in dental practice. Many practitioners use adrenaline (epinephrine) as additive with lignocaine, and some have used clonidine, instead of adrenaline. Both having benefits and limitations.

AIMS

Hence a study was undertaken in our department to evaluate the advantages and disadvantages of using (plain lidocaine local anaesthetic) versus (lidocaine with adrenaline as additive) versus (lidocaine with clonidine as additive).

STUDY DESIGN

Randomised, prospective, double blind study.

MATERIALS AND METHODS

Seventy five patients requiring extraction of maxillary molar teeth who fall under ASA I category were included and randomly divided into group - I (n=25) (Lignocaine), group - II (n=25) (Lignocaine ± Adrenaline) and group - III (n=25) (Lignocaine ± Clonidine). The observations recorded were, time of onset of anaesthesia, hemodynamic parameters, blood loss during procedure and duration of post operative analgesia.

STATISTICAL ANALYSIS

The statistical analysis was carried out using SPSS 16 software.

RESULTS

A statistically significant difference was seen in blood loss, being higher in group I and duration of anaesthesia, being shortest in group I. There was no statistical difference between the three groups amongst other parameters.

CONCLUSION

Adrenaline at 10 μg/ml and clonidine at 15 μg/ml can be safely used as additives with lignocaine, in maxillary infiltration anaesthesia for dental extraction; with addition of either of these two drugs, having an equal advantage over use of plain lignocaine; in terms of lower blood loss and longer duration of anaesthesia; but, with no difference in the onset of anaesthesia and with no significant hemodynamic changes.

摘要

引言

利多卡因是牙科实践中常用的局部麻醉剂。许多从业者将肾上腺素用作利多卡因的添加剂,也有一些人使用可乐定替代肾上腺素。两者都有优点和局限性。

目的

因此,我们科室进行了一项研究,以评估使用(单纯利多卡因局部麻醉剂)与(添加肾上腺素的利多卡因)与(添加可乐定的利多卡因)的优缺点。

研究设计

随机、前瞻性、双盲研究。

材料与方法

纳入75例需要拔除上颌磨牙且属于ASA I级的患者,并随机分为I组(n = 25)(利多卡因)、II组(n = 25)(利多卡因±肾上腺素)和III组(n = 25)(利多卡因±可乐定)。记录的观察指标包括麻醉起效时间、血流动力学参数、手术过程中的失血量和术后镇痛持续时间。

统计分析

使用SPSS 16软件进行统计分析。

结果

失血量存在统计学显著差异,I组较高;麻醉持续时间也有显著差异,I组最短。三组在其他参数方面无统计学差异。

结论

10μg/ml的肾上腺素和15μg/ml的可乐定可安全地用作利多卡因的添加剂,用于上颌浸润麻醉拔牙;添加这两种药物中的任何一种,与单纯使用利多卡因相比具有同等优势;在减少失血量和延长麻醉持续时间方面;但在麻醉起效时间上无差异,且无显著的血流动力学变化。

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