Flanagan Dennis F
Windham Dental Group, Willimantic, CT, USA.
Local Reg Anesth. 2015 Dec 18;9:1-6. doi: 10.2147/LRA.S94647. eCollection 2016.
Four percent articaine local anesthetic has been successfully used to attain local anesthesia for dental procedures. Mandibular block anesthesia may consume longer time to attain and have a higher failure of local anesthesia compared to infiltration. Mandibular facial infiltration has been reported to successfully attain effective local anesthesia for dental procedures. This study involved only several tooth sites and found that 1.8 cc of 4% articaine facial infiltration in the mandible may be effective when the facial mandibular cortex is <2.0-3.0 mm. A waiting time of 5-10 minutes may be required for effective anesthesia. An additional 1.8 cc of dose may be required to attain anesthesia if an initial 1.8 cc of dose fails. The need for additional anesthetic may be predicted by a measurement of the facial cortex using cone beam computerized tomography. A study of mandibular sites is needed to delineate the anatomical dimensions, density of cortical bone, and apical neural location for ensuring successful local anesthetic infiltration.
4%的阿替卡因局部麻醉剂已成功用于牙科手术的局部麻醉。与浸润麻醉相比,下颌阻滞麻醉可能需要更长时间才能实现,且局部麻醉失败率更高。据报道,下颌面部浸润麻醉已成功用于牙科手术的有效局部麻醉。本研究仅涉及几个牙位,发现当下颌面部皮质厚度<2.0 - 3.0 mm时,1.8 cc的4%阿替卡因在下颌面部浸润可能有效。有效麻醉可能需要5 - 10分钟的等待时间。如果初始剂量1.8 cc未能达到麻醉效果,可能需要额外增加1.8 cc剂量才能达到麻醉效果。可通过锥形束计算机断层扫描测量面部皮质来预测是否需要额外的麻醉剂。需要对下颌部位进行研究,以确定解剖尺寸、皮质骨密度和根尖神经位置,以确保局部麻醉浸润成功。