Dandriyal R, Pachauri S, Giri K Y, Rastogi S, Prasad N I B, Agarwal S, Singh H P
Department of Oral & Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, UP, India.
Br J Oral Maxillofac Surg. 2017 Jan;55(1):67-70. doi: 10.1016/j.bjoms.2016.09.011. Epub 2016 Oct 3.
Our aim was to evaluate the efficacy of clonidine with lidocaine as a local anaesthetic agent for inferior alveolar mandibular nerve blocks for dental extraction. We studied 200 patients who required extraction of mandibular teeth and divided them into two groups of 100 each, the first of which was given lidocaine and adrenaline (12.5μg/ml) and the second lidocaine and clonidine (15μg/ml). Cardiovascular vascular variables (blood pressure, heart rate, and mean arterial pressure) were assessed before, during, and after extraction, and postoperative pain was measured on a visual analogue scale. There was a significant reduction in systolic blood pressure (p=0.0001) and heart rate (p=0.000) after injection of clonidine. However, they both increased after injections of lidocaine plus adrenaline, and there was a significant reduction in pain at four hours postoperatively with clonidine (p=0.000). Our results showed that anaesthesia with lidocaine and clonidine decreases systolic blood pressure and heart rate 10minutes after injection for extraction of lower mandibular teeth. We suggest that patients who have local anaesthetic with lidocaine and clonidine are at minimal cardiovascular risk and there is no difference in the onset of anaesthesia.
我们的目的是评估可乐定与利多卡因作为局部麻醉剂用于下颌牙槽神经阻滞拔牙的疗效。我们研究了200例需要拔除下颌牙的患者，并将他们分为两组，每组100例，第一组给予利多卡因和肾上腺素（12.5μg/ml），第二组给予利多卡因和可乐定（15μg/ml）。在拔牙前、拔牙期间和拔牙后评估心血管变量（血压、心率和平均动脉压），并使用视觉模拟量表测量术后疼痛。注射可乐定后收缩压（p=0.0001）和心率（p=0.000）显著降低。然而，注射利多卡因加肾上腺素后两者均升高，可乐定组术后4小时疼痛显著减轻（p=0.000）。我们的结果表明，利多卡因和可乐定麻醉在下颌牙拔除注射后10分钟可降低收缩压和心率。我们认为，接受利多卡因和可乐定局部麻醉的患者心血管风险最小，麻醉起效无差异。
