Deo Saroj Prasad
Department of Oral and Maxillofacial Surgery, National Medical College, Birgunj, Nepal.
Ann Maxillofac Surg. 2016 Jul-Dec;6(2):260-266. doi: 10.4103/2231-0746.200341.
Dexamethasone has been frequently used in oral surgical procedure and accepted by oral and maxillofacial surgeon community worldwide. However, this is the first clinical trial that used dexamethasone as adjuvant with lignocaine in dental nerve block (DNB).
The purpose of this double-blind, randomized control trial (RCT) was to compare the effect of dexamethasone with normal saline (NS) in a lignocaine DNB.
This prospective, double-blind, RCT was carried out after obtaining approval from the Institutional Ethical Committee.
In forty patients, the present placebo-controlled clinical trial was conducted; allocated randomly into two groups: study group (SG) or control group (CG). The single-dose submucosal dexamethasone or NS injection was administered immediately after 2% lignocaine with epinephrine 1:2,00,000 nerves block during mandibular third molar surgery (TMS). Visual analog scale score, number, and exact time nonsteroidal anti-inflammatory drugs were administered were used to measure postoperative analgesia in 2 and 7 days.
All the data were entered into the Spreadsheet (Excel, Microsoft) and Chi-square test, Mann-Whitney U-test, Student's paired and unpaired -test, and Fisher exact test were used.
This study found maximum duration of DNB in SG was 248.88 min and in CG was 175.44 min, whereas minimum duration in SG was 197 min and in CG was 140.78 min.
Dexamethasone prolongs the action of lignocaine 2% in DNB for TMS.
地塞米松已在口腔外科手术中频繁使用,并被全球口腔颌面外科医生群体所接受。然而,这是第一项将地塞米松与利多卡因联合用于牙神经阻滞(DNB)的临床试验。
这项双盲、随机对照试验(RCT)的目的是比较地塞米松与生理盐水(NS)在利多卡因牙神经阻滞中的效果。
这项前瞻性、双盲、RCT在获得机构伦理委员会批准后进行。
在40名患者中进行了本安慰剂对照临床试验;随机分为两组:研究组(SG)或对照组(CG)。在下颌第三磨牙手术(TMS)期间,在2%含肾上腺素1:200,000的利多卡因神经阻滞之后,立即单剂量黏膜下注射地塞米松或生理盐水。使用视觉模拟量表评分、非甾体抗炎药的使用数量和确切时间来测量术后2天和7天的镇痛效果。
所有数据录入电子表格(Excel,微软),并使用卡方检验、曼-惠特尼U检验、学生配对和非配对t检验以及费舍尔精确检验。
本研究发现,研究组牙神经阻滞的最长持续时间为248.88分钟,对照组为175.44分钟,而研究组的最短持续时间为197分钟,对照组为140.78分钟。
地塞米松可延长2%利多卡因在下颌第三磨牙手术牙神经阻滞中的作用时间。