J Oral Facial Pain Headache. 2017;31(2):124-128. doi: 10.11607/ofph.1642.
To compare the anesthetic efficacy of 1.8 mL of 2% lidocaine with 1:200,000 epinephrine, 4% articaine with 1:100,000 epinephrine, and 0.5% bupivacaine with 1:200,000 epinephrine on producing inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis.
A total of 91 adult patients who were actively experiencing mandibular molar pain were involved in this study. The patients were randomly divided into three groups on the basis of the anesthetic solution used. The first group received IANB with 1.8 mL of 2% lidocaine with 1:200,000 epinephrine, the second group received IANB with 4% articaine with 1:100,000 epinephrine, and the third group received IANB with 0.5% bupivacaine with 1:200,000 epinephrine. After 15 minutes of IANB, conventional endodontic access preparation was started. The pain during the treatment was noted on a Heft-Parker visual analog scale (HP VAS). The primary outcome measure was anesthetic success, and anesthesia was considered successful if the patient reported no pain or weak/mild pain (HP VAS score < 55 mm) during endodontic treatment (pulp access and canal preparation procedures). The data were analyzed with one-way analysis of variance and chi-square test.
The anesthetic success rates of 2% lidocaine, 4% articaine, and 0.5% bupivacaine were 23%, 33%, and 17%, respectively. The differences were statistically insignificant (P > .05).
The 2% lidocaine solution used for IANB had similar success rates when compared with 4% articaine and 0.5% bupivacaine.
比较 1.8 毫升 2%利多卡因加 1:200000 肾上腺素、4%阿替卡因加 1:100000 肾上腺素和 0.5%布比卡因加 1:200000 肾上腺素在患有症状性不可复性牙髓炎的患者中产生下牙槽神经阻滞（IANB）的麻醉效果。
本研究共纳入 91 名主动经历下颌磨牙疼痛的成年患者。根据所用麻醉剂溶液将患者随机分为三组。第一组接受 1.8 毫升 2%利多卡因加 1:200000 肾上腺素的 IANB，第二组接受 4%阿替卡因加 1:100000 肾上腺素的 IANB，第三组接受 0.5%布比卡因加 1:200000 肾上腺素的 IANB。IANB 后 15 分钟开始常规根管预备。治疗过程中的疼痛采用 Heft-Parker 视觉模拟量表（HP VAS）记录。主要结局指标为麻醉成功率，如果患者在根管治疗（牙髓进入和根管预备过程）期间报告无疼痛或弱/轻度疼痛（HP VAS 评分<55mm），则认为麻醉成功。采用单因素方差分析和卡方检验进行数据分析。
2%利多卡因、4%阿替卡因和 0.5%布比卡因的麻醉成功率分别为 23%、33%和 17%。差异无统计学意义（P>0.05）。
与 4%阿替卡因和 0.5%布比卡因相比，2%利多卡因溶液用于 IANB 的成功率相似。
