Kishimoto Toshiyuki, Matsuura Nobuyuki, Kasahara Masataka, Ichinohe Tatsuya
Assistant Professor, Department of Dental Anesthesiology, Tokyo Dental College, Mihama-ku, Chiba-shi, Japan.
Senior Assistant Professor, Department of Dental Anesthesiology, Tokyo Dental College, Mihama-ku, Chiba-shi, Japan.
Anesth Prog. 2017 Summer;64(2):73-79. doi: 10.2344/anpr-64-02-05.
We analyzed trigeminal somatosensory evoked potentials (TSEP) to the alveolar mucosa to investigate the efficacy of an amide local anesthetic, 2% lidocaine hydrochloride with 12.5 μg/mL epinephrine (Lido treatment) as a topical anesthetic. Eighteen consenting healthy adult volunteers were enrolled. A volume of 0.06 mL of Lido, 0.06 g of 20% benzocaine, or 0.06 mL of physiological saline (control) was instilled onto a hemostatic adhesive patch, which was then applied to the alveolar mucosa at the maxillary right canine for 5 minutes. An electrical stimulus approximately 5 times that of the sensory threshold was applied using a surface stimulation electrode. The trigeminal somatosensory evoked potential was recorded immediately, 5 minutes, and 10 minutes after removal of the patch. Positive P125 and P310 peaks and negative N100 and N340 peaks were observed as a result of the electrical stimulation. A significant decrease in the percentage change in amplitude of N100-P125 was observed in the Lido treatment immediately, 5 minutes, and 10 minutes after patch removal. In the Lido treatment, trigeminal somatosensory evoked potential amplitude at N100-P125 decreased significantly, suggesting that topical anesthesia produced by an amide local anesthetic may have a topical anesthetic effect as potent as that produced by an ester local anesthetic.
我们分析了牙槽黏膜的三叉神经体感诱发电位(TSEP),以研究酰胺类局部麻醉药2%盐酸利多卡因加12.5μg/mL肾上腺素(利多治疗)作为局部麻醉剂的效果。招募了18名同意参与的健康成年志愿者。将0.06 mL利多、0.06 g 20%苯佐卡因或0.06 mL生理盐水(对照)滴注到止血贴剂上,然后将其应用于右上颌尖牙处的牙槽黏膜5分钟。使用表面刺激电极施加约为感觉阈值5倍的电刺激。在去除贴剂后立即、5分钟和10分钟记录三叉神经体感诱发电位。电刺激结果观察到正向P125和P310峰以及负向N100和N340峰。在利多治疗中,去除贴剂后立即、5分钟和10分钟时,N100 - P125振幅的百分比变化显著降低。在利多治疗中,N100 - P125处的三叉神经体感诱发电位振幅显著降低,表明酰胺类局部麻醉药产生的局部麻醉可能具有与酯类局部麻醉药产生的局部麻醉效果一样强的效果。