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在下颌第三磨牙手术中,4%阿替卡因单支与双支药筒向磨牙后区浸润注射的比较。

Double versus single cartridge of 4% articaine infiltration into the retro-molar area for lower third molar surgery.

作者信息

Sawang Kamonpun, Chaiyasamut Teeranut, Kiattavornchareon Sirichai, Pairuchvej Verasak, Bhattarai Bishwa Prakash, Wongsirichat Natthamet

机构信息

Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.

出版信息

J Dent Anesth Pain Med. 2017 Jun;17(2):121-127. doi: 10.17245/jdapm.2017.17.2.121. Epub 2017 Jun 29.

Abstract

BACKGROUND

There are no studies regarding 4% articaine infiltration injection into the retro-molar area for an impacted lower third molar (LITM) surgery. This study aimed to evaluate the efficacy of infiltration using 1.7 ml (single cartridge: SC) of 4% articaine versus 3.4 ml (double cartridges: DC) of 4% articaine with 1:100,000 epinephrine in LITM surgery.

METHOD

This study involved 30 healthy patients with symmetrical LITM. The patients were assigned to receive either a DC or SC of 4% articaine with 1:100,000 epinephrine as a local anesthetic for each operation. Onset, duration, profoundness, need for additional anesthetic administration, total volume of anesthetic used, vitality of the tooth, and pain score during operation were recorded.

RESULTS

The DC of 4 % articaine had a significantly higher success rate (83.3%) than did the SC (53.3%; P < 0.05). The duration of soft tissue anesthesia was longer in the DC group. The intra-operative pain was higher in the SC group with a significant (P < 0.05) requirement for a supplementary local anesthetic.

CONCLUSION

We concluded that using DC for the infiltration injection had a higher success rate, longer duration of anesthesia, less intra-operative pain, and a lower amount of additional anesthesia than SC in the surgical removal of LITM. We recommend that a DC of 4% articaine and a 1:100,000 epinephrine infiltration in the retro-molar region can be an alternative anesthetic for LITM surgery.

摘要

背景

目前尚无关于在低位阻生第三磨牙(LITM)手术中向磨牙后区注射4%阿替卡因浸润麻醉的研究。本研究旨在评估在LITM手术中,使用1.7毫升(单支药筒:SC)4%阿替卡因与3.4毫升(双支药筒:DC)含1:100,000肾上腺素的4%阿替卡因进行浸润麻醉的效果。

方法

本研究纳入30例双侧低位阻生第三磨牙对称的健康患者。每次手术时,患者被分配接受含1:100,000肾上腺素的4%阿替卡因单支药筒或双支药筒作为局部麻醉。记录起效时间、持续时间、麻醉深度、追加麻醉药物的需求、所用麻醉药物的总量、牙齿活力以及术中疼痛评分。

结果

4%阿替卡因双支药筒组的成功率(83.3%)显著高于单支药筒组(53.3%;P < 0.05)。双支药筒组软组织麻醉持续时间更长。单支药筒组术中疼痛程度更高,追加局部麻醉药物的需求具有显著性差异(P < 0.05)。

结论

我们得出结论,在LITM手术中,与单支药筒相比,使用双支药筒进行浸润注射成功率更高、麻醉持续时间更长、术中疼痛更少且追加麻醉量更低。我们建议,在磨牙后区注射含1:100,000肾上腺素的4%阿替卡因双支药筒可作为LITM手术的一种替代麻醉方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c2/5564145/78533d70fbfb/jdapm-17-121-g001.jpg

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