含肾上腺素的 4%丙胺卡因/2%利多卡因用于下齿槽神经阻滞的麻醉效果：一项前瞻性、随机、双盲研究。

Anesthetic Efficacy of a Combination of 4% Prilocaine/2% Lidocaine with Epinephrine for the Inferior Alveolar Nerve Block: A Prospective, Randomized, Double-blind Study.

机构信息

Private Practice Limited to Endodontics, Madison, Mississippi.

Division of Endodontics, The Ohio State University, Columbus, Ohio.

出版信息

J Endod. 2018 May;44(5):683-688. doi: 10.1016/j.joen.2018.01.004. Epub 2018 Feb 17.

DOI:10.1016/j.joen.2018.01.004

PMID:29459150

Abstract

INTRODUCTION

Prilocaine plain has a high pH and concentration (4%), which could decrease the pain of injection and increase success. The purpose of this study was to compare pain associated with anesthetic solution deposition and the degree of pulpal anesthesia obtained with the combination of prilocaine and lidocaine versus a lidocaine and lidocaine combination when used for inferior alveolar nerve blocks (IANBs).

METHODS

One hundred eighteen asymptomatic subjects were randomly given a combination of 1 cartridge of 4% prilocaine plain plus 1 cartridge of 2% lidocaine with 1:100,000 epinephrine or a combination of 2 cartridges of 2% lidocaine with 1:100,000 epinephrine for the IANB at 2 separate appointments. Subjects rated the pain associated with anesthetic solution deposition of injection. Mandibular teeth were tested with an electric pulp tester every 4 minutes for 57 minutes. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 17 minutes and the 80 reading was continuously sustained for 57 minutes. Comparisons for anesthetic success were analyzed using the exact McNemar test, and pain ratings associated with anesthetic solution deposition were analyzed using multiple Wilcoxon matched pairs signed rank tests; both were adjusted using the step-down Bonferroni method of Holm.

RESULTS

Four percent prilocaine plain was significantly less painful upon anesthetic solution deposition. Pulpal anesthetic success was not significantly different between the 2 combinations.

CONCLUSIONS

The combination of 4% prilocaine plain plus 2% lidocaine with 1:100,000 epinephrine did not increase pulpal anesthetic success for IANBs compared with a combination of 2 cartridges of 2% lidocaine with 1:100,000 epinephrine. Pain associated with anesthetic solution deposition from the first cartridge of 4% prilocaine plain was significantly less when compared with the first cartridge of 2% lidocaine with 1:100,000 epinephrine.

摘要

简介

盐酸丙胺卡因呈高 pH 值和高浓度（4%），这可以降低注射疼痛并提高成功率。本研究的目的是比较使用盐酸丙胺卡因和利多卡因与利多卡因和利多卡因混合制剂进行下牙槽神经阻滞（IANB）时，麻醉溶液沉积相关疼痛和牙髓麻醉程度。

方法

118 名无症状受试者随机在 2 次就诊时分别接受 1 支 4%盐酸丙胺卡因加 1 支 2%利多卡因加 1:100000 肾上腺素或 2 支 2%利多卡因加 1:100000 肾上腺素的组合用于 IANB。受试者对注射时麻醉溶液沉积引起的疼痛进行评分。每 4 分钟使用牙髓电活力计测试下颌牙齿，共 57 分钟。当连续 2 次 80 次读数在 17 分钟内获得且 80 次读数持续 57 分钟时，认为麻醉成功。使用精确 McNemar 检验分析麻醉成功的比较，使用多个 Wilcoxon 匹配对签名秩检验分析麻醉溶液沉积相关疼痛评分；两者均使用 Holm 逐步降序 Bonferroni 方法进行调整。