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4% 阿替卡因和 2% 利多卡因用于下颌乳磨牙拔除和牙髓切断术的麻醉效果:一项等效性平行前瞻性随机对照试验。

Anaesthetic efficacy of 4% articaine and 2% lidocaine for extraction and pulpotomy of mandibular primary molars: an equivalence parallel prospective randomized controlled trial.

机构信息

Department of Paediatric Dentistry, Leeds School of Dentistry, University of Leeds, Leeds, UK.

Faculty of Dentistry, National University of Singapore, Singapore, Singapore.

出版信息

Int J Paediatr Dent. 2018 May;28(3):335-344. doi: 10.1111/ipd.12361. Epub 2018 Mar 24.

DOI:10.1111/ipd.12361
PMID:29573375
Abstract

AIM

To compare the anaesthetic efficacy for pain and behaviour during treatment with mandibular infiltration using 4% articaine (BI) with inferior dental nerve clock (IDNB) using 2% lidocaine for extraction or pulp therapy in mandibular primary molars.

DESIGN

This was equivalence parallel prospective RCT. A total of 98 children aged 5-9 years old were randomly assigned into two groups: BI supplemented by buccal intrapapillary infiltration with 4% articaine; IDNB with 2% lidocaine supplemented with long buccal infiltration. Behaviour during the injection and treatment procedures was assessed using Wong-Baker Facial Rating Scale (W-BFRS), Visual Analogue Scale (VAS), and Frankl Behaviour Rating Scale (FBRS).

RESULTS

During the injection phase, the absolute differences in success rates between the two techniques were 0.06 (95% CI: -0.11 to 0.23) for VAS and -0.08 (95% CI: -0.19 to 0.03) for the behaviour of the child (FBRS). FBRS results showed the equivalence of the two, whereas the VAS results showed nonequivalence with the 95% confidence intervals slightly exceeding the equivalence margin (±0.20). W-BFRS success rates were 63.3% for both. During the treatment, VAS results showed similar success rates, demonstrating equivalence between the two as did the results for FBRS.

CONCLUSION

The results suggested equivalence in success rates for both anaesthetic techniques during treatment.

摘要

目的

比较使用 4%阿替卡因(BI)行下颌浸润麻醉与使用 2%利多卡因行下颌神经阻滞麻醉(IDNB)用于下颌乳磨牙拔牙或牙髓治疗时,在缓解疼痛和行为方面的麻醉效果。

设计

这是一项等效性平行前瞻性 RCT 研究。共有 98 名 5-9 岁的儿童被随机分为两组:BI 辅以颊侧髓内浸润 4%阿替卡因;IDNB 辅以长颊侧浸润 2%利多卡因。使用 Wong-Baker 面部疼痛评估量表(W-BFRS)、视觉模拟评分(VAS)和 Frankl 行为评定量表(FBRS)评估注射和治疗过程中的行为。

结果

在注射阶段,两种技术成功率的绝对差异分别为 VAS 为 0.06(95%置信区间:-0.11 至 0.23),儿童行为(FBRS)为-0.08(95%置信区间:-0.19 至 0.03)。FBRS 结果表明两种方法等效,而 VAS 结果显示不等效,95%置信区间略超过等效边界(±0.20)。W-BFRS 的成功率均为 63.3%。在治疗过程中,VAS 结果显示相似的成功率,FBRS 结果也表明两种方法等效。

结论

结果表明,两种麻醉技术在治疗过程中的成功率相当。

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