韧带内麻醉在上颌第一磨牙拔除术中的疗效
Efficacy of intraligamentary anesthesia in maxillary first molar extraction.
作者信息
Ryalat Soukaina Tawfiq, Al-Shayyab Mohammad H, Amin Wala, AlRyalat Saif Aldeen, Al-Ryalat Nosaiba, Sawair Faleh
机构信息
Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontology, Faculty of Dentistry, University of Jordan, Amman, Jordan,
Department of Prosthodontics, Faculty of Dentistry, University of Jordan, Amman, Jordan.
出版信息
J Pain Res. 2018 Sep 12;11:1829-1833. doi: 10.2147/JPR.S170324. eCollection 2018.
INTRODUCTION
Infiltration anesthesia (IA) is the method to anaesthetize maxillary teeth successfully. In contrast, intraligamentary anesthesia (ILA) has been used as supplementary anesthesia during tooth extraction, particularly when regional block anesthesia has failed. In this study, we compare the efficacy of and patient satisfaction with ILA vs IA when extracting maxillary first molar teeth.
METHODS
Forty patients were enrolled in this study and 80 maxillary first molars extracted. All patients served as their own control, with ILA as the experimental side and IA as the control side. The two techniques were compared for efficacy using a visual analog scale (VAS) and patient satisfaction compared using a verbal rating scale (VRS).
RESULTS
The mean VAS pain score for extraction using ILA was lower than that for IA (20.30±3.18 and 13.93±1.95 mm, respectively; <0.001). For injection pain, the mean VAS pain score in the ILA side was higher than the IA side (42.28±4.51 and 31.73±3.1 mm, respectively; <0.001). VRS results showed a higher number of patients who felt that pain during ILA was greater than expected compared with IA.
CONCLUSION
IA appears less painful during injection compared with ILA, and provides sufficient pain relief during extraction. However, ILA can be used when IA fails to achieve the desired pain suppression, as it provides higher extraction-pain relief.
引言
浸润麻醉（IA）是成功麻醉上颌牙齿的方法。相比之下，牙周膜内麻醉（ILA）一直被用作拔牙时的辅助麻醉，特别是在区域阻滞麻醉失败时。在本研究中，我们比较了拔除上颌第一磨牙时ILA与IA的疗效及患者满意度。
方法
本研究纳入40例患者，拔除80颗上颌第一磨牙。所有患者均以自身作为对照，ILA侧为实验组，IA侧为对照组。使用视觉模拟量表（VAS）比较两种技术的疗效，使用言语评定量表（VRS）比较患者满意度。
结果
使用ILA拔牙的平均VAS疼痛评分低于使用IA的评分（分别为20.30±3.18和13.93±1.95mm；<0.001）。对于注射疼痛，ILA侧的平均VAS疼痛评分高于IA侧（分别为42.28±4.51和31.73±3.1mm；<0.001）。VRS结果显示，与IA相比，更多患者感觉ILA期间的疼痛大于预期。
结论
与ILA相比，IA在注射时疼痛似乎较轻，并且在拔牙期间提供足够的疼痛缓解。然而，当IA未能实现所需的疼痛抑制时，可以使用ILA，因为它能提供更高的拔牙疼痛缓解效果。
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