Saralaya Shruthi, Adirajaiah Sahana B, Anehosur Venkatesh
1Department of Oral and Maxillofacial Surgery & Department of Craniofacial Surgery and Research Centre, SDM College of Dental Sciences, Dharwad, Karnataka 580009 India.
2Department of Oral and Maxillofacial Surgery, Coorg Institute of Dental Sciences, Virajpet, Madikeri, Karnataka 571218 India.
J Maxillofac Oral Surg. 2019 Sep;18(3):405-411. doi: 10.1007/s12663-018-1109-0. Epub 2018 Apr 3.
Articaine entered clinical use in 1976; however, evidence basis for articaine's reputation is not entirely clear. The aim of the study is to compare and analyze 4% articaine with 1:100,000 epinephrine and 2% lignocaine with 1:100,000 epinephrine in patients operated for mandibular third molar impaction with respect to efficacy and safety, time of onset and duration of anesthesia and duration of postoperative analgesia.
The study was done on fifty patients requiring surgical extraction of mandibular third molar; randomly divided into two groups of 25 each, receiving 4% articaine hydrochloride with 1:100,000 epinephrine and 2% lignocaine hydrochloride with 1:100,000 epinephrine. Difficulty index for extraction, volume, onset and duration of anesthesia and duration of postoperative analgesia were recorded. Pain was assessed using Heft-Parker VAS. The data were analyzed using appropriate statistical analysis.
The mean onset time for articaine and lignocaine is 3.16 ± 0.55 and 3.2 ± 0.48 min, respectively. Articaine group experienced statistically significant longer period of analgesia and duration of action 289.04 ± 40 and 361.88 ± 40 min, respectively, as compared to lignocaine which is 144.2 ± 12 and 197.44 ± 25 min, respectively. No statistical difference between the two groups with regard to pain experience.
4% Articaine is more potent and has longer duration of action with better postoperative analgesia and could be considered as an alternative to lignocaine in clinical practice. With management of postoperative pain being the critical component of patient care, clinical trials are required to develop long acting local anesthetic with increased postoperative analgesia effect.
阿替卡因于1976年进入临床应用；然而，阿替卡因声誉的证据基础并不完全清楚。本研究的目的是比较和分析4%阿替卡因加1:100,000肾上腺素和2%利多卡因加1:100,000肾上腺素在下颌第三磨牙阻生手术患者中的疗效和安全性、麻醉起效时间和持续时间以及术后镇痛持续时间。
对50例需要手术拔除下颌第三磨牙的患者进行研究；随机分为两组，每组25例，分别接受4%盐酸阿替卡因加1:100,000肾上腺素和2%盐酸利多卡因加1:100,000肾上腺素。记录拔牙难度指数、麻醉体积、起效和持续时间以及术后镇痛持续时间。使用赫夫特-帕克视觉模拟评分法评估疼痛。采用适当的统计分析方法对数据进行分析。
阿替卡因和利多卡因的平均起效时间分别为3.16±0.55分钟和3.2±0.48分钟。与利多卡因组分别为144.2±12分钟和197.44±25分钟相比，阿替卡因组的镇痛时间和作用持续时间在统计学上显著更长，分别为289.04±40分钟和361.88±40分钟。两组在疼痛体验方面无统计学差异。
4%阿替卡因效力更强，作用持续时间更长，术后镇痛效果更好，在临床实践中可被视为利多卡因的替代品。由于术后疼痛管理是患者护理的关键组成部分，需要进行临床试验以开发具有增强术后镇痛效果的长效局部麻醉剂。
