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局部麻醉剂在微型种植体植入过程中疼痛感知方面的疗效:对照临床试验的系统评价

Efficacy of Topical Anesthetics in Pain Perception During Mini-implant Insertion: Systematic Review of Controlled Clinical Trials.

作者信息

Lacerda-Santos Rogério, Bravin Thaísa Caliman, Carvalho Fabíola Galbiatti, Pithon Matheus Melo, Lima Antonia Bárbara Leite, da Silva Karina Gomes

机构信息

Department of Orthodontics and Pediatric Dentistry, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, Brazil.

Department of Orthodontics, State University of the Southwest of Bahia, Jéquie, Bahia, Brazil.

出版信息

Anesth Prog. 2019 Fall;66(3):119-132. doi: 10.2344/anpr-66-01-11.

Abstract

The focus of this systematic review is to assess the efficacy of several commonly utilized anesthetic techniques for reducing pain during the placement of mini-implants. An electronic search was conducted in the databases PubMed, Scopus, Web of Science, Medline Complete, Cochrane, Trials Central, and Clinical Trials, without limitations on year of publication or language. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) were considered. Two reviewers of articles independently evaluated the results of the study, and the risk of bias of included articles was evaluated according to the Cochrane Scale. Five eligible articles (3 RCTs and 2 CCTs) were included. The quality of the body of evidence was considered low because of the presence of multiple methodological problems, high risks of bias, and heterogeneity in the articles included. There was evidence that the efficacy of the analgesia of infiltrative anesthesia was most effective in promoting a lower perception of pain compared to the other anesthetic agents, although an injection was required. Among topical anesthetics, compound topical anesthetics with 20% lidocaine were more effective than compound topical anesthetics with low lidocaine concentration and conventional topical anesthetic with 20% benzocaine.

摘要

本系统评价的重点是评估几种常用麻醉技术在减少微型种植体植入过程中疼痛方面的疗效。在PubMed、Scopus、Web of Science、Medline Complete、Cochrane、Trials Central和Clinical Trials数据库中进行了电子检索,对发表年份和语言没有限制。纳入随机对照试验(RCT)和对照临床试验(CCT)。两名文章评审员独立评估研究结果,并根据Cochrane量表评估纳入文章的偏倚风险。纳入了五篇符合条件的文章(3篇RCT和2篇CCT)。由于存在多个方法学问题、高偏倚风险以及所纳入文章的异质性,证据体质量被认为较低。有证据表明,浸润麻醉的镇痛效果在促进降低疼痛感知方面比其他麻醉剂最有效,尽管需要注射。在局部麻醉剂中,含20%利多卡因的复方局部麻醉剂比低利多卡因浓度的复方局部麻醉剂和含20%苯佐卡因的传统局部麻醉剂更有效。

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