Faculty of Dentistry, Oral Surgery Department, Ege University, Bornova, Izmir, Turkey.
Faculty of Dentistry, Oral Surgery Department, Ege University, Izmir, Turkey.
Clin Oral Investig. 2020 Oct;24(10):3539-3546. doi: 10.1007/s00784-020-03224-5. Epub 2020 Feb 17.
The aim of this study was to compare the anesthetic efficacy, the duration of anesthesia, and the postoperative analgesia of lidocaine and bupivacaine and to determine any difference in hemodynamic parameters in patients who required impacted third molar removal.
Thirty-eight patients between the ages of 18 and 40, with no systemic disease, were included in the study, with an indication of impacted lower third molar extraction. One of two local anesthetic agents (Marcaine and Jetokain Simplex) was randomly selected for tooth extractions. The parameters evaluated were the onset of anesthetic agent action, the duration of operation, the duration of postoperative analgesia, and postoperative visual analog scale scores. Hemodynamic parameters were observed and evaluated preoperatively and during the operation. All data were evaluated statistically.
When the time of anesthesia onset was analyzed according to both anesthetic solutions, the difference was in favor of lidocaine (p = 0.01). The duration of action was longer in the bupivacaine group than in the lidocaine group (p = 0.00002). VAS values for the pain obtained during injection were lower in the lidocaine group (p = 0.009).However, according to the results of our study, the postoperative analgesic efficacy of bupivacaine is similar to that of lidocaine (p = 0.087).
After evaluation of these results, we can recommend the use of lidocaine and bupivacaine safely in dentistry practice. But long-duration effect of bupivacaine and the rapid effect of lidocaine may make lidocaine more preferable.
It is important to determine the clinically effective and safe anesthetic solution.
本研究旨在比较利多卡因和布比卡因的麻醉效果、麻醉持续时间和术后镇痛效果，并确定需要拔除阻生第三磨牙的患者的血流动力学参数是否存在差异。
本研究纳入了 38 名年龄在 18 至 40 岁之间、无系统性疾病、需要拔除下颌阻生第三磨牙的患者。随机选择两种局部麻醉剂（Marcaine 和 Jetokain Simplex）之一用于拔牙。评估的参数包括麻醉剂起效时间、手术持续时间、术后镇痛持续时间和术后视觉模拟评分。观察并评估术前和手术期间的血流动力学参数。所有数据均进行统计学评估。
根据两种麻醉剂分析麻醉起效时间时，利多卡因组的差异更有利（p=0.01）。布比卡因组的作用持续时间长于利多卡因组（p=0.00002）。利多卡因组注射时疼痛的 VAS 值较低（p=0.009）。然而，根据我们的研究结果，布比卡因的术后镇痛效果与利多卡因相似（p=0.087）。
在评估这些结果后，我们可以推荐在牙科实践中安全使用利多卡因和布比卡因。但是布比卡因的作用持续时间长和利多卡因的起效迅速可能使利多卡因更受欢迎。
确定临床有效和安全的麻醉剂溶液非常重要。
