Sahu Swati, Patley Abhishek, Kharsan Vinay, Madan R S, Manjula V, Tiwari Rahul Vinay Chandra
Department of OMFS, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India.
Department of Oral and Maxillofacial Surgery, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India.
J Family Med Prim Care. 2020 Feb 28;9(2):904-908. doi: 10.4103/jfmpc.jfmpc_998_19. eCollection 2020 Feb.
A prospective randomized double-blind controlled trial was conducted to evaluate the latency and duration of pterygomandibular nerve block with a mixture of 1.8 ml 2% lignocaine with 1:80,000 epinephrine and 1 ml of 4 mg dexamethasone and its impact on postoperative sequelae after surgical extraction of impacted mandibular third molars.
This study was conducted in 40 subjects referred to the department of oral and maxillofacial surgery; they were divided into 20 subjects each in group A and B with the age range of 18-72 years planned for elective surgical removal of unilateral impacted mandibular third molar. Each patient was randomly selected to receive anesthesia using 1.8 ml 2% lignocaine with 1:80,000 epinephrine in group A or 2.8 ml twin mix (1.8 ml 2% lignocaine with 1:80,000 epinephrine + 1 ml 4 mg dexamethasone) in group B. After injection of the anesthetic solution, the time to anesthetic effect, duration of anesthesia from initial patient perception of the anesthetic effect to the time when the effect subsides, need to reanesthetize the surgical site were recorded, and 10-point visual analog scale (VAS) was used to subjectively assess the overall pain intensity while injecting the study drug, during surgery, and in the postoperative period.
Mean VAS value for pain on local anesthetic injection was less in twin-mix group. The time of onset of the local anesthetic was significantly less for the study group T, 51.35 ± 7.15 s when compared with patients in study group C ( less than 0.0001). The duration of soft tissue anesthesia was longer for all the patients in the study group T. On comparative evaluation between study group C and study group T, patients in the control group had more severe swelling and reduction in mouth opening in the postoperative period.
The addition of dexamethasone to lignocaine and its administration as an intraspace injection significantly shortens the latency and prolongs the duration of the soft tissue anesthesia, with improved quality of life in the postoperative period after surgical extraction of mandibular third molars.
进行了一项前瞻性随机双盲对照试验，以评估含1.8毫升2%利多卡因与1:80,000肾上腺素混合液以及1毫升4毫克地塞米松的翼下颌神经阻滞的潜伏期和持续时间，及其对下颌阻生第三磨牙手术拔除术后后遗症的影响。
本研究在40名转诊至口腔颌面外科的受试者中进行；他们被分为A组和B组，每组20名，年龄范围为18 - 72岁，计划择期手术拔除单侧下颌阻生第三磨牙。每位患者被随机选择在A组使用1.8毫升2%利多卡因与1:80,000肾上腺素进行麻醉，或在B组使用2.8毫升混合液（1.8毫升2%利多卡因与1:80,000肾上腺素 + 1毫升4毫克地塞米松）。注射麻醉溶液后，记录麻醉起效时间、从患者最初感觉到麻醉效果到效果消退的麻醉持续时间、手术部位需要再次麻醉的情况，并使用10分视觉模拟量表（VAS）主观评估注射研究药物时、手术期间和术后的总体疼痛强度。
混合液组局部麻醉注射时的平均VAS疼痛值较低。研究组T局部麻醉的起效时间明显短于研究组C，为51.35 ± 7.15秒（P < 0.0001）。研究组T所有患者的软组织麻醉持续时间更长。在研究组C和研究组T的比较评估中，对照组患者术后肿胀更严重，开口度减小。
在利多卡因中添加地塞米松并进行间隙内注射可显著缩短潜伏期，延长软组织麻醉持续时间，改善下颌第三磨牙手术拔除术后的生活质量。
