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4%阿替卡因与1:100,000肾上腺素的下牙槽神经阻滞麻醉对人下颌牙齿血流及麻醉的影响

The effect of inferior alveolar nerve block anesthesia of 4% articaine and epinephrine 1:100,000 on blood flow and anesthesia of human mandibular teeth.

作者信息

Samdrup Tshering, Kijsamanmith Kanittha, Vongsavan Kadkao, Rirattanapong Praphasri, Vongsavan Noppakun

机构信息

Dental Department, Lungtenphu Military Hospital, Royal Bhutan Army, Thimphu, Bhutan.

Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.

出版信息

J Dent Sci. 2021 Jan;16(1):249-255. doi: 10.1016/j.jds.2020.05.013. Epub 2020 Jun 4.

Abstract

BACKGROUND/PURPOSE: Local anesthetics and anesthetic techniques affect the patterns of pulpal blood flow (PBF) and pulpal anesthesia in human teeth. This study aimed to determine PBF changes and pulpal anesthesia of intact mandibular first molars and canines after administration of 4% articaine with epinephrine 1:100,000 using inferior alveolar nerve block (IANB).

MATERIALS AND METHODS

Ten healthy subjects received IANB of 4% articaine with epinephrine 1:100,000. Laser Doppler flowmetry and electrical pulp testing were combined to assess PBF changes and pulpal anesthesia of intact mandibular first molars and canines. The data were analyzed using one-way repeated-measures analysis of variance and Student-Newman-Keuls test.

RESULTS

IANB with 4% articaine and epinephrine 1:100,000 did not have any significant change in PBF for the first 20 min post injection in mandibular first molars, and for 45 min post injection in the canines ( > 0.05). However, a hyperemic response occurred during 25-60 min post injection in the molars, and between 60 and 75 min post injection in the canines ( < 0.05). Thereafter, the PBF in both teeth returned to the baseline. Onset of pulpal anesthesia was 8.60 ± 2.12 min in the molars, and 9 ± 1.94 min in the canines. Duration of pulpal anesthesia was 82.40 ± 41.56 min in the molars, and 84 ± 47.40 min in the canines.

CONCLUSION

In case of successful IANB, 4% articaine and epinephrine 1:100,000 caused insignificant changes in PBF up to 30 min but a hyperemic response at later time points. Thereafter, the PBF returned to the baseline.

摘要

背景/目的:局部麻醉药和麻醉技术会影响人类牙齿的牙髓血流(PBF)模式和牙髓麻醉效果。本研究旨在确定使用下牙槽神经阻滞(IANB)法给予含1:100,000肾上腺素的4%阿替卡因后,完整下颌第一磨牙和尖牙的PBF变化及牙髓麻醉情况。

材料与方法

10名健康受试者接受含1:100,000肾上腺素的4%阿替卡因的IANB。联合使用激光多普勒血流仪和牙髓电测试来评估完整下颌第一磨牙和尖牙的PBF变化及牙髓麻醉情况。采用单因素重复测量方差分析和Student-Newman-Keuls检验对数据进行分析。

结果

含1:100,000肾上腺素的4%阿替卡因进行IANB后,下颌第一磨牙在注射后20分钟内PBF无显著变化,尖牙在注射后45分钟内PBF无显著变化(P>0.05)。然而,磨牙在注射后25 - 60分钟出现充血反应,尖牙在注射后60 - 75分钟出现充血反应(P<0.05)。此后,两颗牙齿的PBF均恢复至基线水平。磨牙的牙髓麻醉起效时间为8.60±2.12分钟,尖牙为9±1.94分钟。磨牙的牙髓麻醉持续时间为82.40±41.56分钟,尖牙为84±47.40分钟。

结论

在IANB成功的情况下,含1:100,000肾上腺素的4%阿替卡因在30分钟内引起的PBF变化不显著,但在随后时间点会出现充血反应。此后PBF恢复至基线水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f167/7770255/524bc77af6a6/gr1.jpg

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