Division of Endodontics, The Ohio State University, Columbus, Ohio.
Division of Biosciences, The Ohio State University, Columbus, Ohio.
J Endod. 2021 Apr;47(4):558-565. doi: 10.1016/j.joen.2020.12.014. Epub 2020 Dec 30.
The pulpal anesthetic success rates for an inferior alveolar nerve block (IANB) alone in patients presenting with symptomatic irreversible pulpitis are less than adequate. Nitrous oxide and clonidine have shown increases in IANB success when administered individually, but their success has not been evaluated when used together. The purpose of this prospective, randomized, double-blind study was to determine the effect of nitrous oxide/oxygen plus an IANB using lidocaine/clonidine on the success of the IANB in patients with symptomatic irreversible pulpitis and to evaluate the effect of clonidine on blood pressure and pulse.
Sixty-two emergency patients experiencing moderate to severe pain and a diagnosis of symptomatic irreversible pulpitis were enrolled. Subjects were randomly divided into 2 groups and received nitrous oxide/oxygen and an IANB using 2% lidocaine with either 27 μg clonidine or 18 μg epinephrine as vasoconstrictors. Blood pressure and pulse were recorded before and during the emergency endodontic treatment. Anesthetic success was defined as no or mild pain upon access and instrumentation of the canals.
The pulpal anesthetic success rate in both treatments was 58%, with no significant difference between the groups. There was no statistically significant difference in pulse or systolic blood pressure with the use of clonidine compared with epinephrine. Diastolic blood pressure was significant.
The use of nitrous/oxide plus the addition of lidocaine/clonidine for the IANB in teeth with symptomatic irreversible pulpitis resulted in no statistically significant difference in anesthetic success of the IANB. There were no statistically significant differences in pulse or systolic blood pressure with the use of clonidine compared with epinephrine; diastolic blood pressure was significant.
对于患有症状性不可复性牙髓炎的患者，单独使用下牙槽神经阻滞（IANB）的牙髓麻醉成功率不足。一氧化二氮和可乐定单独使用时可增加 IANB 的成功率，但它们一起使用时的成功率尚未得到评估。本前瞻性、随机、双盲研究的目的是确定一氧化二氮/氧气加用利多卡因/可乐定的 IANB 在患有症状性不可复性牙髓炎的患者中对 IANB 成功率的影响，并评估可乐定对血压和脉搏的影响。
纳入 62 名患有中度至重度疼痛且诊断为症状性不可复性牙髓炎的急诊患者。受试者随机分为 2 组，分别接受含 2%利多卡因的 27 μg 可乐定或 18 μg 肾上腺素作为血管收缩剂的一氧化二氮/氧气和 IANB。在紧急牙髓治疗前和期间记录血压和脉搏。麻醉成功定义为进入和器械进入根管时无疼痛或轻度疼痛。
两种治疗方法的牙髓麻醉成功率均为 58%，两组间无显著差异。与肾上腺素相比，使用可乐定的脉搏或收缩压无统计学差异。舒张压有显著差异。
在患有症状性不可复性牙髓炎的牙齿中使用一氧化二氮/氧气加用利多卡因/可乐定进行 IANB，其麻醉效果无统计学差异。与肾上腺素相比，使用可乐定的脉搏或收缩压无统计学差异；舒张压有显著差异。
