Research Center for Healthcare Industry Innovation, National Taipei University of Nursing and Health Sciences, Taipei City 112, Taiwan.
Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
Pain Res Manag. 2021 Jan 25;2021:6623792. doi: 10.1155/2021/6623792. eCollection 2021.
Administration of medications such as dexmedetomidine as a topical anesthetic has been suggested in the pain control in dentistry. This double-blind randomized control trial study evaluated postoperative pain and associated factors following impacted third molar extraction surgery. Lidocaine alone was taken as the control and lidocaine plus dexmedetomidine as the intervention.
Forty patients undergoing mandibular third molar extraction entered the study and were randomly allocated to the control and interventional groups. 0.15 ml of dexmedetomidine was added to each lidocaine cartridge and the drug concentration was adjusted to 15 g for the intervention group while only lidocaine was used in the control group. A visual analog scale was used to measure and record pain levels at the end of the surgery and 6, 12, and 24 hours after the surgery and number of painkillers taken by the patients after the surgery was also recorded.
Pain scores of the intervention group decreased significantly during the surgery and also 6, 12, and 24 hours after the surgery compared to the control group. The pain score was correlated significantly with our intervention during the surgery and also 6 and 12 hours after that (all value < 0.05). There was a nonsignificant reduction in the number of painkillers taken by the patients at 6, 12, and 24 hours after surgery (all value > 0.05).
In patients undergoing molar surgery, administration of a combination of dexmedetomidine and lidocaine is beneficial for the pain control. Compared to the injection of lidocaine alone, combination of dexmedetomidine and lidocaine can be used for a better pain control in molar surgeries.
在牙科疼痛控制中,已有人建议将右美托咪定等药物作为局部麻醉剂进行给药。本双盲随机对照试验研究评估了下颌第三磨牙拔除术后的疼痛及相关因素。单独使用利多卡因作为对照,利多卡因加右美托咪定为干预组。
40 名接受下颌第三磨牙拔除术的患者进入研究,并随机分配到对照组和干预组。在干预组中,每支利多卡因管中加入 0.15 毫升右美托咪定,将药物浓度调整至 15μg,而对照组仅使用利多卡因。使用视觉模拟评分法测量和记录手术结束时以及手术后 6、12 和 24 小时的疼痛程度,并记录手术后患者服用的止痛药数量。
与对照组相比,干预组在手术过程中和手术后 6、12 和 24 小时的疼痛评分显著降低。手术过程中和手术后 6 和 12 小时的疼痛评分与我们的干预措施显著相关(均 P 值 < 0.05)。手术后 6、12 和 24 小时,患者服用止痛药的数量无显著减少(均 P 值 > 0.05)。
在接受磨牙手术的患者中,给予右美托咪定和利多卡因的联合用药有利于控制疼痛。与单独注射利多卡因相比,右美托咪定和利多卡因的联合使用可更好地控制磨牙手术中的疼痛。