Bahrololoomi Zahra, Rezaei Maedeh
Department of Pediatric Dentistry, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
J Dent Anesth Pain Med. 2021 Feb;21(1):61-69. doi: 10.17245/jdapm.2021.21.1.61. Epub 2021 Jan 29.
Inferior alveolar nerve block (IANB) using lidocaine 2% is commonly used for anesthetizing primary mandibular molars; however, this technique has the highest level of patient discomfort compared to other local anesthesia techniques. Therefore, alternative anesthesia techniques are necessary. The aim of this study was to evaluate the efficacy of a single buccal infiltration of 4% articaine with IANB using 2% lidocaine, for the bilateral extraction of primary mandibular molars.
The present study was conducted on 30 patients aged between 6 and 9 years, who required the extraction of bilateral primary mandibular molars. The patients were randomly divided into two groups as follows: In the first session, Group A received IANB with lidocaine 2% and group B received infiltration with articaine 4%. In the second session, another injection method was performed on the opposite side. The Wong-Baker Facial Pain scale (WBFPS), Face Leg Activity Cry, and Consolability (FLACC), and physiologic parameters were used to assess pain perception.
The independent t-test showed no statistically significant difference in blood pressure and heart rate before and after extraction (P > 0.05). The mean FLACC index in the lidocaine and articaine groups was 0.89 and 1.36, respectively; there was no statistically significant difference between them (P > 0.05). According to the results of the chi-square test, there was no statistically significant difference between the groups for WBFPS (P > 0.05).
The articaine infiltration technique may be an alternative to the IANB for the extraction of primary mandibular molars.
使用2%利多卡因进行下牙槽神经阻滞(IANB)常用于麻醉下颌乳磨牙;然而,与其他局部麻醉技术相比,该技术给患者带来的不适程度最高。因此,需要替代麻醉技术。本研究的目的是评估单次颊侧浸润4%阿替卡因联合使用2%利多卡因进行IANB,用于双侧拔除下颌乳磨牙的疗效。
本研究对30例年龄在6至9岁之间、需要双侧拔除下颌乳磨牙的患者进行。患者被随机分为两组如下:在第一阶段,A组接受2%利多卡因的IANB,B组接受4%阿替卡因的浸润麻醉。在第二阶段,对另一侧采用另一种注射方法。采用面部表情疼痛量表(WBFPS)、面部腿部活动哭闹及安慰程度量表(FLACC)和生理参数来评估疼痛感知。
独立样本t检验显示拔牙前后血压和心率无统计学显著差异(P>0.05)。利多卡因组和阿替卡因组的平均FLACC指数分别为0.89和1.36;两组之间无统计学显著差异(P>0.05)。根据卡方检验结果,两组在WBFPS方面无统计学显著差异(P>0.05)。
阿替卡因浸润技术可能是拔除下颌乳磨牙时IANB的一种替代方法。