使用下牙槽神经阻滞麻醉（IANB）在双侧下颌第三磨牙手术拔除中比较罗哌卡因（0.75%和0.5%）与2%利多卡因加肾上腺素（1:200000）的麻醉效果：一项前瞻性、随机、单盲研究。
Comparison of anaesthetic efficacy of ropivacaine (0.75% & 0.5%) with 2% lignocaine with adrenaline (1:200000) in surgical extraction of bilateral mandibular 3 molars using IANB:a prospective, randomized, single blind study.
作者信息
Rajpari Kamil N, Andrade Neelam N, Nikalje Trupti
机构信息
Dept of Oral and Maxillofacial Surgery, Nair Hospital Dental College, Mumbai, Maharashtra, India.
出版信息
J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):263-268. doi: 10.1016/j.jobcr.2021.02.005. Epub 2021 Feb 9.
AIM
To evaluate and compare the anaesthetic efficacy of 0.75% ropivacaine and 0.5% ropivacaine with 2% lignocaine with 1:200000 Adrenaline (LWA) for surgical extraction of bilateral mandibular 3rd molars using Direct inferior alveolar nerve block (IANB).
MATERIAL AND METHODS
Total of 60 outpatients of both sex,age group of 18-40 included in a prospective, randomized, single blind, split mouth clinical study after satisfying inclusion and exclusion criteria. Group I includes 30 patients and 0.75% ropivacaine as test drug, Group II includes 30 patients and 0.5% ropivacaine as test drug. In both group control drug was LWA.Parameters measured were onset of action, duration of action, systolic blood pressure, diastolic blood pressure, heart rate, visual analogue scale (VAS), faces pain scale (FPS).
RESULT
Onset of action of 0.75%/0.5% ropivacaine (101.84 ± 16.92 secs/113.03 ± 12.77 sec) was faster than LWA (Group I-218 ± 21.51 secs, Group II-196.47 ± 26.27 secs). Duration of action of 0.75%/0.5% ropivacaine (343.55 ± 16.44 mins/319.03 ± 19.30 mins) was longer than 2% Lignocaine with 1:200000 adrenaline (Group I I-173 ± 16.86 mins, Group II-175.20 ± 18.02 mins). In Group I - VAS/FPS of 0.75% Ropivacaine (0.97 ± 0.54/1.32 ± 0.65) was significantly lower as compared to LWA (2.90 ± 0.83/3.29 ± 0.69). In group II-VAS/FPS of 0.5% ropivacaine (1.40 ± 0.72/1.47 ± 0.50) was lower as compared to LWA (3.40 ± 0.89/3.30 ± 0.87). Mean systolic blood pressure, diastolic blood pressure, heart rate was lower for ropivacaine (0.75%, 0.5%) than LWA except mean heart rate higher for 0.75% ropivacaine at 10 min after injection. Else mean heart rate lower in other time interval.
CONCLUSION
Ropivacaine (0.75%,0.5%) was more efficacious than 2% lignocaine with adrenaline (1:200000) it terms of all measured parameters in study.
目的
采用直接下牙槽神经阻滞（IANB），评估并比较0.75%罗哌卡因、0.5%罗哌卡因与含1:200000肾上腺素的2%利多卡因（LWA）用于双侧下颌第三磨牙手术拔除时的麻醉效果。
材料与方法
在满足纳入和排除标准后，将60例年龄在18 - 40岁的门诊患者纳入一项前瞻性、随机、单盲、双侧口内对照的临床研究。第一组包括30例患者，使用0.75%罗哌卡因作为试验药物；第二组包括30例患者，使用0.5%罗哌卡因作为试验药物。两组的对照药物均为LWA。测量的参数包括起效时间、作用持续时间、收缩压、舒张压、心率、视觉模拟评分（VAS）、面部疼痛评分（FPS）。
结果
0.75%/0.5%罗哌卡因的起效时间（101.84 ± 16.92秒/113.03 ± 12.77秒）快于LWA（第一组 - 218 ± 21.51秒，第二组 - 196.47 ± 26.27秒）。0.75%/0.5%罗哌卡因的作用持续时间（343.55 ± 16.44分钟/319.03 ± 19.30分钟）长于含1:200000肾上腺素的2%利多卡因（第一组 - 173 ± 16.86分钟，第二组 - 175.20 ± 18.02分钟）。在第一组中，0.75%罗哌卡因的VAS/FPS（0.97 ± 0.54/1.32 ± 0.65）显著低于LWA（2.90 ± 0.83/3.29 ± 0.69）。在第二组中，0.5%罗哌卡因的VAS/FPS（1.40 ± 0.72/1.47 ± 0.50）低于LWA（3.40 ± 0.89/ 3.30 ± 0.87）。除注射后第10分钟0.75%罗哌卡因的平均心率较高外，罗哌卡因（0.75%、0.5%）的平均收缩压、舒张压、心率均低于LWA。在其他时间间隔，平均心率较低。
结论
在本研究的所有测量参数方面，罗哌卡因（0.75%，0.5%）比含肾上腺素（1:200000）的2%利多卡因更有效。
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