Former Graduate Student in Endodontics, The Ohio State University, Columbus, Ohio.
Private practice, Columbus, Ohio.
Anesth Prog. 2021 Jun 1;68(2):69-75. doi: 10.2344/anpr-68-01-10.
The inferior alveolar nerve block (IANB) does not always result in successful pulpal anesthesia. Nitrous oxide may increase the success of the IANB. The purpose of this investigation was to study the effect of nitrous oxide/oxygen (N2O/O2) on IANB injection pain and mandibular pulpal anesthesia in asymptomatic subjects. One hundred five asymptomatic subjects received an IANB after the administration of N2O/O2 or room air/oxygen (air/O2) at 2 separate appointments. After the IANB, subjects rated their level of pain for each phase of the injection (needle insertion, needle placement, and solution deposition) using a Heft Parker visual analog scale. Pulpal anesthesia was evaluated with an electric pulp tester for 60 minutes. The mean pain rating for all 3 injection phases showed a statistically significant reduction in pain when N2O/O2 was used compared with Air/O2 (P < .05). Odds ratios demonstrated a statistically significant increase in IANB success for the N2O/O2 group compared with the air/O2 group. N2O/O2 administration statistically decreased pain for all 3 injection phases of the IANB. In addition, nitrous oxide statistically increased the likelihood of pulpal anesthesia for posterior mandibular teeth. However, the incidence of pulpal anesthesia was not 100%.
下牙槽神经阻滞（IANB）并不总能成功地实现牙髓麻醉。一氧化二氮（N2O）可能会增加 IANB 的成功率。本研究的目的是研究一氧化二氮/氧气（N2O/O2）对无症状患者 IANB 注射疼痛和下颌牙髓麻醉的影响。105 名无症状患者在 2 次预约时分别接受了 N2O/O2 或空气/氧气（air/O2）给药后的 IANB。IANB 后，受试者使用 Heft-Parker 视觉模拟评分法对注射的每个阶段（针插入、针放置和溶液沉积）的疼痛程度进行评分。电牙髓测试仪评估 60 分钟的牙髓麻醉。所有 3 个注射阶段的平均疼痛评分显示，与空气/O2 相比，使用 N2O/O2 时疼痛明显减轻（P<0.05）。比值比表明，与空气/O2 组相比，N2O/O2 组 IANB 成功率有统计学显著增加。N2O/O2 给药可显著降低 IANB 所有 3 个注射阶段的疼痛。此外，一氧化二氮还可显著增加下颌后牙牙髓麻醉的可能性。然而，牙髓麻醉的发生率并非 100%。
