Brownbill J W, Walker P O, Bourcy B D, Keenan K M
Anesth Prog. 1987 Nov-Dec;34(6):215-9.
Thirty-gauge needles are generally not recommended by dental schools, yet many dentists use them. Thin needles (30 gauge) can aspirate blood, have similar deflection to thick needles (25 gauge), and resist breakage. Measurable clinical differences between inferior dental block injections using 25-gauge or 30-gauge short needles for children is addressed in this research paper. Random allocation assigned 76 cases to 30-gauge and 62 cases to 25-gauge tribeveled. Twenty-seven-gauge short needles are in routine use for inferior dental nerve block injections in our clinics. After informed written consent was obtained, inferior dental block injections were carefully administered to children (62 males and 76 females, mean age 10 years ± 3 [SD], range 4-18 years) by faculty and students in pediatric dentistry and observed by one of two trained observers. After aspiration in two planes (180°), 0.5 mL of 2% lidocaine with 1:100,000 epinephrine was deposited in the lingual block area then 1.0 mL in the inferior dental area after touching bone. Any aspirate was recorded and subjective pain scores were taken immediately using a visual analogue scale. Five minutes after the commencement of the injection, the efficacy was tested objectively by two light needle pricks of the mucosa adjacent to the cuspid. The comparability of groups as regards age and sex was verified. Half of the injections were effective at five minutes in each group. There were no significant differences in efficacy, or pain scores. Both 25- and 30-gauge groups had nine instances of slight aspiration and two instances of more marked aspirations. The overall aspiration rate was 16%. It is concluded that 25- and 30-gauge needles do not differ significantly with respect to efficacy, pain, or aspiration. Children do not think that inferior dental nerve block injections hurt very much, and there is no evidence to support a change from 25- to 30-gauge needles.
牙科学校通常不推荐使用30号针头，但许多牙医仍在使用。细针头（30号）可以抽吸出血液，与粗针头（25号）具有相似的偏斜度，并且抗折断。本研究论文探讨了使用25号或30号短针头为儿童进行下牙槽神经阻滞注射之间可测量的临床差异。随机分配将76例患者分为30号组，62例患者分为25号组。27号短针头在我们诊所常规用于下牙槽神经阻滞注射。在获得知情书面同意后，儿科牙科的教员和学生为儿童（62名男性和76名女性，平均年龄10岁±3 [标准差]，范围4 - 18岁）仔细进行下牙槽神经阻滞注射，并由两名经过培训的观察者之一进行观察。在两个平面（180°）回抽后，将0.5 mL含1:100,000肾上腺素的2%利多卡因注入舌侧阻滞区域，然后在触及骨面后在下牙槽区域注入1.0 mL。记录任何回抽情况，并立即使用视觉模拟量表记录主观疼痛评分。注射开始五分钟后，通过对尖牙相邻黏膜进行两次轻针刺来客观测试疗效。验证了两组在年龄和性别方面的可比性。每组中有一半的注射在五分钟时有效。在疗效或疼痛评分方面没有显著差异。25号组和30号组均有9例轻微回抽和2例更明显回抽情况。总体回抽率为16%。结论是，25号和30号针头在疗效、疼痛或回抽方面没有显著差异。儿童并不认为下牙槽神经阻滞注射非常疼痛，并且没有证据支持从25号针头改为30号针头。
