Deo Saroj Prasad, Ahmad Md Shakeel, Singh Abanish
Department of Oral and Maxillofacial Surgery, National Medical College, Birgunj, Nepal.
Department of Dentistry, National Medical College, Birgunj, Nepal.
J Korean Assoc Oral Maxillofac Surg. 2022 Feb 28;48(1):21-32. doi: 10.5125/jkaoms.2022.48.1.21.
Inferior alveolar nerve block (IANB) is commonly used for mandibular dentoalveolar surgery. The objective of this study was to evaluate and compare the effectiveness of coadministration of dexamethasone (4 mg/mL) or adrenaline (0.01 mg/mL) as an adjuvant with lignocaine 2% in IANB during third molar surgery (TMS).
This double-blind, randomized controlled trial was conducted between March and August 2020. The investigators screened patients needing elective TMS under local anesthesia. Based on strict inclusion and exclusion criteria, patients were enrolled in this study. These patients were assigned randomly into two study groups: dexamethasone group (DXN) or adrenaline group (ADN). Outcome variables were postoperative edema, trismus, visual analogue scale (VAS), perioperative analgesia, onset time, and duration of IANB.
Eighty-three patients were enrolled in this study, of whom 23 (27.7%) were eliminated or excluded during follow-up. This study thus included data from 60 samples. Mean age was 32.28±11.74 years, including 28 females (46.7%) in the ADN (16 patients, 57.1%) and DXN (12 patients, 42.9%) groups. The duration of action for DXN (mean±standard deviation [SD], 4:02:07±0:34:01 hours; standard error [SE], 0:06:00 hours; log-rank =0.001) and for ADN (mean±SD, 1:58:34±0:24:52 hours; SE, 0:04:42 hours; log-rank =0.001) were found. Similarly, time at which 1st analgesic consume and total number of nonsteroidal antiinflammatory drugs need to rescue postoperative analgesia was found statistically significant between study groups (t (58)=-11.95; confidence interval, -2:25:41 to -1:43:53; =0.001). Early-hours VAS was also significantly different between the study groups.
A single injection of dexamethasone prolongs the duration of action of lignocaine 2% IANB. Additionally, it can be used in cases where adrenaline is contraindicated.
下牙槽神经阻滞（IANB）常用于下颌牙槽外科手术。本研究的目的是评估和比较在第三磨牙手术（TMS）期间，将地塞米松（4mg/mL）或肾上腺素（0.01mg/mL）作为佐剂与2%利多卡因联合用于IANB的有效性。
本双盲、随机对照试验于2020年3月至8月进行。研究人员筛选了需要在局部麻醉下进行择期TMS的患者。根据严格的纳入和排除标准，患者被纳入本研究。这些患者被随机分为两个研究组：地塞米松组（DXN）或肾上腺素组（ADN）。观察指标包括术后水肿、牙关紧闭、视觉模拟评分（VAS）、围手术期镇痛、起效时间和IANB持续时间。
本研究共纳入83例患者，其中23例（27.7%）在随访期间被剔除或排除。因此，本研究纳入了60例样本的数据。平均年龄为32.28±11.74岁，ADN组（16例，57.1%）和DXN组（12例，42.9%）中有28名女性（46.7%）。发现DXN组的作用持续时间（均值±标准差[SD]，4:02:07±0:34:01小时；标准误[SE]，0:06:00小时；对数秩=0.001）和ADN组（均值±SD，1:58:34±0:24:52小时；SE，0:04:42小时；对数秩=0.001）。同样，研究组之间首次使用镇痛药的时间和术后镇痛所需非甾体抗炎药的总数在统计学上有显著差异（t(58)=-11.95；置信区间，-2:25:41至-1:43:53；P=0.001）。两组早期的VAS也有显著差异。
单次注射地塞米松可延长2%利多卡因IANB的作用持续时间。此外，在肾上腺素禁忌的情况下也可使用。
