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评估丁丙诺啡与含肾上腺素的2%利多卡因在下颌第三磨牙手术后作为术后镇痛剂的疗效:一项对比研究。

To evaluate the Efficacy of Buprenorphine and 2% lignocaine with adrenaline as postoperative analgesia following mandibular third molar surgery: A Comparative Study.

作者信息

Bagade Sachin Prakash, Joshi Sanjay S, Punamiya Sneha, Malliwal Anuradha, Naik Charudatta S, Ansari Arsalan

机构信息

Department of Oral and Maxillofacial Surgery, Terna Dental College, Navi Mumbai, Maharashtra, India.

Department of Anaesthesiology, Terna Medical College, Navi Mumbai, Maharashtra, India.

出版信息

Ann Maxillofac Surg. 2021 Jul-Dec;11(2):236-240. doi: 10.4103/ams.ams_416_20. Epub 2022 Feb 1.

Abstract

INTRODUCTION

Opioid analgesics have an advantage over nonsteroidal anti-inflammatory drugs in that they do not cause direct organ damage. Buprenorphine has an antinociceptive potency approximately 25-50 times greater than that of morphine. Hence, in this study, buprenorphine was added to local anaesthesia in relieving postoperative pain after lower third molar surgery when given as inferior alveolar nerve block. The aim of this study was to evaluate the efficacy of buprenorphine in managing postoperative pain after lower third molar surgery.

MATERIALS AND METHODS

Fifty patients requiring lower third molar surgery were randomly divided into two groups. Group A received buprenorphine added to 2% lignocaine with 1:80,000 adrenaline and Group B received 2% lignocaine with 1:80,000 adrenaline. Parameters assessed were onset of anaesthesia, depth of anaesthesia, intraoperative monitoring of adverse effects, duration of analgesia, and number of analgesics consumed. Statistical analysis was carried out using SPSS software version 21. The data were compared using Student's -test. The level of significance was set at 0.05.

RESULTS

There was a significant difference in onset of anaesthesia between Group A and Group B ( < 0.05). Depth of anaesthesia and duration of analgesia were greater in Group A (56 h 36 min) than Group B (3 h 24 min). Analgesics consumed by Group A (0.9) were significantly less compared to Group B (9.2) and it was highly significant ( = 0.000).

DISCUSSION

Buprenorphine when added to local anaesthesia can prolong postoperative analgesia with minimum or no side effects. Hence, buprenorphine can be safely used for lower third molar surgery.

摘要

引言

阿片类镇痛药相对于非甾体抗炎药具有优势,即它们不会造成直接的器官损伤。丁丙诺啡的镇痛效力比吗啡高约25 - 50倍。因此,在本研究中,在下颌第三磨牙手术中,当进行下牙槽神经阻滞时,将丁丙诺啡添加到局部麻醉剂中以减轻术后疼痛。本研究的目的是评估丁丙诺啡在管理下颌第三磨牙手术后疼痛方面的疗效。

材料与方法

50例需要进行下颌第三磨牙手术的患者被随机分为两组。A组在含1:80,000肾上腺素的2%利多卡因中添加丁丙诺啡,B组接受含1:80,000肾上腺素的2%利多卡因。评估的参数包括麻醉起效时间、麻醉深度、术中不良反应监测、镇痛持续时间以及镇痛药的消耗量。使用SPSS 21版软件进行统计分析。数据采用学生t检验进行比较。显著性水平设定为0.05。

结果

A组和B组在麻醉起效时间上存在显著差异(<0.05)。A组的麻醉深度和镇痛持续时间(56小时36分钟)比B组(3小时24分钟)更长。A组消耗的镇痛药(0.9)与B组(9.2)相比显著更少,且差异极显著(=0.000)。

讨论

丁丙诺啡添加到局部麻醉中可延长术后镇痛时间,且副作用最小或无副作用。因此,丁丙诺啡可安全用于下颌第三磨牙手术。

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Expert Rev Clin Pharmacol. 2016;9(3):375-83. doi: 10.1586/17512433.2016.1141047. Epub 2016 Jan 28.
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Pharmacology of peripheral opioid receptors.外周阿片受体的药理学。
Curr Opin Anaesthesiol. 2011 Aug;24(4):408-13. doi: 10.1097/ACO.0b013e32834873e5.
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Acute postoperative pain management.急性术后疼痛管理。
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