Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, Nantes Université, Nantes, France.
CHU Nantes, Unité d'Investigation Clinique en Odontologie, UIC 11, Nantes Université, Nantes, France.
Int Endod J. 2023 Aug;56(8):922-931. doi: 10.1111/iej.13935. Epub 2023 May 29.
The aim of this study was to compare the cardiovascular effects [heart rate, oxygen saturation (SpO ) systolic and diastolic blood pressure] and the anaesthetic efficacy of intraosseous computerized anaesthesia (ICA) versus inferior alveolar nerve block (IANB) in Symptomatic irreversible pulpitis (SIP).
The study protocol was registered with ClinicalTrials.gov (NCT03802305). In a randomized, prospective clinical trial, 72 mandibular molar teeth with SIP were randomly allocated to conventional IANB injection (n = 36) or ICA injection (n = 36), both with 1.8 mL of 4% articaine with 1:100 000 epinephrine. The primary objective was to assess the cardiovascular parameters (heart rate, oxygen saturation, blood pressure) before, during and after the anaesthesia. The secondary objectives were to compare ICA with IANB for success and postoperative outcomes for up to 3 days.
The maximum increase in heart rate in the ICA group was greater than in the IANB. Other cardiovascular parameters did not show differences throughout the clinical procedure. There were no statistically significant differences (p > .05) between groups for sex, age, or anxiety. The total success rate of ICA (91.43%) was significantly higher (p = .0034) than that of IANB (69.44%).
This study establishes that ICA is safe and efficient in the first intention for the treatment of SIP of the mandibular molar.
本研究旨在比较骨内计算机麻醉(ICA)与下牙槽神经阻滞(IANB)在症状性不可复性牙髓炎(SIP)中的心血管效应[心率、血氧饱和度(SpO2)、收缩压和舒张压]和麻醉效果。
本研究方案已在 ClinicalTrials.gov 注册(NCT03802305)。在一项随机、前瞻性临床试验中,72 颗下颌磨牙有 SIP 症状,随机分为常规 IANB 注射组(n=36)或 ICA 注射组(n=36),均使用 1.8mL 4%的含 1:100000 肾上腺素的阿替卡因。主要目的是评估麻醉前、麻醉中和麻醉后的心血管参数(心率、血氧饱和度、血压)。次要目的是比较 ICA 与 IANB 在术后 3 天内的成功率和术后结果。
ICA 组的心率最大增加量大于 IANB 组。其他心血管参数在整个临床过程中没有差异。两组在性别、年龄或焦虑方面均无统计学差异(p>.05)。ICA 的总成功率(91.43%)明显高于 IANB(69.44%)(p=0.0034)。
本研究证实 ICA 是治疗下颌磨牙 SIP 的首选安全有效的方法。