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阿替卡因与利多卡因在下颌前牙颊侧局部浸润麻醉中用于拔牙的效果比较:一项前瞻性随机对照临床研究。

Articaine versus Lidocaine in only buccal infiltration anesthesia for the extraction of mandibular anterior teeth. A prospective split-mouth randomized-controlled clinical study.

机构信息

Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt.

Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.

出版信息

BMC Oral Health. 2023 Aug 28;23(1):604. doi: 10.1186/s12903-023-03292-5.

Abstract

OBJECTIVE

To investigate the effectiveness of a single labial infiltration of 4% articaine versus 2% lidocaine for the extraction of mandibular anterior teeth without an additional lingual injection.

PATIENTS AND METHODS

A prospective, randomized-controlled, split-mouth clinical study was implemented. Healthy adult patients seeking bilateral extraction of mandibular anterior teeth were included in this study. Teeth extractions were randomly assigned to two equal groups, where one mandibular anterior tooth was extracted using a solitary labial infiltration of either 4% articaine (the study group) or 2% lidocaine (the control group). After 14 days, the other mandibular anterior tooth was extracted using the other local anesthetic agent. The selection of the anesthetic agent injected in the first session was done in a randomized fashion. After 5 min of local anesthetic injection, the tooth was extracted, and each patient was asked to record the intensity of the extraction pain using the Visual Analogue Scale (VAS).

RESULTS

Thirty-one patients were included in the study. The efficacy of a single labial injection for mandibular anterior teeth extraction was established by the fact that none of the patients in the study or control group required re-administration of local anesthesia. The mean VAS for pain control during tooth extraction was 1.16 ± 0.93 for the articaine group and 1.71 ± 0.90 for the lidocaine group. The pain score showed a statistically significant decrease in the articaine group compared to that in the lidocaine group (P = 0.017).

CONCLUSION

Although the anesthetic effects of only buccal infiltration of 4% articaine and 2% lidocaine for extraction of mandibular anterior teeth were comparable, the use of 4% articaine would have more effective and predictable outcomes.

CLINICALTRIALS

ORG: (ID: NCT05223075) 3/2/2022.

摘要

目的

研究在不进行舌侧注射的情况下,对下颌前牙进行单侧唇侧浸润注射 4%阿替卡因与 2%利多卡因麻醉的效果。

方法

这是一项前瞻性、随机对照、split-mouth 临床研究。纳入寻求双侧下颌前牙拔除的健康成年患者。将拔牙随机分配到两组,一组下颌前牙采用 4%阿替卡因(研究组)或 2%利多卡因(对照组)进行单一唇侧浸润麻醉。14 天后,用另一种局麻药拔除另一侧下颌前牙。第一阶段注射的局麻药选择采用随机方式。局部麻醉注射后 5 分钟,拔牙,每位患者用视觉模拟评分(VAS)记录拔牙疼痛强度。

结果

本研究纳入 31 名患者。研究组和对照组均无患者需要再次给予局部麻醉,证明单侧唇侧注射用于下颌前牙拔牙是有效的。阿替卡因组拔牙时疼痛控制的平均 VAS 为 1.16±0.93,利多卡因组为 1.71±0.90。阿替卡因组的疼痛评分明显低于利多卡因组(P=0.017)。

结论

虽然仅在下颌前牙唇侧浸润注射 4%阿替卡因和 2%利多卡因的麻醉效果相当,但使用 4%阿替卡因的效果更有效且更可预测。

临床试验

注册号:NCT05223075,3 月 2 日,2022 年。

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