阿替卡因与利多卡因用于上颌乳磨牙拔除术麻醉效果的自身对照比较：一项随机对照试验
Split-mouth Comparison of Anesthetic Efficacy of Articaine and Lidocaine for Extractions of Deciduous Maxillary Teeth: A Randomized Controlled Trial.
作者信息
Jankar Jayashree L, Pustake Bhushan J
机构信息
Department of Pediatric and Preventive Dentistry, Pandit Deendayal Upadhyay Dental College & Hospital, Solapur, Maharashtra, India.
Department of Pedodontics and Preventive Dentistry, Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hiray Dental College & Hospital, Nashik, Maharashtra, India.
出版信息
Int J Clin Pediatr Dent. 2024 Apr;17(Suppl 1):S6-S10. doi: 10.5005/jp-journals-10005-2734.
PURPOSE
To clinically evaluate whether 4% articaine administered alone as a single buccal infiltration in deciduous maxillary tooth extraction can provide favorable palatal anesthesia compared to buccal and palatal infiltrations using 2% lidocaine.
MATERIALS AND METHODS
A prospective, double-blind, split-mouth, randomized controlled clinical study was carried out on 60 children comprising 36 females and 24 males in the age group of 5-10 years. During two separate appointments, children randomly received either 4% articaine with 1:1,00,000 epinephrine (group I-experimental) as buccal infiltration alone, or 2% lidocaine with 1:80,000 epinephrine (group II-control) as buccal plus palatal infiltration. Second local anesthetic agent was administered at least 1 week apart from first administration. Efficacy of anesthesia was assessed using subjective [Wong-Baker Faces Pain Scale (WBFPS)] and objective [sound, eye, motor (SEM)] scales along with occurrence of any adverse effects.
RESULTS
For infiltration procedure, 4% articaine (group I) had statistically highly significant ( < 0.001) pain scores on WBFPS as well as on SEM scale compared to 2% lidocaine (group II). According to WBFPS ( = 0.43) and SEM ( = 0.32) scores, the pain on extraction between 4% articaine and 2% lidocaine was statistically insignificant.
CONCLUSION
About 4% articaine buccal infiltration showed better clinical anesthetic efficacy, thus providing effective palatal anesthesia due to its enhanced vestibule-palatal diffusion with no significant postanesthetic complications. Hence, articaine can be used as an alternative to lidocaine in children for extractions of deciduous maxillary teeth.
HOW TO CITE THIS ARTICLE
Jankar JL, Pustake BJ. Split-mouth Comparison of Anesthetic Efficacy of Articaine and Lidocaine for Extractions of Deciduous Maxillary Teeth: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2024;17(S-1):S6-S10.
目的
临床评估在拔除上颌乳牙时，单独使用4%阿替卡因进行单次颊侧浸润麻醉与使用2%利多卡因进行颊侧和腭侧浸润麻醉相比，是否能提供良好的腭部麻醉效果。
材料与方法
对60名5至10岁的儿童进行了一项前瞻性、双盲、口内对照、随机对照临床研究，其中包括36名女性和24名男性。在两次单独的就诊过程中，儿童随机接受以下两种麻醉方式之一：单独使用含1:1,000,000肾上腺素的4%阿替卡因进行颊侧浸润麻醉（第一组 - 实验组），或使用含1:80,000肾上腺素的2%利多卡因进行颊侧加腭侧浸润麻醉（第二组 - 对照组）。第二次局部麻醉剂的给药时间与第一次给药至少间隔1周。使用主观[面部表情疼痛量表（WBFPS）]和客观[声音、眼睛、动作（SEM）]量表评估麻醉效果，并观察是否出现任何不良反应。
结果
在浸润操作过程中，与2%利多卡因（第二组）相比，4%阿替卡因（第一组）在WBFPS和SEM量表上的疼痛评分在统计学上具有高度显著性（<0.001）。根据WBFPS（=0.43）和SEM（=0.32）评分，4%阿替卡因和2%利多卡因在拔牙时的疼痛在统计学上无显著差异。
结论
约4%阿替卡因颊侧浸润显示出更好的临床麻醉效果，由于其在前庭 - 腭部的扩散增强，从而提供了有效的腭部麻醉，且无明显的麻醉后并发症。因此，在儿童拔除上颌乳牙时，阿替卡因可作为利多卡因的替代品。
如何引用本文
Jankar JL, Pustake BJ. Split - mouth Comparison of Anesthetic Efficacy of Articaine and Lidocaine for Extractions of Deciduous Maxillary Teeth: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2024;17(S - 1):S6 - S10.
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