Kalra Geeta, Makkar Sameer, Menrai Neha, Kalia Vimal, Suri Nikita, Gupta Sandeep
Department of Oral and Maxillofacial Surgery, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh India.
Depart of Conservative Dentistry and Endodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh India.
J Maxillofac Oral Surg. 2024 Oct;23(5):1255-1260. doi: 10.1007/s12663-023-01945-0. Epub 2023 Jun 30.
To compare the efficacy and onset of local anesthesia using buffered versus non-buffered 2% lidocaine with 1:100,000 adrenaline and 4% articaine with 1:100,000 adrenaline in dental extraction.
A prospective, clinical study was carried out in oral and maxillofacial surgery department. Twenty-eight patients were considered in the study and were divided into 4 groups. Each group randomly received either buffered 2% lidocaine with 1:100,000 adrenaline, non-buffered 2% lidocaine with 1:100,000 adrenaline, buffered 4% articaine with 1:100,000 adrenaline or non-buffered 4% articaine with 1:100,000 adrenaline. The outcome variable was onset of anesthesia and effectiveness of anesthesia in buffered and non-buffered group.
Results showed that the mean onset of time and efficacy of local anesthesia was significantly better in buffered when compared with non-buffered local anesthetic solution with adrenaline.
In conclusion, the addition of sodium bicarbonate as a buffering agent decreases time of onset and increases the effectiveness of local anesthetics, thus providing comfort to the patient. The mean onset of time for first symptom as well as lip numbness was more for non-buffered lidocaine followed by non-buffered articaine, buffered lidocaine and buffered articaine. The mean onset of time for subjective and objective symptoms was more for non-buffered anesthetic solution as compared to buffered anesthetic solution. VAS readings were not statistically significant among the four groups.
比较在拔牙术中使用缓冲与未缓冲的含1:100,000肾上腺素的2%利多卡因以及含1:100,000肾上腺素的4%阿替卡因进行局部麻醉的效果和起效时间。
在口腔颌面外科进行了一项前瞻性临床研究。该研究纳入了28例患者,并将其分为4组。每组随机接受缓冲的含1:100,000肾上腺素的2%利多卡因、未缓冲的含1:100,000肾上腺素的2%利多卡因、缓冲的含1:100,000肾上腺素的4%阿替卡因或未缓冲的含1:100,000肾上腺素的4%阿替卡因。观察指标为缓冲组和未缓冲组麻醉的起效时间和麻醉效果。
结果显示,与含肾上腺素的未缓冲局部麻醉溶液相比,缓冲局部麻醉溶液的局部麻醉平均起效时间和效果显著更佳。
总之,添加碳酸氢钠作为缓冲剂可缩短起效时间并提高局部麻醉药的效果,从而为患者提供舒适感。未缓冲的利多卡因出现首个症状以及唇部麻木的平均起效时间最长,其次是未缓冲的阿替卡因、缓冲的利多卡因和缓冲的阿替卡因。与缓冲麻醉溶液相比,未缓冲麻醉溶液出现主观和客观症状的平均起效时间更长。四组之间的视觉模拟评分(VAS)读数无统计学意义。