Akhil Kumar T, Uppada Uday Kiran, Tiwari Prabhat, Paul Dushyanth
Department Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, India.
Department Oral and Maxillofacial Surgery, Saveetha Dental College, Chennai, India.
J Maxillofac Oral Surg. 2024 Oct;23(5):1261-1266. doi: 10.1007/s12663-023-01989-2. Epub 2023 Aug 16.
To evaluate the anesthetic efficacy of 1% chloroprocaine in comparison to 2% lignocaine hydrochloride and adrenaline (1:80,000) in third molar surgery.
A randomized single-blind trial comprising of 30 healthy patients requiring bilateral extraction of impacted lower third molars with similar difficulty index was undertaken. A test dose was administered to all patients with subdermal infiltration of 1% chloroprocaine with 0.5 ml. A classic inferior alveolar and long buccal nerve block was given using 1% chloroprocaine 2 ml on one side and 2% lignocaine hydrochloride 2 ml with adrenaline on the other side. The time to onset and duration of action were noted. Pain during the surgical intervention, need for additional local anesthetic solution during the surgical intervention and the hemodynamic changes associated with the administration of the drugs were monitored.
Chloroprocaine had an early onset of action with a mean of 1.17 ± 0.55 min as compared to lignocaine 4.2 ± 0.48 min. Patients administered with lignocaine experienced less postoperative pain compared with chloroprocaine since the duration of action of chloroprocaine was lesser than that of lignocaine. Additional amount of LA was required when chloroprocaine was administered as compared to lignocaine. Chloroprocaine alone did not cause any appreciable changes in the hemodynamics, but lignocaine with adrenaline caused a transient increase in arterial pressure and heart rate 2 min following the administration. It was also observed that more blood was lost following chloroprocaine administration than with lignocaine.
Chloroprocaine has a rapid onset of action and short duration of action with minimal effects on the hemodynamic changes than lignocaine. Considering the fact that it is a safe drug with no effects of the cardiovascular system it can be advocated that Chloroprocaine can be used as an effective local anesthetic agent for performing oral and maxillofacial surgical interventions of short duration.
评估1%氯普鲁卡因与2%盐酸利多卡因加肾上腺素（1:80,000）在第三磨牙手术中的麻醉效果。
进行一项随机单盲试验，纳入30例需要双侧拔除难度指数相似的下颌阻生第三磨牙的健康患者。对所有患者皮下注射0.5 ml的1%氯普鲁卡因作为试验剂量。一侧使用2 ml的1%氯普鲁卡因进行经典的下牙槽神经和颊长神经阻滞，另一侧使用2 ml含肾上腺素的2%盐酸利多卡因进行阻滞。记录起效时间和作用持续时间。监测手术干预期间的疼痛、手术干预期间是否需要额外的局部麻醉溶液以及与药物给药相关的血流动力学变化。
氯普鲁卡因起效较早，平均起效时间为1.17±0.55分钟，而利多卡因的平均起效时间为4.2±0.48分钟。与氯普鲁卡因相比，使用利多卡因的患者术后疼痛较轻，因为氯普鲁卡因的作用持续时间短于利多卡因。与利多卡因相比，使用氯普鲁卡因时需要额外追加局部麻醉药。单独使用氯普鲁卡因对血流动力学没有明显影响，但含肾上腺素的利多卡因给药后2分钟会导致动脉压和心率短暂升高。还观察到，使用氯普鲁卡因后比使用利多卡因失血量更多。
氯普鲁卡因起效迅速且作用持续时间短，对血流动力学变化的影响比利多卡因小。鉴于它是一种对心血管系统无影响的安全药物，可以提倡将氯普鲁卡因用作进行短期口腔颌面外科手术的有效局部麻醉剂。
