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一项关于关节内注射罗哌卡因治疗 TMD 的临床试验。

A clinical trial of ropivacaine in arthocentesis for TMD.

机构信息

Department of Oral and Maxillofacial Surgery, College &Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, 530021, China.

Department of Stomatology, Guigang City People's Hospital, Guigang, 537000, China.

出版信息

BMC Oral Health. 2024 Oct 29;24(1):1311. doi: 10.1186/s12903-024-04606-x.

Abstract

INTRODUCTION

This study aims to compare the efficacy of ropivacaine and lidocaine in the treatment of temporomandibular joint (TMJ) disorders, with the goal of exploring a more effective treatment for TMJ disorders.

METHODS

Patients with Wilkes stage III and IV unilateral TMJ disorders were enrolled in the study. 0.5% ropivacaine was used for local anesthesia in group A, 2% lidocaine was used in group B. Sodium hyaluronate was injected after supra-articular lavage in both groups. The patients' general conditions, pain scores, and maximum opening before and after treatment were collected, the time of onset and maintenance of anesthesia, and the levels of inflammatory factors IL-1β and IL-6 in the joint lavage fluid were detected.

RESULTS

Study showed that the onset of anesthesia was faster and longer maintained in group A. The decrease in IL-1β was more pronounced in group A (16.08 ± 3.10) than in group B (18.03 ± 2.84), p < 0.05. At 2 months after treatment, the joint clicking rate was higher in group A (75%) compared to group B (35%), p < 0.05. At 3 months after treatment, the joint clicking rate was higher in group A (76.69%) compared to group B (40%) and the maximum mouth opening was greater in group A (45.00 ± 2.38) compared to group B (41.73 ± 4.18), p < 0.05. There were no statistically significant differences in VAS score and lateral excursion in group A compared with group B at 2 months and 3 months after treatment.

CONCLUSIONS

Compared with lidocaine, the application of ropivacaine combined with sodium hyaluronate supra-articular lavage for the treatment of temporomandibular joint disorder is more clinically effective.

CLINICAL TRIALS REGISTRATION NUMBER

ChiCTR2300075241 (30/08/2023).

摘要

介绍

本研究旨在比较罗哌卡因和利多卡因治疗颞下颌关节(TMJ)紊乱的疗效,以期探索更有效的 TMJ 紊乱治疗方法。

方法

本研究纳入 Wilkes 分期为 III 期和 IV 期的单侧 TMJ 紊乱患者。A 组采用 0.5%罗哌卡因行局部麻醉,B 组采用 2%利多卡因。两组均在关节上腔冲洗后注射透明质酸钠。收集患者一般情况、疼痛评分、治疗前后最大张口度,记录麻醉起效时间和维持时间,检测关节冲洗液中炎症因子 IL-1β和 IL-6 水平。

结果

研究显示,A 组麻醉起效更快,维持时间更长。A 组关节冲洗液中 IL-1β的下降幅度更为显著(16.08±3.10),低于 B 组(18.03±2.84),p<0.05。治疗后 2 个月,A 组关节弹响率(75%)高于 B 组(35%),p<0.05。治疗后 3 个月,A 组关节弹响率(76.69%)高于 B 组(40%),A 组最大张口度(45.00±2.38)大于 B 组(41.73±4.18),p<0.05。治疗后 2 个月和 3 个月,A 组 VAS 评分和侧向运动与 B 组相比差异均无统计学意义。

结论

与利多卡因相比,罗哌卡因联合透明质酸钠关节上腔冲洗治疗颞下颌关节紊乱更为有效。

临床试验注册编号

ChiCTR2300075241(30/08/2023)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdd3/11520862/ca6762dcb360/12903_2024_4606_Figa_HTML.jpg

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