上颌颊侧浸润麻醉腭部麻醉效果的前瞻性随机交叉研究。
Efficacy of Maxillary Buccal Infiltration of Articaine for Palatal Anesthesia: A Prospective, Randomized, Crossover Study.
出版信息
Anesth Prog. 2024 May 3;71(1):8-14. doi: 10.2344/23-00023.
OBJECTIVE
Although there are conflicting data, several authors have proposed that articaine's molecular properties suggest improved perfusion capabilities over other amide anesthetics. The purpose of this prospective, randomized, crossover study was to evaluate the anesthetic efficacy of palatal soft-tissue anesthesia following a buccal infiltration of 1.8 and 3.6 mL of 4% articaine with 1:100,000 epinephrine.
METHODS
One hundred eighteen adults received 1.8 or 3.6 mL of 4% articaine with 1:100,000 epinephrine as a buccal infiltration of the maxillary first molar at 2 separate appointments. Palatal soft-tissue anesthesia was evaluated with a dental explorer. Anesthetic success was defined as the absence of pain with an explorer stick. For the subjects who achieved palatal anesthesia, mapping was conducted over 70 minutes, and the overall area of palatal anesthesia was calculated. The data were analyzed using chi-square tests.
RESULTS
The highest percentage of palatal anesthetic success was 20% for the 1.8-mL volume and 32% for the 3.6-mL volume both at 30 minutes. A statistically significant difference between the 1.8- and 3.6-mL volumes was seen at 40 minutes. There was high variability in area measurements for subjects who achieved palatal anesthesia. The highest area measurements were 92 mm2 for the 1.8-mL volume at 20 minutes and 113 mm2 for the 3.6-mL volume at 10 minutes.
CONCLUSION
Because of the low success rates (20%-32%) and the high variability of the area anesthetized for the subjects who achieved palatal anesthesia, the clinical efficacy of 1.8 or 3.6 mL of articaine via buccal infiltration for palatal anesthesia is of questionable value.
目的
尽管存在相互矛盾的数据，但已有多位作者提出，阿替卡因的分子特性表明其具有比其他酰胺类麻醉剂更好的灌注能力。本前瞻性、随机、交叉研究的目的是评估 1.8 和 3.6 mL 浓度为 4%的阿替卡因加 1:100000 肾上腺素行颊侧浸润后对上颚软组织麻醉的效果。
方法
118 名成年人在 2 次预约时分别接受 1.8 或 3.6 mL 浓度为 4%的阿替卡因加 1:100000 肾上腺素作为上颌第一磨牙的颊侧浸润。用牙科探针评估腭部软组织麻醉效果。以无探针痛作为麻醉成功的标准。对于达到腭部麻醉的受试者，在 70 分钟内进行了绘图，并计算了总的腭部麻醉面积。采用卡方检验对数据进行分析。
结果
在 30 分钟时，1.8 mL 组的腭部麻醉成功率最高为 20%，3.6 mL 组为 32%。在 40 分钟时，1.8 和 3.6 mL 组之间存在统计学显著差异。达到腭部麻醉的受试者的面积测量值变化较大。1.8 mL 组在 20 分钟时的最高面积测量值为 92mm2，3.6 mL 组在 10 分钟时为 113mm2。
结论
由于腭部麻醉的成功率较低（20%-32%），且达到腭部麻醉的受试者的麻醉面积变化较大，因此颊侧浸润 1.8 或 3.6 mL 阿替卡因用于腭部麻醉的临床疗效值得怀疑。
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