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4%阿替卡因联合24G针头行颊神经阻滞与2%利多卡因联合20G针头行下颌牙槽神经阻滞用于患有牙槽脓肿儿童的临床麻醉效果比较评估

Comparative Evaluation of Clinical Anesthetic Efficacy of 4% Articaine with 24-Gauge Needle in Buccal Nerve Block Compared to 2% Lignocaine with 20-Gauge Needle in Inferior Alveolar Nerve Block in Children with Dentoalveolar Abscess.

作者信息

Sharma Jyoti, Sharma Nitin, Gera Divya, Nagori Richa R, Sharma Deepanshu

机构信息

Department of Pediatric and Preventive Dentistry, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India.

Department of Pharmacology, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India.

出版信息

Int J Clin Pediatr Dent. 2024 Nov;17(11):1236-1240. doi: 10.5005/jp-journals-10005-2994. Epub 2024 Dec 19.

Abstract

AIMS AND BACKGROUND

Local anesthetics play a crucial role in pain management in pediatric dentistry, where anxiety and fear are common among young patients. This study aimed to compare the anesthetic efficacy of 2% lignocaine with a 20-gauge needle in an inferior alveolar nerve block (IANB) and 4% articaine with a 24-gauge needle in a buccal nerve block (BNB) during the extraction of dentoalveolar abscesses in children aged 5-11 years.

MATERIALS AND METHODS

A 12-month randomized controlled trial involving 100 healthy children was conducted following ethical standards. Patients were assigned to receive either lignocaine or articaine anesthesia. Pain assessments were conducted using the Wong-Baker Faces Pain Rating Scale (W-BFRS) and visual analog scale (VAS). Postoperative follow-ups were performed to evaluate pain, biting incidents, and numbness duration.

RESULTS

The study demonstrated a strong positive correlation between W-BFRS and VAS ratings, indicating effective pain assessment. While both techniques showed efficacy, the BNB + local infiltration (LI) technique exhibited lower rates of reanesthesia and discomfort compared to IANB + LI. Follow-up assessments revealed shorter numbness duration and reduced biting incidents with the BNB + LI technique.

CONCLUSION

This study underscores the importance of considering patient comfort and experience when selecting anesthesia techniques in pediatric dentistry. Articaine emerges as a favorable option, offering improved pain management and patient satisfaction compared to lignocaine. Both the IANB + LI and BNB + LI techniques are viable options, with the choice influenced by adverse events and patient preferences. This research contributes valuable insights into optimizing pain management for pediatric dental procedures, particularly in cases of dentoalveolar abscesses.

HOW TO CITE THIS ARTICLE

Sharma J, Sharma N, Gera D, Comparative Evaluation of Clinical Anesthetic Efficacy of 4% Articaine with 24-Gauge Needle in Buccal Nerve Block Compared to 2% Lignocaine with 20-Gauge Needle in Inferior Alveolar Nerve Block in Children with Dentoalveolar Abscess. Int J Clin Pediatr Dent 2024;17(11):1236-1240.

摘要

目的与背景

局部麻醉剂在儿童牙科的疼痛管理中起着关键作用,因为年轻患者中焦虑和恐惧很常见。本研究旨在比较在5至11岁儿童牙槽脓肿拔除术中,2%利多卡因搭配20号针头在下牙槽神经阻滞(IANB)中的麻醉效果与4%阿替卡因搭配24号针头在颊神经阻滞(BNB)中的麻醉效果。

材料与方法

按照伦理标准进行了一项为期12个月的随机对照试验,涉及100名健康儿童。患者被分配接受利多卡因或阿替卡因麻醉。使用面部表情疼痛评分量表(W - BFRS)和视觉模拟量表(VAS)进行疼痛评估。术后进行随访以评估疼痛、咬伤事件和麻木持续时间。

结果

研究表明W - BFRS评分与VAS评分之间存在强正相关,表明疼痛评估有效。虽然两种技术都显示出疗效,但与IANB + 局部浸润(LI)相比,BNB + 局部浸润(LI)技术的再次麻醉率和不适感较低。随访评估显示,BNB + LI技术的麻木持续时间更短,咬伤事件减少。

结论

本研究强调了在儿童牙科选择麻醉技术时考虑患者舒适度和体验的重要性。与利多卡因相比,阿替卡因成为一个有利的选择,可提供更好的疼痛管理和患者满意度。IANB + LI和BNB + LI技术都是可行的选择,选择受不良事件和患者偏好影响。本研究为优化儿童牙科手术的疼痛管理提供了有价值的见解,特别是在牙槽脓肿的情况下。

如何引用本文

Sharma J, Sharma N, Gera D, 4%阿替卡因搭配24号针头在颊神经阻滞中与2%利多卡因搭配20号针头在下牙槽神经阻滞用于儿童牙槽脓肿临床麻醉效果的比较评估。《国际临床儿科牙科学杂志》2024;17(11):1236 - 1240。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/308e/11703763/eb8c1d57e2ca/ijcpd-17-1236-g001.jpg

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