Karunakar P, Solomon Raji Viola, Kumar B Sravan, Reddy S Shalini
Department of Conservative Dentistry, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India.
J Conserv Dent Endod. 2024 Dec;27(12):1228-1233. doi: 10.4103/JCDE.JCDE_625_24. Epub 2024 Dec 10.
Injection pain and incomplete anesthesia can lead to procedural failure, causing fear and anxiety among patients. The aim of the study was to compare and evaluate pain at the site, the onset of action, duration, anesthetic efficacy, and success rates of conventional, buffered, and precooled 2% lidocaine of an inferior alveolar nerve block (IANB) in symptomatic irreversible pulpitis (SIP).
In this double-blind, randomized clinical trial, 45 patients with deep carious lesions having moderate-to-severe pain in the mandibular first molar teeth were selected. Patients were randomized into one of the following groups: Group I-Conventional lidocaine (Control), Group II-Buffered lidocaine (Experimental), and Group III-Precooled lidocaine with intraoral cryotherapy (Experimental). All patients received an IANB followed by which the pain at the site, onset of action, duration, anesthetic efficacy, and success rate were compared and evaluated.
Kruskal-Wallis and Chi-square tests were used for statistical analysis.
Data were statistically analyzed and there was a significant reduction in pain at the site with faster onset of action and higher anesthetic efficacy in buffered lidocaine followed by precooled lidocaine. The success rate for conventional IANB is 38.9%, for buffered lidocaine, 86.2%, and for precooled lidocaine, 78.9%.
In patients with a mandibular molar presenting with SIP, block anesthesia with buffered lidocaine showed the best results and a superior success rate, followed by precooled lidocaine, with the least efficacy seen in the conventional lidocaine group.
注射疼痛和麻醉不全可导致操作失败,引起患者恐惧和焦虑。本研究旨在比较和评估在症状性不可逆性牙髓炎(SIP)患者中,传统、缓冲和预冷的2%利多卡因在下牙槽神经阻滞(IANB)时的注射部位疼痛、起效时间、持续时间、麻醉效果及成功率。
在这项双盲、随机临床试验中,选择45例下颌第一磨牙有中重度疼痛的深龋患者。患者被随机分为以下几组:第一组——传统利多卡因(对照组),第二组——缓冲利多卡因(试验组),第三组——采用口腔内冷冻疗法的预冷利多卡因(试验组)。所有患者均接受下牙槽神经阻滞,随后比较和评估注射部位疼痛、起效时间、持续时间、麻醉效果及成功率。
采用Kruskal-Wallis检验和卡方检验进行统计分析。
对数据进行统计分析后发现,缓冲利多卡因组其次是预冷利多卡因组,注射部位疼痛显著减轻,起效更快,麻醉效果更好。传统下牙槽神经阻滞的成功率为38.9%,缓冲利多卡因组为86.2%,预冷利多卡因组为78.9%。
在下颌磨牙伴症状性不可逆性牙髓炎的患者中,缓冲利多卡因阻滞麻醉效果最佳,成功率最高,其次是预冷利多卡因,传统利多卡因组效果最差。