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比较0.75%罗哌卡因和2%利多卡因对第三磨牙手术术中出血及术后疼痛的影响:一项双盲、双侧对照研究。

Comparing the Effect of 0.75% Ropivacaine and 2% Lidocaine on Intraoperative Bleeding and Postoperative Pain of Third Molar Surgery: A Double Blinded, Split Mouth Study.

作者信息

Samieirad Sahand, Pourafshar Elmira, Shiezadeh Farid, Hosseini Abrishami Majid

机构信息

Oral and Maxillofacial Surgery Department, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran.

Dentist, Privet Practice, Mashhad, Iran.

出版信息

World J Plast Surg. 2025;14(1):10-16. doi: 10.61186/wjps.14.1.10.

DOI:10.61186/wjps.14.1.10
PMID:40453399
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12124264/
Abstract

BACKGROUND

We aimed to compare the effect of 0.75% ropivacaine and 2% lidocaine with 1:100,000 epinephrine on intraoperative bleeding and postoperative pain following mandibular third molar surgery.

METHODS

In this split-mouth clinical trial, 60 patients required bilateral impacted third molar of the mandible were prepared for operation in the Department of Maxillofacial Surgery of Mashhad Dental Faculty, Mashhad, Iran. Surgery was performed randomly on one side using ropivacaine and on the other side with lidocaine with epinephrine. The intraoperative bleeding, the postoperative pain (at 3, 6, 12, 18, and 24 hours after the operation), and the difficulty of the surgery were measured in each group and compared.

RESULTS

In all postoperative time intervals, the pain was lower in the ropivacaine group than in the lidocaine group. The rate of intraoperative bleeding in the ropivacaine group was lower than in the lidocaine group. In the lidocaine group, pain initially increased and reached its maximum value after three hours, but decreased after the sixth hour and reached its minimum value 24 hours after surgery. In the ropivacaine group, the pain increased initially and was at its peak at 3 and 6 hours, after which it decreased and reached its lowest value at 24 hours.

CONCLUSION

Postoperative pain was less in the 0.75% ropivacaine group than in the 2% lidocaine with 1:100,000 epinephrine group during all postoperative periods. Also, the amount of bleeding during the operation was less in the ropivacaine group.

摘要

背景

我们旨在比较0.75%罗哌卡因和2%利多卡因加1:100,000肾上腺素在下颌第三磨牙手术后对术中出血和术后疼痛的影响。

方法

在这项双侧对照临床试验中,60例需要拔除双侧下颌阻生第三磨牙的患者在伊朗马什哈德牙科医学院颌面外科准备手术。手术随机在一侧使用罗哌卡因,另一侧使用利多卡因加肾上腺素。测量每组的术中出血、术后疼痛(术后3、6、12、18和24小时)以及手术难度并进行比较。

结果

在所有术后时间段,罗哌卡因组的疼痛低于利多卡因组。罗哌卡因组的术中出血率低于利多卡因组。在利多卡因组,疼痛最初增加并在三小时后达到最大值,但在第六小时后下降并在术后24小时达到最小值。在罗哌卡因组,疼痛最初增加并在3和6小时达到峰值,之后下降并在24小时达到最低值。

结论

在所有术后阶段,0.75%罗哌卡因组的术后疼痛低于2%利多卡因加1:100,000肾上腺素组。此外,罗哌卡因组术中出血量较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/905b/12124264/85d222ba900e/wjps-14-010-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/905b/12124264/85d222ba900e/wjps-14-010-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/905b/12124264/85d222ba900e/wjps-14-010-g001.jpg

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本文引用的文献

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Medicina (Kaunas). 2021 Jul 30;57(8):782. doi: 10.3390/medicina57080782.
2
Update on Local Anesthetic Toxicity, Prevention and Treatment During Regional Anesthesia in Infants and Children.婴幼儿区域麻醉期间局部麻醉药毒性、预防及治疗的最新进展
J Pediatr Pharmacol Ther. 2021;26(5):445-454. doi: 10.5863/1551-6776-26.5.445. Epub 2021 Jun 28.
3
Comparative Analysis of the Anesthetic Efficacy of 0.5% Ropivacaine Versus 2% Lignocaine Hydrochloride with Adrenaline (1:80,000) for Inferior Alveolar Nerve Block in Surgical Removal of Impacted Mandibular Third Molars.
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J Maxillofac Oral Surg. 2021 Jun;20(2):234-239. doi: 10.1007/s12663-020-01428-6. Epub 2020 Jul 31.
4
Comparison of anaesthetic efficacy of ropivacaine (0.75% & 0.5%) with 2% lignocaine with adrenaline (1:200000) in surgical extraction of bilateral mandibular 3 molars using IANB:a prospective, randomized, single blind study.使用下牙槽神经阻滞麻醉(IANB)在双侧下颌第三磨牙手术拔除中比较罗哌卡因(0.75%和0.5%)与2%利多卡因加肾上腺素(1:200000)的麻醉效果:一项前瞻性、随机、单盲研究。
J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):263-268. doi: 10.1016/j.jobcr.2021.02.005. Epub 2021 Feb 9.
5
Can local anesthesia with ropivacaine provide postoperative analgesia in extraction of impacted mandibular third molars? A randomized clinical trial.罗哌卡因局部麻醉能否提供下颌阻生第三磨牙拔除术后镇痛?一项随机临床试验。
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