两种局麻药物在下颌第三磨牙拔除中麻醉效果的比较  

Comparison of anesthesia effect of two local anesthetic drugs in the extraction of mandibular third molar

作　　者：蓝炎涛 张丽霞[1] 申龙朵 LAN Yantao;ZHANG Lixia;SHEN Longduo(Huizhou Stomatological Hospital&Huizhou Stomatological Hospital Affiliated to Jinan Univer-sity School of Medicine,Huizhou 516000,China;不详)

机构地区：[1]惠州口腔医院·暨南大学医学院附属惠州口腔医院,广东惠州516000

出　　处：《现代医院》2020年第6期919-921,共3页Modern Hospitals

基　　金：惠州市科技计划项目(2019Y242,2019Y245)。

摘　　要：目的探讨阿替卡因肾上腺素注射液和盐酸甲哌卡因/肾上腺素注射液在下颌第三磨牙拔除中麻醉效果的研究。方法选取2019年1月-8月在惠州口腔医院颌面外科门诊就诊的49例双侧下颌第三磨牙需预防性拔除的患者作为研究对象,根据随机双盲原则分别选取阿替卡因肾上腺素注射液和盐酸甲哌卡因/肾上腺素注射液进行下牙槽神经进行麻醉,评估其麻醉效果。结果阿替卡因肾上腺素注射液组和盐酸甲哌卡因/肾上腺素注射液组麻醉起效时间分别为(55.58±6.04)s和(89.24±6.85)s,两者之间差异有统计学意义(P=0.00);阿替卡因肾上腺素注射液组和盐酸甲哌卡因/肾上腺素注射液组患者术中疼痛分别为(1.04±0.93)和(1.33±1.00),差异无统计学意义(P=0.21);阿替卡因肾上腺素注射液组和盐酸甲哌卡因/肾上腺素注射液组麻醉持续时间分别为(230.76±33.17)min和(172.09±18.36)min,两组之间差异有统计学意义(P=0.00)。阿替卡因肾上腺素注射液组有7人(14.29%)需补充麻醉,盐酸甲哌卡因/肾上腺素注射液组有13人(26.53%)需补充麻醉。结论阿替卡因肾上腺素注射液具有起效快、持续时间久,建议在下牙槽神经阻滞麻醉拔除第三磨牙的患者中首选阿替卡因肾上腺素注射液进行麻醉。Objective The study aimed at evaluating the clinical efficacy of articaine over mepivacaine in the surgi-cal removal of impacted mandibular third molars.Methods Forty-nine patients with bilateral mandibular third molars nee-ding preventive extraction who visited Huizhou Stomatological Hospital from January 2019 to August 2019 were selected as the study subjects.Articaine adrenaline injection and mepivacaine hydrochloride/epinephrine injection were selected for inferior alveolar nerve anesthesia according to the principle of random double blindness to evaluate the anesthetic effect.Results The differences in latency with articaine(55.58±6.04)s and with mepivacaine hydrochloride(89.24±6.85)s,which was statistically significant(P=0.00),pain during procedure for articaine(1.04±0.93)and for mepivacaine hydrochloride(1.33±1.00),which was not statistically significant(P=0.21),and mean duration of anesthetic effect for articaine was(230.76±33.17)min and(172.09±18.36)min min for mepivacaine hydrochloride,which was statistically significant(P=0.00).For re-anesthesia,7 out of 49 patients needed re-anesthesia at the frequency of 14.29%for articaine and 13 out of 49 patients needed re-anesthesia at a frequency of 26.53%for mepivacaine hydrochloride.Conclusion Articaine adrena-line injection has a quick onset and a long duration.Therefore,we recommend that the first choice for patients with third mo-lar extraction under inferior alveolar nerve block anesthesia is Articaine adrenaline injection.

关 键 词：下牙槽神经阻滞麻醉 第三磨牙 阿替卡因肾上腺素注射液 盐酸甲哌卡因/肾上腺素注射液 

分 类 号：R971.2[医药卫生—药品]