局部浸润麻醉和阻滞麻醉在下颌中高位阻生第三磨牙拔除术中麻醉效果的对照研究  

Anesthetic effect in extraction of medium-high impacted third molars in mandible:local infiltration anesthesia vs.block anesthesia

作　　者：钟江龙 王洁琪[1] 叶秀华[1] 陈伟良[1] 王友元[1] 范松[1] ZHONG Jianglong;WANG Jieqi;YE Xiuhua;CHEN Weiliang;WANG Youyuan;FAN Song(Department of Stomatology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院口腔科,广州510120

出　　处：《实用医学杂志》2022年第23期2942-2946,共5页The Journal of Practical Medicine

基　　金：广东省基础与应用基础研究基金企业联合基金-面上项目(编号:2021A1515220138)。

摘　　要：目的对比改良局部浸润麻醉与下牙槽神经阻滞麻醉在下颌中高位阻生第三磨牙拔除术中的麻醉效果。方法67例双侧均需行中高位下颌阻生齿拔除的受试者一侧行改良局部浸润麻醉,另一侧行下牙槽神经阻滞麻醉。记录注射疼痛感(VAS自评)、唇舌麻木情况、手术时间、麻醉成功率、术中术后疼痛情况等并行对比分析。结果研究组和对照组麻醉成功率分别为93.8%和93.7%(P=0.964)。对照组分别有3例和2例受试者术中未感到舌和下唇麻木,研究组则高达37例和59例(P<0.01)。研究组麻药注射时的疼痛自评分数均值为15.74,低于对照组的30.19(P<0.01)。两组在术中及术后2、6 h和1、2、3、7 d的疼痛自评数值差异均无统计学意义。结论中高位下颌阻生第三磨牙行改良局部浸润麻醉法可取得与阻滞麻醉相似的麻醉效果,且更易做到微痛、无痛,是优于下牙槽神经阻滞麻醉的方法。Objective To compare the anesthetic effect of modified local infiltration anesthesia with inferior alveolar nerve block anesthesia in the extraction of a high impacted third molar in the mandible.Methods Sixtyseven patients undergoing bilateral extraction of medium to high mandibular obstructive teeth were anesthetized with modified local infiltration on one side and inferior alveolar nerve block on the other side.The pain sensation of injection(VAS self-assessment),lip and tongue numbness,operation time,anesthesia success rate,and intraoperative and postoperative pain were recorded and compared between them.Results The success rates of anesthesia in the test and control groups were 93.8%and 93.7%,respectively(P=0.964).In the control group,3 and 2 patients did not experience intraoperative numbness of the tongue and lower lip,respectively,compared with 37and 59 in the test group(P<0.01).The mean value of pain self-rating during anesthetic injection in the test group was significantly lower than in the control group(15.74 vs.30.19,P<0.01).There were no statistical differences between the two groups in pain self-assessment values intraoperatively and at 2 hours,6 hours,1 day,2 days,3days and 7 days postoperatively.Conclusion Modified local infiltration anesthesia for medium to high level mandibular blocked third molars can achieve similar anesthetic effect as block anesthesia does.It is superior to the block anesthesia,for it is easier to achieve minimal or no pain.

关 键 词：下颌阻生第三磨牙 浸润麻醉 下牙槽神经阻滞麻醉 

分 类 号：R782.11[医药卫生—口腔医学]