阿替卡因浸润麻醉和利多卡因神经阻滞麻醉在下颌第二乳磨牙切髓术中的疗效对比  

Comparison of the therapeutic effects between articaine infiltration anesthesia and lidocaine nerve block anesthesia in pulpotomy of deciduous mandibular second molar

作　　者：王宇 刘芬 司红羚[1] 王雅洁 侯庆荣 靳荣昭 WANG Yu;LIU Fen;SI Hongling;WANG Yajie;HOU Qingrong;JIN Rongzhao(Key laboratory of Shaanxi Province for Craniofacial Precision Medicine Research,College of Stomatology,Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases,College of Stomatology,The First Clinic of College of Stomatology,Xi'an Jiaotong University,710048,China;Department of Pediatric Dentistry,College of Stomatology,Xi'an Jiaotong University)

机构地区：[1]西安交通大学口腔医院陕西省颅颌面精准医学研究重点实验室,陕西省牙颌疾病临床研究中心,西安交通大学口腔医院第一(兴庆)门诊部,710048 [2]西安交通大学口腔医院儿童口腔科

出　　处：《实用口腔医学杂志》2024年第4期537-541,共5页Journal of Practical Stomatology

基　　金：广东省自然科学基金(编号:2023A1515012126)。

摘　　要：目的:比较阿替卡因浸润麻醉和利多卡因神经阻滞麻醉应用于下颌第二乳磨牙切髓术的疗效。方法:纳入需要行双侧下颌第二乳磨牙牙髓切断术的儿童患者,采用单盲交叉试验,在两次治疗中分别给予阿替卡因浸润麻醉和利多卡因神经阻滞麻醉。在麻醉药物注射及牙髓治疗结束后,通过声音,眼睛和肢体运动及Wong-Baker面部表情疼痛评估图判断患者对疼痛的反应并进行定量比较。利用Student’s-t检验和卡方检验对所获取的数据进行统计分析。结果:共纳入50名符合标准的儿童患者,均顺利完成两次治疗。在阿替卡因浸润麻醉过程中,声音,眼睛和肢体运动三个反应疼痛程度的指标评分均低于利多卡因神经阻滞麻醉(P<0.05)。而面部表情疼痛评估图分析结果也提示阿替卡因浸润麻醉的疼痛不适更加轻微(P<0.05)。在下颌第二乳磨牙切髓术过程中,两种疼痛评估方式均表明不同麻醉方式下患儿对疼痛的感知无差异(P>0.05)。结论:在下颌乳磨牙牙髓治疗中,阿替卡因浸润麻醉可能有效替代利多卡因神经阻滞麻醉。Objective:To compare the efficacy of articaine infiltration anesthesia and lidocaine nerve block anesthesia in pulpotomy of deciduous mandibular second molars.Methods:Single blind crossover test was used for the pediatric patients who required bilateral deciduous mandibular second molar pulpotomy were given articaine infiltration anesthesia and lidocaine nerve block anesthesia respectively before the 2 times of operation.After the injection of anesthetic drugs and dental pulp treatment,the patients'responses to pain were evaluated through sound,eye and body movements,and Wong-Baker facial pain rating scales.Quantitative comparisons were made.Student's t-test and chi-square test were performed for the collected data.Results:50 pediatric patients who met the inclusion criteria and successfully completed 2 treatments without any missed visits or adverse events.During the process of articaine infiltration anesthesia,the scores of the 3 indicators of pain severity,namely sound,eye and body movements,were lower than those of lidocaine nerve block anesthesia(P<0.05).The analysis of facial pain rating scales also suggested that patients'pain and discomfort during the infiltration anesthesia process with articaine were milder(P<0.05).During the treatment of pulpotomy,both pain assessment methods showed no statistically significant difference in pain perception between the 2 anesthesia injections(P>0.05).Conclusion:Articaine infiltration anesthesia may effectively replace lidocaine nerve block anesthesia in pulp treatment of mandibular primary molars.

关 键 词：乳牙 牙髓治疗 阿替卡因 利多卡因 浸润麻醉 阻滞麻醉 

分 类 号：R782.054[医药卫生—口腔医学]