联合麻醉在下颌阻生齿微创拔除中的临床研究  

Clinical study of combined anesthesia in minimally invasive extraction of impacted mandibular teeth

作　　者：戴永铮 杨英泽[1] 孟丹婕 Dai Yongzheng;Yang Yingze;Meng Danjie(Hefei Stomatology Hospital,Hefei Clinical School of Stomatology,Anhui Medical University,Hefei,Anhui 230001,China)

机构地区：[1]合肥市口腔医院·安徽医科大学合肥口腔临床学院,安徽合肥230001

出　　处：《首都食品与医药》2024年第16期51-54,共4页Capital Food Medicine

基　　金：安徽医科大学校科研基金项目(编号:2020xkj022)。

摘　　要：目的探讨利多卡因阻滞麻醉加阿替卡因浸润麻醉的联合麻醉方案在下颌阻生齿拔除中的麻醉效果.方法采用自身左右对照,一边应用传统2%利多卡因阻滞麻醉(对照组),另一边应用2%利多卡因阻滞麻醉加4%阿替卡因浸润麻醉的联合麻醉(实验组),观察麻药注射时以及手术操作过程中各阶段的疼痛情况(疼痛评估量表,NRS)、麻醉的起效时间、术后出血情况的差异.采用Graphpad Prism 8.0软件对数据进行统计学分析.结果39例患者完成研究,实验组的麻药注射时疼痛水平显著低于对照组(t=8.62,P<0.05);实验组疼痛率显著低于对照组(χ^(2)=6.27,P<0.05);术中在切开翻瓣和缝合操作时实验组疼痛率显著低于对照组(χ^(2)=8.37,P<0.05),但在去骨、分冠、脱位操作时两组疼痛发生率差异无统计学意义(χ^(2)=1.17,1.14,P>0.05);实验组与对照组麻醉起效时间(t=0.18,P>0.05)和术后出血率(χ^(2)=0.46,P>0.05)差异无统计学意义.结论在阻生齿拔除过程中,联合麻醉可以提供可靠的麻醉效果,是值得推广的麻醉方案.Objective To investigate the anesthetic effect of block anesthesia with lidocaine combined with infiltration anesthesia with artecaine in the extraction of impacted teeth.Methods A study with a cross-over design,with each patient also serving as their own control,one side was given traditional block anesthesia with 2%lidocaine(control group),the other side was given traditional block anesthesia with 2%lidocaine combined with infiltration anesthesia with 4%articaine(experimental group).Outcome variables were the time of onset of anesthesia,postoperative bleeding and the pain levels at the time of anesthetic injection and at various stages during the procedure(Pain Assessment Scale,NRS).Graphpad Prism 8.0 software was used for statistical analysis of the data.Results 39 patients completed the experiment,the pain level of the experimental group was significantly lower than that of the control group,the difference was statistically significant(t=8.62,P<0.05);compared with the depth of anesthesia during operation,the pain rate of the experimental group was lower than that of the control group,the difference was statistically significant(χ^(2)=6.27,P<0.05);the pain rate of the experimental group was lower than that of the control group during incision and flap operation and suture operation,the difference was statistically significant(χ^(2)=8.37,P<0.05).However,there was no significant difference in the incidence of pain between the two groups during boning,segmenting crown and dislocation operation(χ^(2)=1.17,1.14,P>0.05).There was no significant difference between the experimental group and the control group in the onset time of anesthesia(t=0.18,P>0.05)and the rate of postoperative bleeding(χ^(2)=0.46,P>0.05).Conclusion Combined anesthesia can provide more reliable anesthetic effect in the process of extraction of impacted teeth.

关 键 词：阻滞麻醉 阿替卡因 下颌阻生齿 

分 类 号：R614[医药卫生—麻醉学]