上牙槽前中神经阻滞麻醉与局部浸润麻醉在上颌牙周治疗中的应用效果

Comparative analysis of the effects of anterior middle superior alveolar nerve block anesthesia and local infiltration anesthesia in treatment of maxillary periodontal diseaes

目的分析上牙槽前中神经阻滞麻醉与局部浸润麻醉在上颌牙周治疗中的应用效果。方法对2015年3月至2017年6月就诊治疗的96例因牙周炎行根面平整及龈下刮治治疗患者临床资料做回顾性分析,并根据麻醉方式的不同分为上牙槽前中神经阻滞麻醉组和局部浸润麻醉组,每组48例。比较2组患者VAS评分、麻醉时间、麻醉成功率、麻醉不适感及不良反应的发生情况等。结果上牙槽前中神经阻滞麻醉组的VAS评分及麻醉时间均少于局部浸润麻醉组(P<0.05),2组患者麻醉成功率(85.42%vs 89.58%)比较差异无统计学意义(P>0.05),上牙槽前中神经阻滞麻醉组的无不适例数明显多于局部浸润麻醉组(P<0.05),轻、中、重度不适例数均少于对照组(P<0.05),均未出现极度不适例数,可表明神经阻滞麻醉组麻醉舒适度较好。2组患者不良反应发生率(6.24%vs4.16%)比较差异无统计学意义(χ~2=0.211,P=0.646)。结论在上颌牙周治疗中应用上牙槽前中神经阻滞麻醉可有效的降低患者注射疼痛及提高其麻醉舒适度,更易被患者接受。

Objective To compare and analyze the therapeutic effects of anterior middle superior alveolar（ AMSA）nerve block anesthesia and local infiltration anesthesia in treatment of periodontitis involving maxillary region. To compare and analyze the effect of anterior and middle alveolar nerve block anesthesia and local infiltration anesthesia in maxillary periodontal treatment. Methods The clinical data of 96 patients with periodontitis who were treated with root planning and subgingival scaling in our hospital from March 2015 to June 2017 were retrospectively analyzed. According to the different anesthesia methods,they were divided into the AMSA nerve block anesthesia group（ n = 48） and the local infiltration anesthesia group（ n = 48）. The VAS score,anesthesia time,anesthesia success rate,anesthetic-related discomfort and adverse reactions were recorded and compared between the two groups. Results The VAS scores and anesthesia duration in AMSA nerve block anesthesia group were significantly less than those in local infiltration anesthesia group（ P〈 0. 05）,however,there was no significant difference in success rate of anesthesia between the two groups（ 85. 42% vs 89. 58%,P〈 0. 05）. The patients without anesthetic-related discomfort in AMSA nerve block anesthesia group were significantly more than those in local infiltration anesthesia group（ P〈 0. 05）,moreover,the patients with mild,moderate and severe anestheticrelated discomfort were significantly less than those in control group（ P〈 0. 05）. In addition,there were no cases of extreme anesthetic-related discomfort,and the patients in the nerve block anesthesia group had better anesthetic-related comfort. There was no significant difference in incidence rate of adverse reactions between the two groups（ 6. 24% vs 4. 16%）（ χ2= 0. 211,P〉 0. 05）. Conclusion The AMSA nerve block anesthesia can effectively reduce the pain during the injection,and can improve the patient comfort degree in treatment of periodontitis,therefore,it is more acceptable to the patients.