阿替卡因麻醉下拔除上颌恒磨牙不施行腭侧注射麻醉的可行性

Feasibility of permanent maxillary tooth removal using articaine anesthesia without palatal injection

目的探讨拔除上颌恒磨牙时单用阿替卡因进行颊侧注射不施行腭侧注射的可行性。方法选择2007年5—7月在四川省人民医院口腔科就诊的104例需拔除上颌恒磨牙的患者为研究对象,38例患者为双侧上颌均有恒磨牙需要拔除,选择其中一侧作为试验牙,另一侧作为对照牙;两侧磨牙分2次拔除,间隔时间为7d。66例患者为单侧上颌恒磨牙拔除,将需拔除牙作为试验牙,以前的拔牙经历作为对照。试验组由颊侧前庭沟注射点注入1.7mL盐酸阿替卡因,对照组除颊侧注射外,在腭侧同时注射2%盐酸利多卡因0.25mL。麻醉5min后拔除患牙。由患者填写视觉模拟量表,对疼痛打分。结果试验组上颌恒磨牙麻醉成功率为96.2%,对照组上颌恒磨牙麻醉成功率为97.1%,二者之间的差异无统计学意义(P>0.05)。结论在上颌恒磨牙的拔除中,阿替卡因颊侧注射麻醉后能达到较好的麻醉效果,可以不进行腭侧麻醉。

Objective This study was to test the feasibility of permanent maxillary tooth removal using articaine without a second palatal injection. Methods Of 104 patients, 38 patients had bilateral extraction and 66 patients had unilateral extraction of maxillary tooth. In the test group, 1.7 mL articaine with 1：100 000 epinephrine was injected into the buccal vestibule of the tooth and the tooth were extracted after 5 minutes. In the control group, the patients were subjected to both palatal injection with 2% lidocaine hydrochloride and buccal injection with articaine. All patients completed visual analog scales （VAS） after extraction. Results The achievement ratio of permanent maxillary tooth anesthesia of test group was 96.2%. The achievement ratio of permanent maxillary tooth anesthesia of control group was 97.1%. There was no statistical significance between achievement ratio of test group and control group （P〉0.05）. Conclusion Permanent maxillary tooth removal without palatal injection is possible by articaine injection to the buccal vestibule of the tooth.