颊侧浸润麻醉对上颌磨牙麻醉效果的临床观察

The clinical pulpal anesthetic efficacy of buccal infiltration to maxillary molars

目的:比较颊侧浸润麻醉与传统阻滞麻醉对上颌磨牙牙髓的麻醉效果。方法:选择因上颌磨牙深龋或牙髓炎患者,患牙在局麻下行去龋或开髓、拔髓操作。麻药为含1:80000肾上腺素的2%利多卡因。患者随机分为A、B、C三组,每组各100例。A组采用颊侧黏膜下浸润麻醉,剂量1.8ml;B组采用与A组相同的黏膜下浸润麻醉,剂量0.9ml;C组采用传统阻滞麻醉,剂量1.8ml。以视觉模拟评分法(VAS)对注射和操作的疼痛程度进行评分,以Kruskal-Wallis方法检验各组间差异。结果:①Kruskal-Wallis检验显示注射疼痛,组间有统计学差异(p<0.05),而操作疼痛,组间无统计学差异(p>0.05);②Nemenyi法进一步比较各组间注射疼痛的差异,A组与B组无显著性差异(p>0.05),而A组与C组、B组和C组之间存在显著性差异(p<0.05)。结论:对于上颌磨牙的麻醉,颊侧浸润麻醉(1.8ml或0.9ml)与传统的阻滞麻醉在操作疼痛评分中无显著性差异,但是注射疼痛显著低于阻滞麻醉。提示0.9ml含1:80000肾上腺素的2%利多卡因颊侧浸润麻醉即可获得较好的上颌磨牙牙髓麻醉效果。

Objective： To compare the pulpal anesthetic efficacy with the buccal infiltration and traditional block injection. Method： First-visit patients with caries or pulpitis in maxillary molars were chosen,which performed caries-removal, pulp chamber exposure and pulp extirpation. 2% lidocaine with 1：80000 epinephrine was used. The patients were randomly assigned in three groups, 100 teeth per group. Group A： 1.8 ml anesthetic was injected as submucous infiltration anesthesia. Group B：the injection method was the same as group A,but the dosage was 0.9 ml. Group C： 1.8 ml anesthetic was used as block anesthesia. Visual analogue scale （VAS） was used to assess the pain degree during the injection and op- crating procedure. Data were analyzed using Kruskal-Wallis test and Nemenyi test. Result： For the injection pain assess- mentthere were difference among the groups （p〈0.05）. Nemenyi test showed that significant difference existed between group A and C, B and C （p〈0.05）. For the operating pain assessment, there was no difference among the groups （p〉0.05）. Conclusion：For the pulpal anaesthesia of maxillary molars,the bueeal infiltration with 0.9 ml 2% lidoeaine with 1：80000 epinephrine could get anesthetic efficacy.