阿替卡因肾上腺素注射液浸润麻醉在下颌智齿拔除中的应用

The Application of Articaine Hydrochlorine and Epinephrine Tartrate Injection for Infiltration Anesthesia in Removing the Mandibular Wisdom Tooth

目的探讨阿替卡因肾上腺素注射液在下颌智齿拔除中的麻醉效果及安全性。方法将96例105颗智齿随机分为治疗组53例58颗牙和对照组43例47颗牙。治疗组采用阿替卡因肾上腺素注射液行局部浸润麻醉,对照组采用利多卡因注射液神经传导阻滞麻醉。比较2组麻醉效果、不良反应及并发症的情况。结果治疗组麻醉注射时视觉模拟评分(VAS)值与对照组比较差异有统计学意义(P<0.05),而拔牙操作中VAS值与对照组比较差异无统计学意义(P>0.05)。治疗组麻醉良好率、总有效率分别为84.48%、100.00%,对照组分别为93.62%、100.00%,2组比较差异均无统计学意义(均P>0.05)。除对照组1例出现血管损伤致局部血肿的并发症外,2组均未出现不良反应。结论拔除下颌智齿时,阿替卡因肾上腺素注射液黏膜下浸润麻醉可达到与利多卡因注射液神经阻滞麻醉相当的效果,而无不良反应及并发症。

Objective To investigate the anesthetic efficacy and safety of articaine hydrochlorine and epinephrine tartrate injection in removing of mandibular wisdom tooth. Methods 96 patients （105 mandibular wisdom teeth） were selected and divided randomly into two groups： experimental group （53 cases with 58 teeth）and control group （43 cases with 47 teeth）. The patients in experimental group were given articaine hydrochlorine and epinephrine tartrate injection for infiltration anesthesia and those in control group were given lidocaine injection for nerver block anesthesia. The anesthetic efficacy, as well as adverse reaction and complication were then recorded and analyzed. Results The visual analogue scale （VAS） value during marcotic injection in experimental group was much slighter than that of control group（P〈0.05）,while during the extraction of tooth,no significant difference was found in two groups （P〉0.05）. The fair anesthesia rate and overall successful rate in experimental group were 84.48%, 100.00% respectively, while in control group 93. 62%, 100. 00%. There was no significant difference between two groups（all P〉0.05）. Local hematoma was found in one case in control group. No adverse reaction and complication were found in all of other cases in both group. Conclusion In additon to no adverse reaction and complication,the anesthetic efficacy of articaine hydrochlorine and epinephrine tartrate injection for submucous infiltration anesthesia is as good as that of lidocaine injection for nerve block anesthesia during removing mandibular wisdom teeth.