三种局麻方法对下颌磨牙麻醉效果的临床评价

The Clinical Pulpal Anesthetic Efficacy of Three Types of Local Analgesia to Mandibular Molars

目的:比较下牙槽神经阻滞麻醉、局部浸润麻醉和牙周膜麻醉对下颌磨牙牙髓的麻醉效果。方法:将210例下颌磨牙急性牙髓炎患者随机均分为三组,采用下牙槽神经阻滞麻醉(A组)、黏膜下浸润麻醉(B组)及牙周膜麻醉(C组)与无痛局麻仪和甲哌卡因进行局部注射。麻醉起效后常规行开髓和拔髓术。以视觉模拟疼痛法(VAS评分法)对治疗时的疼痛进行评分。采用SPSS12.0统计分析软件进行χ2检验。结果:A、B、C三组麻醉成功率分别为91.4%、55.7%、87.1%。A组与C组的差别无显著性(P>0.05),B组与A组、B组与C组间差别均有显著性(P<0.05)。结论:下颌磨牙牙髓治疗中应用无痛局麻仪和甲哌卡因进行下牙槽神经阻滞麻醉和牙周膜麻醉,均能取得较好的麻醉效果。

Objective： To compare the pulpal anesthetic efficacy with three local anesthetic methods. Method： 210 patients with acute pulpitis in mandibular molars were randomly assigned in three groups randomly, which need to remove pulp chamber and pulp. The computerized local anesthetic delivery system and mepivacaine were used. Three injection methods of block anesthesia （group A）, submucous infiltration anesthesia （group B） and peridontal ligament anesthe- sia （group C） were used to manipulate the local anesthesia. Visual analogue scale （VAS） was used to assess the pain degree during operating procedure. Data were analyzed using χ2 test by SPSS12. 0. Results： Successful rates were 94. 1% （A）, 55.7%（B）, and 87.1% （C） respectively. Group A and C showed no significant difference（P〉0. 05）, while significant differences were observed between group A and B or C and B（P〈0. 05）. Condasion： For the pulpal anesthetic of mandibular molars, the block anesthesia and peridontal ligament anesthesia with the computerized local anesthetic delivery system and mepivacaine could obtain relatively well anesthetic effect.