两种不同下牙槽神经阻滞麻醉方法用于下颌阻生第三磨牙拔除术的对比研究

A contrast study of two different block anesthesia of inferior alveolar nerve used for the extraction of impacted mandibular third-molar

目的:探讨一种更加有效的下齿槽神经阻滞麻醉的方法。方法:随机选取需翻瓣去骨法拔除下颌阻生第三磨牙患者150例。实验组50例,采用Gow-Gates法阻滞麻醉,对照一组50例,采用下颌支内侧隆突阻滞麻醉,对照二组在采用对照组一的方法注射后保留少量局麻药加用患牙颊侧近远中及舌侧三点浸润麻醉。采用VAS评分法观察疼痛情况。三组病例均使用阿替卡因肾上腺素注射液。结果:与对照一组相比,采用Gow-Gates法阻滞麻醉的病例疼痛明显减轻,但是与对照二组相比,该法没有明显优势。结论:传统的下颌支内侧隆突阻滞麻醉加用局部浸润麻醉可以有效提高下牙槽神经阻滞麻醉的成功率,达到与Gow-Gates阻滞麻醉相同的麻醉效果。

Objective：To discuss a more effective method of block anesthesia of inferior alveolar nerve.Method： 150 cases of patients who need extraction of the impacted mandibular third-molar by opening flapping and deboning were selected and divided randomly into three groups：Experimental group（50 cases） with Gow-Gates mandibular block,control group one（50 cases） with block anesthesia of internal ramus prominence and control group two（50 cases） with extra infiltration anesthesia of buccal mesiocclusion and distocclusion and lingual side of offending teeth after the same injection method as control group one.The pain situation was observed by Visual Analogue Scale.All the three groups used the articaine hydrochlorine and epinephrine tartrate injection.Result：The cases performed Gow-Gates mandibular block showed less pain than control group one,but contrast to control group two,the method showed no superiority.Conclusion：The conventional block anesthesia of internal ramus prominence added with local infiltration anesthesia could enhance the success ratio of block anesthesia of inferior alveolar nerve effectively and achieve the same effect as Gow-Gates mandibular block.