计算机控制下局部麻醉注射系统在儿童的应用

Application of computer-controlled local anesthetic delivery system in children

目的比较计算机控制下局部麻醉注射系统(CCLADS)与手推式注射器局部麻醉中的儿童行为特征及对2种注射器的自评估情况。方法选择4～9岁需局部麻醉且同颌相应磨牙所需治疗方式相同的患儿30例,随机分为2组,第1组先应用CCLADS进行麻醉,其中上颌采用颊侧骨膜上浸润麻醉,下颌采用牙周膜(PDL)麻醉;第2组先应用手推式注射器进行麻醉,上下颌均为颊侧骨膜上浸润麻醉。第2次就诊时2组互换注射方式。注射过程中,采用改良行为量表(MCHEOPS)对患儿行为进行评分;治疗结束时,由患儿根据视觉模拟量表(FIS)评估麻醉及治疗时的疼痛程度。结果 CCLADS注射1 min时的MCHEOPS值和FIS值均低于手推式注射器(P<0.05)。2种注射器治疗时患儿的FIS值无统计学差异(P>0.05)。结论 CCLADS在一定程度上能使局部麻醉更舒适,减少患儿在注射过程中的疼痛。

Objective To compare the reaction of children receiving computer-controlled local anesthetic delivery system（CCLADS） and a conventional syringe,and evaluate the efficacy of anesthesia and the reaction after treatment.Methods 30 children aged 4 to 9 years old,whose bilateral primary molars in the same jaw present similar lesions with similar treatment were included in the study.These bilateral primary molars were treated under local anesthesia in 2 separate visits with random use of either the CCLADS or conventional syringe.For the first visit,the first group received CCLADS anesthesia,in which buccal infiltration anesthesia was performed for maxillary primary molars,and periodontal ligament anesthesia was performed for mandibular primary molars.The second group received conventional anesthesia,in which buccal infiltration anesthesia was performed for both maxillary and mandibular primary molars.For the second visit,two groups used alternative anesthestic method.Pain behavior was observed and scored by modified-children＇s hospital of eastern ontario pain scale（MCHEOPS）.Pain perception was rated using facial image scale（FIS）. Results The MCHEOPS and FIS scores in 1 min injection of children with CCLADS were lower than children with conventional syringe（P0.05）.No difference was found in the FIS score in treatment between two injectors（P0.05）. Conclusion In local anesthesia,CCLADS can reduce the injection pain caused by conventional syringe to a certain extent.