STA^(TM)系统韧带内注射麻醉在双尖牙拔除过程中的应用研究

Application research of intra-ligament injection with a computer-controlled local anesthetic delivery system STATMin the treatment of premolar extraction

目的研究STATM系统韧带内注射麻醉在双尖牙拔除过程中应用效果。方法将60例因正畸须拔除双侧4颗双尖牙患者采用单纯随机法分为A组和B组。A组(n=30)首次就诊采用黏膜下注射麻醉,第二次就诊采用STATM系统韧带内注射麻醉;B组(n=30)两次就诊麻醉方式与A组相反,记录麻醉注射操作及麻醉起效、失效时间,患者焦虑评分,术中、术后血压及心率变化。由患者自行评估麻醉注射过程中及手术中疼痛程度。结果 STATM系统韧带内注射麻醉注射操作时间较长(P<0.05),失效时间较短(P<0.05),两种注射方式间麻醉起效时间差异无统计学意义。初次就诊时两组患者之间焦虑评分无统计学差异,第二次就诊时B组患者手术前焦虑评分较低(P<0.05)。STATM系统韧带内注射过程中疼痛程度较轻,两种麻醉方式在术中麻醉效果无统计学差异。采用STATM系统韧带内注射时患者血压、心率升高较少(P<0.05)。结论 STATM系统韧带内注射在双尖牙拔除过程中麻醉效果肯定,与局部浸润注射麻醉相比较注射过程中疼痛更轻,患者血压、心率升高较少,可缓解患者再次治疗时的紧张情绪,更为安全。

Objective To observe the effectof the intra-ligament injection, administeredwith a computer-controlled local anesthetic delivery system STATM(Single ToothAnesthesia), in the premolar extraction. Methods 60 patientswho have 4 premolars to be extracted were randomly divided intogroup A(n=30) and group B(n=30), both to extract there bilateral premolar teeth in 2 times. The traditional sub-membranes anesthesia(SMA) was performed for the fi rst time treatment in group A, for the second time in group B. Intra-ligament injection with the STATMsystem(STA)was performed for the second time treatment in group A, for the fi rst time in group B. The time coston injection, reaction, expiration of the anesthetic the DMAS, the fl uctuation of blood pressure and heart ratewas recorded. The patientswere asked to evaluate theirpain according to the pain questionnaire. Results The time coston injection was longer(P<0.05), but the expiration time was shorter(P<0.05)withintra-ligament injection with a computer-controlled local anesthetic delivery system STATM(P<0.05). The patients' DMAS score has no statistical difference before their fi rst tooth extraction treatment. Before the second treatment time the DMAS score of group Bwasless than group A(P<0.05). The pain and the fl uctuation of BP and HR with STATM were less than SMA(P<0.05). Conclusion The intra-ligament injection, administered with the STATM is feasible in the premolar extraction. The pain feelingduring injection, HR change and BP fl uctuation weremuch less in STATM anesthesia than that of SMA.