0.5%罗哌卡因应用于下颌阻生智齿拔除术的临床效果观察

Clinical observation of 0.5% Ropivacaine in extraction of mandibular impacted wisdom tooth

目的通过对罗哌卡因(A组)与盐酸甲哌卡因肾上腺素注射液(B组)、盐酸利多卡因(C组)的比较,对罗哌卡因应用于拔除下颌阻生牙的临床效果进行观察。方法将需要拔除下颌阻生牙的患者78例,随机分为A、B、C 3组。A组27例,采用0.5%盐酸罗哌卡因加肾上腺素注射5 ml;B组25例,采用盐酸甲哌卡因肾上腺素注射液1.8 ml;C组26例采用盐酸利多卡因加肾上腺素注射5 ml。观察3组的麻醉药物起效时间、麻醉药物持续时间、术中、术后疼痛评估、拔牙所需时间等。结果 A组与C组在麻醉药物起效时间、麻醉药物持续时间、术后疼痛程度上比较,差异有统计学意义(P<0.01);A组与B组麻醉药物持续时间比较差异有统计学意义(P<0.01);3组术中疼痛程度比较差异无统计学意义(P>0.05)。3组麻醉药物在拔牙时间、术中是否翻瓣、去骨与术后疼痛程度上比较,差异无统计学意义(P>0.05)。结论在临床拔除阻生牙中,0.5%罗哌卡因与利多卡因比较,具有起效快、麻醉药物持续时间长、术后疼痛程度较轻的显著特点;与甲哌卡因比较,临床效果相近。

Objective To observe the clinical effect of Ropivacaine on extraction of mandibular impacted tooth, and to compare it with Mepivacaine hydrochloride and Lidocaine. Methods A total of 78 cases who re- quired removal of mandibular impacted wisdom teeth were selected. They were randomly divided into group A, group B and group C. For local anesthesia, 27 cases in the group A received 0.5% Ropivacaine hydrochloride and epinephrine （5 ml）, 25 cases in the group B received 2% Mepivacaine hydrochloride and adrenaline （1.8 ml） and 26 cases in the group C received 2% Lidocaine hydrochloride and adrenaline （5 ml）. The onset time of anesthesia effect, anesthetic duration, intraoperative and postoperative pain assessment and extraction time were observed in the three groups. Data analysis was carried out with SPSS 19.0 software package. Results There were significant differences in the onset time of anesthesia effect, anesthetic duration and postoperative pain degree between the groups A and C （P〈 0.01）; but there was significant difference only in anesthestic duration between the groups A and B （P〈 0.01）. There were no significant differences in the intraoperative pain among the three groups （P 〉 0.05）. There was no significant difference in extraction time, use of the flap, bone removal, or degree of postoperative pain among the three groups using different anesthetics （P 〉 0.05）. Conclusions Compared with Lidocaine, 0.5% Ropivacaine has the advantages in clinical extraction of mandibular impacted tooth, such as rapid onset time of anesthesia effect, longer anesthetic duration and milder postoperative pain; but it has similar effect with Mepivacaine.