联合麻醉在下颌阻生智齿拔除术中的临床应用

Clinical study on the anesthetic efficacy of combined anesthesia with articaine and lidocaine for extraction of impacted mandibular third molars

目的比较必兰和利多卡因不同麻醉方法在下颌阻生智齿拔除手术中的麻醉效果。方法 160颗下颌阻生智齿随机分为必兰局部浸润麻醉组、必兰阻滞麻醉组、利多卡因阻滞麻醉组、必兰和利多卡因联合麻醉组进行局部麻醉,行拔除手术,观察麻醉效果,并进行统计学分析。结果必兰和利多卡因联合麻醉组在下颌阻生智齿拔除术中的麻醉效果均优于必兰局部浸润麻醉组、必兰阻滞麻醉组和利多卡因阻滞麻醉组,差异均有统计学意义(P<0.05)。必兰阻滞麻醉组和利多卡因阻滞麻醉组的麻醉效果均优于必兰局部浸润麻醉组,差异均有统计学意义(P<0.05)。必兰阻滞麻醉组和利多卡因阻滞麻醉组之间的麻醉效果差异无统计学意义(P>0.05)。结论必兰和利多卡因联合麻醉用于拔除下颌阻生智齿有较好的麻醉效果,值得临床推广应用。

Objective To investigate the anesthetic efficacy of extraction of impacted mandibular third molars by four anesthetic methods with articaine or/and lidocaine. Methods A total of 160 impacted mandibular third molars which would be extracted were randomly assigned into four groups, local infiltration anesthesia with articaine, block anesthesia of internal ramus prominence with articaine, block anesthesia of internal ramus prominence with lidocaine and combined anesthesia with articaine and lidocaine. The anesthesia efficacy was evaluated. Results The anesthetic efficacy of combined anesthesia with articaine and lidocaine was better than those of the other three groups （P 〈 0.05 ）. The anesthetic efficacy of the two groups of block anesthesia of internal ramus prominence with articaine and lidocaine were better than that of the group of local infiltration anesthesia with articaine （P 〈 0.05 ）, and there was no significant difference between the two groups of block anesthesia （P 〉 0.05 ）. Conclusion Combined anesthesia with articaine and lidocaine has better anesthetic efficacy in extraction of impacted mandibular third molar.