不同剂量阿替卡因对不可复性牙髓炎下牙槽神经阻滞麻醉效果的比较

Comparison of Different Volumes of Articaine for Inferior Alveolar Nerve Block with Symptomatic Irreversible Pulpitis

目的:本研究对仅有刺激痛的早期不可复性牙髓炎的患者在下牙槽阻滞麻醉时,比较使用1.7mL阿替卡因和3.4mL阿替卡因的麻醉成功率的差异。方法:将76名患者随机分为两组,1.7mL组和3.4mL组(两组都为4%阿替卡因与1∶100000的肾上腺素),进行下牙槽阻滞麻醉。根管治疗过程中,使用Heft-Parker视觉模拟量表(VAS)记录患者的疼痛值。对数据进行T检验和卡方检验。结果:72名患者纳入了研究结果,两组的成功率都没有达到100%,组间有显著差异(P<0.001),3.4 mL组有较高的成功率74.4%,1.7 mL组成功率为27.8%。结论:在对下颌第一磨牙进行下牙槽阻滞时,提高阿替卡因的注射剂量可以显著提高麻醉的成功率,但也达不到100%的麻醉成功。

Objective：To compare the efficacy of 1.7mL and 3.4mL articaine for an inferior alveolar nerve block（IANB）when treating molars with symptomatic irreversible pulpitis.Methods：Seventy-six teeth were randomly received conventional IANB injection either with 1.7mL or 3.4mL of 4% articaine with 1：100000epinephrine.The patients recorded their pain before and during access cavity preparation as well as during root canal instrumentation using a HeftParker visual analog scale.Data were analyzed by T and chi-square tests.Results：Seventy-two patients were eligible to participate in this study,which showed that 3.4 mL articaine provided a significantly higher success rate（74.4%）of IANBs compared with 1.7 mL of the same anesthetic solution（27.8%）although neither group had 100%successful anesthesia（P0.001）.Conclusion：Increasing the volume of articaine provided a significantly higher success rate of IANBs in mandibular first molar teeth with symptomatic irreversible pulpitis,but it did not result in 100% anesthetic success.