罗哌卡因用于下颌阻生智齿拔除麻醉效果观察

Efficacy of ropivacaine in extraction of mandibular impacted third molar

目的观察评价罗哌卡因应用于下颌阻生智齿拔除的麻醉效果。方法将2016年1—6月首都医科大学附属北京友谊医院口腔科就诊的150例需要拔除下颌阻生智齿且无其他系统疾病的患者随机分成2组:试验组(71例)采用0.75%罗哌卡因进行局部麻醉,对照组(79例)则采用2%利多卡因进行局部麻醉。记录麻醉起效时间、麻醉持续时间、拔牙术后不同时间点的疼痛程度(VAS分级)、术后患者是否主动要求服用止痛药、麻醉前后不同时间点患者血压及脉搏,并对麻醉并发症进行监测记录,从而比较两种药物的麻醉效果。结果试验组麻醉起效时间明显短于对照组(P<0.05),而麻醉持续时间明显长于对照组(P<0.05);试验组患者术后不同时间点VAS分级均明显低于对照组(P<0.05),且患者术后主动要求服用止痛药的比率明显低于对照组(P<0.05);对照组患者血压及脉搏在麻药注射结束后各个时间点较注射前均无明显变化(P>0.05);试验组血压在麻药注射后各个时间点较注射前无明显变化(P>0.05),脉搏在注射后30 min有小幅度下降(P<0.05);两组患者注射麻药后均未产生麻醉并发症。结论罗哌卡因因其麻醉起效时间短,麻醉持续时间长,术后阵痛效果好,心血管系统风险小等优点可广泛应用于时间较长的复杂口腔专业操作。

Objective To evaluate the efficacy of ropivacaine in extraction of mandibular impacted third molar. Methods In this study 150 healthy patients who need to extract one mandibular impacted third molar were randomly divided into two groups. The experimental group was given 0.75% ropivacaine to get anesthesia, while the control group received 2% lidocaine. The time to onset and duration of action were noted. The visual analogue score（VAS）was recorded 30 rain and 4 h after extraction. The rate of taking pain relieving drugs was noted. Blood pressure and pulse were monitored during the operation. Monitor the anesthetic complications and compare the anesthetic effect of the two drugs. Results Ropivacaine had a significantly shorter onset and longer duration of oral anesthesia than lidocaine （P 〈 0.05 ）. The experimental group had lower VAS 30 min and 4 h after operation（P 〈 0.05 ）and fewer patients needed pain relieving drugs than the control group （P 〈 0.05）. There was a slight decrease of the pulse in the experimental group 30 min postopera- tively（P 〈 0.05 ）. The pulse and blood pressure in the control group and the blood pressure in the experimental group had no obvious change. There was no complications in both groups. Conclusion Ropivacaine may be suitable for time-consuming oral procedures because of its short onset, long duation, prolonged postoperative analgesia and minimal cardiovascular risk.