罗哌卡因联合阿替卡因肾上腺素拔除下颌第三磨牙的效果观察

Observation on the Effect of Ropivacaine Combined with Articaine Hydrochloride and Epinephrine Tartrate in the Extraction of Mandibular Third molars

目的:比较0.75%罗哌卡因与2%利多卡因阻滞麻醉联合阿替卡因肾上腺素浸润麻醉用于下颌近中中位阻生第三磨牙拔除的麻醉效果。方法:选取2020年11月1日-2021年1月31日滨州医学院附属医院口腔颌面外科收治的80例拔牙患者,根据麻药选择不同将80例患者分为两组,试验组采用罗哌卡因联合阿替卡因肾上腺素,对照组采用利多卡因联合阿替卡因肾上腺素,并评估两组麻醉效果。结果:试验组麻醉起效时间和麻醉持续时间均长于对照组(P<0.05)。术中及麻醉起效后45 min,两组视觉模拟评分法(VAS)评分比较,差异均无统计学意义(P>0.05);麻醉起效后2、4、8、24 h,试验组VAS评分均低于对照组,差异均有统计学意义(P<0.05)。麻醉起效前和麻醉起效后,两组收缩压、舒张压、脉搏比较,差异均无统计学意义(P>0.05)。术后1 d内,试验组患者服用止痛药率低于对照组,试验组生活质量评分高于对照组,差异均有统计学意义(P<0.05)。两组患者术中及术后均未出现麻醉并发症。结论:采用0.75%罗哌卡因阻滞麻醉联合阿替卡因肾上腺素局部浸润麻醉用于拔除下颌近中中位阻生第三磨牙镇痛效果较好,可广泛应用于较复杂的智齿拔除手术。

Objective:To compare the anesthetic effects of 0.75% Ropivacaine and 2% Lidocaine block anesthesia combined with Articaine Hydrochloride and Epinephrine Tartrate infiltration anesthesia for extraction of mandibular meso-middle impacted third molars.Method:A total of 80 patients with tooth extraction treated in the Department of Oral and Maxillofacial surgery of Binzhou Medical University Hospital from November 1,2020 to January 31,2021 were selected,according to different anesthetics,80 patients were divided into two groups,the experimental group used Ropivacaine combined with Articaine Hydrochloride and Epinephrine Tartrate,and the control group used Lidocaine combined with Articaine Hydrochloride and Epinephrine Tartrate.The anesthetic effects of the two groups were evaluated.Result:The onset time and duration of anesthesia in the experimental group were longer than those in the control group (P0.05).VAS scores in the experimental group were lower than those in the control group at 2,4,8 and 24 h after the effect of anesthesia,the differences were statistically significant (P0.05).Within 1 d after surgery,the rate of analgesic use in the experimental group was lower than that in the control group,and the score of quality of life in the experimental group was higher than that in the control group,the differences were statistically significant (P<0.05).There were no anesthesia complications during and after surgery in both groups.Conclusion:The analgesic effect of 0.75% Ropivacaine block anesthesia combined with infiltration anesthesia of Articaine Hydrochloride and Epinephrine Tartrate for the extraction of mandibular meso-middle impacted third molars is better,which can be widely used in more complicated third molars extraction.