牙种植手术中局部麻醉黏膜注射位点和个体因素对患者疼痛度的影响

Influence of Local Anesthesia Mucosal Injection Site and Individual Factors on Patient Pain Levels in Dental Implant Surgery

目的探究牙种植手术局部麻醉时口腔黏膜不同位置麻醉注射位点以及个体因素对患者疼痛度的影响。方法非随机选择2023年9月—2024年1月就诊于广西医科大学附属口腔医院行种植手术的300例患者,记录其性别、年龄分段、吸烟、饮酒情况,并根据患者缺牙位置分别统计540个麻醉位点的疼痛值数字评定量表(Numerical Rating Scale,NRS)评分。采用Logistic回归分析比较不同麻醉注射位点以及性别、年龄、吸烟、饮酒情况对患者疼痛度的影响。结果牙种植手术中,不同局部麻醉注射位点患者的疼痛度不同,差异有统计学意义(P均<0.05)。不同年龄分段的患者NRS评分不同,差异有统计学意义(P均<0.05)。女性的NRS评分1.5(1,2)分高于男性,差异有统计学意义(Z=4.189,P<0.05),吸烟者疼痛NRS评分1(1,2)分低于不吸烟者,差异有统计学意义(Z=-2.019,P<0.05),饮酒与否患者疼痛评分比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,口腔黏膜麻醉注射位点、性别、年龄、吸烟因素是影响患者疼痛度的独立因素(P均<0.05)。结论种植手术中口腔黏膜不同位点局部麻醉时疼痛感受存在差异,其中下颌后牙区舌侧黏膜和上颌后牙区腭侧黏膜疼痛评分相对更高,同时性别、年龄、吸烟因素也会影响患者局麻时的疼痛感受。

Objective To investigate the effects of anesthesia injection sites in different locations of the oral mucosa during local anesthesia for dental implant surgery as well as individual factors on the pain level of patients.Methods 300 patients who underwent dental implant surgery at the Affiliated Stomatological Hospital of Guangxi Medical Uni-versity from September 2023 to January 2024 were unrandomly selected,and their gender,age,smoking and alcohol consumption were recorded.The Numerical Rating Scale(NRS)scores of pain values at each of the 540 anesthetic sites were also counted according to the location of the patients'missing teeth.Logistic regression analysis was used to compare the effects of different anesthetic injection sites as well as gender,age,smoking,and alcohol consumption on patients'pain levels.Results In dental implant surgery,the pain level of patients with different local anesthesia injec-tion sites were different,and the differences were statistically significant(all P<0.05).The NRS scores of patients in different age segments were different,and the differences were statistically significant(all P<0.05).The NRS score of 1.5(1,2)in women was higher than that in men,and the difference was statistically significant(Z=4.189,P<0.05).The pain NRS score of 1(1,2)was lower in smokers than in non-smokers,and the difference was statistically significant(Z=-2.019,P<0.05),and the pain scores of the patients who drank alcohol or not were compared,and the difference was not statistically significant(P>0.05).The results of multifactorial logistic regression analysis showed that oral mucosal anesthesia injection site,gender,age,and smoking factors were independent factors affecting patients'pain level(all P<0.05).Conclusion There were differences in pain perception during local anesthesia at different sites of the oral mu-cosa in implant surgery,with relatively higher pain scores in the lingual mucosa of the mandibular posterior region and the palatal mucosa of the maxillary posterior region,and also the factors of gender,age,and smoking affected the pa-tients'pain perception during local anesthesia.