Background: Articaine is an amide local anaesthetic, which is gaining popularity for use in dental and oral surgical anaesthesia in the United Kingdom. Hitherto there has been insufficient evidence to recommend artica...Background: Articaine is an amide local anaesthetic, which is gaining popularity for use in dental and oral surgical anaesthesia in the United Kingdom. Hitherto there has been insufficient evidence to recommend articaine above the more commonly used lidocaine for dental procedures. The aim of this study is to compare the efficacy of 4% articaine with 1:100,000 adrenaline (4AA) with that of 2% lidocaine with 1:100,000 adrenaline (2LA) administered as buccal infiltrations for anaesthesia in mandibular permanent first molar teeth. Any significant advantage noted may obviate the need for regional blockage of the inferior dental nerve in dental or minor oral surgical procedure under local anaesthesia. Objectives: To review the published literature comparing the efficacies of 4AA and 2LA for achieving pulpal anaesthesia in human mandibular permanent first molar teeth. Null Hypothesis: 4AA and 2LA are of equal efficacy when used to anaesthetize mandibular permanent first molar teeth by buccal infiltration. Method: An electronic search encompassing Ovid MEDLINE?, PubMed (National Center for Biotechnology Information, US National Library of Medicine), SCOPUS?, SCIRUS?, EMBASE? databases and the Cochrane Library was performed to identify trials relating to the efficacy of 4AA and 2LA local anaesthetic solutions on mandibular first molars in adult participants. Study characteristics and outcome data were extracted as a basis for meta-analysis. Results: Three randomised controlled trials were identified for this meta-analysis. The relative efficacy of 4AA over 2LA in anesthetizing permanent first mandibular molars was calculated at 1.57 (95% CI = 1.27 to 1.95). Conclusion: Despite the promising results shown in the meta-analysis it is difficult to say from the evidence presented that 4AA should be used clinically in preference over 2LA.展开更多
Background and Aims: Erector spinae plane block, Paravertebral block and serratus anterior block are three formats for analgesia post-operatively following radical mastectomy. This study compares the analgesic efficac...Background and Aims: Erector spinae plane block, Paravertebral block and serratus anterior block are three formats for analgesia post-operatively following radical mastectomy. This study compares the analgesic efficacy of these modalities for analgesia post-operatively by articaine 2% with adrenaline. Methods: Seventy-five patients with ASA physical status I or II subjected to modified radical mastectomy with axillary clearance were enrolled for the study. After induction of general anaesthesia all patients received 20 mL 2% articaine with adrenaline in each technique of the study. Patients in Group 1 (Erector spinae block [ESB], n = 25), Group 2 paravertebral block [PVB] n = 25), Group 3 (serratus anterior plane block [SAPB] n = 25) were ultrasound-guided on ipsilateral side. Patients were estimated for pain scores at 0, 2, 4, 6, 12 and 24 h, and duration of analgesia post-operatively and relieve analgesic doses required of morphine up to 24 h. Results: Visual analogue scale scores post-operatively were lower in ESB and PVB group compared with SAPB at 4, 6, 12 and 24 h (P P Conclusion: Sonar-guided erector spinae block and thoracic paravertebral block minimize post-operative pain scores, prolongs the duration of analgesia and diminishes requirements for assigning analgesics in the first 24 h of post-operative period compared to ultrasound-guided serratus anterior plane block but, ESB technique was more potent, easily and less side effect in compared with PVB.展开更多
文摘Background: Articaine is an amide local anaesthetic, which is gaining popularity for use in dental and oral surgical anaesthesia in the United Kingdom. Hitherto there has been insufficient evidence to recommend articaine above the more commonly used lidocaine for dental procedures. The aim of this study is to compare the efficacy of 4% articaine with 1:100,000 adrenaline (4AA) with that of 2% lidocaine with 1:100,000 adrenaline (2LA) administered as buccal infiltrations for anaesthesia in mandibular permanent first molar teeth. Any significant advantage noted may obviate the need for regional blockage of the inferior dental nerve in dental or minor oral surgical procedure under local anaesthesia. Objectives: To review the published literature comparing the efficacies of 4AA and 2LA for achieving pulpal anaesthesia in human mandibular permanent first molar teeth. Null Hypothesis: 4AA and 2LA are of equal efficacy when used to anaesthetize mandibular permanent first molar teeth by buccal infiltration. Method: An electronic search encompassing Ovid MEDLINE?, PubMed (National Center for Biotechnology Information, US National Library of Medicine), SCOPUS?, SCIRUS?, EMBASE? databases and the Cochrane Library was performed to identify trials relating to the efficacy of 4AA and 2LA local anaesthetic solutions on mandibular first molars in adult participants. Study characteristics and outcome data were extracted as a basis for meta-analysis. Results: Three randomised controlled trials were identified for this meta-analysis. The relative efficacy of 4AA over 2LA in anesthetizing permanent first mandibular molars was calculated at 1.57 (95% CI = 1.27 to 1.95). Conclusion: Despite the promising results shown in the meta-analysis it is difficult to say from the evidence presented that 4AA should be used clinically in preference over 2LA.
文摘Background and Aims: Erector spinae plane block, Paravertebral block and serratus anterior block are three formats for analgesia post-operatively following radical mastectomy. This study compares the analgesic efficacy of these modalities for analgesia post-operatively by articaine 2% with adrenaline. Methods: Seventy-five patients with ASA physical status I or II subjected to modified radical mastectomy with axillary clearance were enrolled for the study. After induction of general anaesthesia all patients received 20 mL 2% articaine with adrenaline in each technique of the study. Patients in Group 1 (Erector spinae block [ESB], n = 25), Group 2 paravertebral block [PVB] n = 25), Group 3 (serratus anterior plane block [SAPB] n = 25) were ultrasound-guided on ipsilateral side. Patients were estimated for pain scores at 0, 2, 4, 6, 12 and 24 h, and duration of analgesia post-operatively and relieve analgesic doses required of morphine up to 24 h. Results: Visual analogue scale scores post-operatively were lower in ESB and PVB group compared with SAPB at 4, 6, 12 and 24 h (P P Conclusion: Sonar-guided erector spinae block and thoracic paravertebral block minimize post-operative pain scores, prolongs the duration of analgesia and diminishes requirements for assigning analgesics in the first 24 h of post-operative period compared to ultrasound-guided serratus anterior plane block but, ESB technique was more potent, easily and less side effect in compared with PVB.
