实用医学杂志 ›› 2022, Vol. 38 ›› Issue (23): 2942-2946.doi: 10.3969/j.issn.1006⁃5725.2022.23.009

• 临床研究 • 上一篇    下一篇

局部浸润麻醉和阻滞麻醉在下颌中高位阻生第三磨牙拔除术中麻醉效果的对照研究

钟江龙 王洁琪 叶秀华 陈伟良 王友元 范松   

  1. 中山大学孙逸仙纪念医院口腔科(广州 510120)

  • 出版日期:2022-12-10 发布日期:2022-12-10
  • 通讯作者: 范松 E⁃mail:fansong2@mail.sysu.edu.cn
  • 基金资助:
    广东省基础与应用基础研究基金企业联合基金-面上项目(编号:2021A1515220138)

Anesthetic effect in extraction of medium⁃high impacted third molars in mandible:local infiltration anesthe⁃ sia vs. block anesthesia

ZHONG Jianglong,WANG Jieqi,YE Xiuhua,CHEN Weiliang,WANG Youyuan,FAN Song.   

  1. Department of Stomatology,Sun Yat⁃sen Memorial Hospital,Sun Yat⁃sen University,Guangzhou 510120,China

  • Online:2022-12-10 Published:2022-12-10
  • Contact: FAN Song E⁃mail:fansong2@mail.sysu.edu.cn

摘要:

目的 对比改良局部浸润麻醉与下牙槽神经阻滞麻醉在下颌中高位阻生第三磨牙拔除术中的麻醉效果。方法 67 例双侧均需行中高位下颌阻生齿拔除的受试者一侧行改良局部浸润麻醉,另一侧行下牙槽神经阻滞麻醉。记录注射疼痛感(VAS 自评)、唇舌麻木情况、手术时间、麻醉成功率、术中术后疼痛情况等并行对比分析。结果 研究组和对照组麻醉成功率分别为 93.8%和 93.7%(P = 0.964)。对照组分别有 3 例和 2 例受试者术中未感到舌和下唇麻木,研究组则高达 37 例和 59 例(P < 0.01)。研究组麻药注射时的疼痛自评分数均值为 15.74,低于对照组的 30.19(P < 0.01)。两组在术中及术后 2、6 h 和 1、2、3、7 d 的疼痛自评数值差异均无统计学意义。结论 中高位下颌阻生第三磨牙行改良局部浸润麻醉法可取得与阻滞麻醉相似的麻醉效果,且更易做到微痛、无痛,是优于下牙槽神经阻滞麻醉的方法。

关键词:

下颌阻生第三磨牙, 浸润麻醉, 下牙槽神经阻滞麻醉

Abstract:

Objective To compare the anesthetic effect of modified local infiltration anesthesia with inferior alveolar nerve block anesthesia in the extraction of a high impacted third molar in the mandible. Methods Sixty⁃ seven patients undergoing bilateral extraction of medium to high mandibular obstructive teeth were anesthetized with modified local infiltration on one side and inferior alveolar nerve block on the other side. The pain sensation of injection(VAS self⁃assessment),lip and tongue numbness,operation time,anesthesia success rate,and intraop⁃ erative and postoperative pain were recorded and compared between them. Results The success rates of anesthe⁃ sia in the test and control groups were 93.8% and 93.7%,respectively(P = 0.964). In the control group,3 and 2 patients did not experience intraoperative numbness of the tongue and lower lip,respectively,compared with 37 and 59 in the test group(P < 0.01). The mean value of pain self⁃rating during anesthetic injection in the test group was significantly lower than in the control group(15.74 vs. 30.19,P < 0.01). There were no statistical differences between the two groups in pain self⁃assessment values intraoperatively and at 2 hours,6 hours,1 day,2 days,3 days and 7 days postoperatively. Conclusion Modified local infiltration anesthesia for medium to high level man⁃ dibular blocked third molars can achieve similar anesthetic effect as block anesthesia does. It is superior to the block anesthesia,for it is easier to achieve minimal or no pain.

Key words:

text-indent:0pt, "> impacted mandible third molar, infiltration anesthesia, inferior alveolar nerve block anes? thesia