罗哌卡因与利多卡因在下颌磨牙牙髓炎中阻滞麻醉效果比较

发布时间：2018-05-04 19:29

本文选题：盐酸罗卡因 + 盐酸利多卡因　；参考：《山东大学》2014年硕士论文

【摘要】：目的比较盐酸罗哌卡因与利多卡因在下颌磨牙不可逆性牙髓炎患者行下牙槽、颊、舌神经阻滞麻醉后牙髓治疗过程中的麻醉效果。材料与方法收集2013年3月至2014年3月期间在山东大学口腔医院就诊的下颌磨牙不可逆性牙髓炎患者40名,男性18名,女性22名,年龄18-60岁,左下颌磨牙29颗,右下颌磨牙11颗,采用简单随机分组方法将40名患者分为A、B两组,均行下牙槽、颊、舌神经阻滞麻醉。A组采用0.75%盐酸罗哌卡因麻醉,B组采用2%利多卡因麻醉,麻药注射完毕记录该时刻,同时记录起效时间及麻醉效果的持续时间。根据治疗过程中患者的疼痛反应以及结合VAS值评价麻醉效果分为麻醉完全有效、麻醉良好、麻醉有效和麻醉失败四级。除麻醉失败一级外,其余三级均记作临床麻醉成功。统计结果由软件SAS9.1处理,其中临床麻醉成功率通过Fisher检验处理。麻醉起效时间、麻醉持续时间和VAS值通过方差分析处理完成。结果 A组75%的成功率较B组80%的成功率在本实验中没有显著差异(P0.05)。平均起效时间A组19.5±6.26min较B组8.9±3.19min有所延缓(P0.05)。A组麻醉平均持续时间10.48±0.78h较B组平均持续时间2.20±0.19h明显延长(P0.0001)。麻醉成功的31例中,术中VAS值2.30±1.94比术前VAS值4.84±2.30明显减小(P0.05)；而麻醉失败的9例中,术中VAS值7.10±2.39较术前VAS值3.93±1.99则明显变大(P0.01),VAS值可以作为一个衡量麻醉成败的参考指标。共收集40例患牙,其中左下后牙占72.5%(29/40),右下后牙占27.5%(11/40)。结论罗哌卡因在治疗下颌磨牙不可逆性牙髓炎行下牙槽、颊、舌神经阻滞麻醉的麻醉成功率和利多卡因无明显差异,其起效时间略长,但麻醉效果持续时间明显长于利多卡因,在很大程度上可以缓解术后疼痛；治疗下颌磨牙牙髓炎尚需其他研究来提高其麻醉成功率。
[Abstract]:Purpose To compare the anesthetic effect of ropivacaine hydrochloride and lidocaine during pulp treatment after lower alveolar, buccal and lingual nerve block in patients with irreversible pulpitis of mandibular molar. Materials and methods From March 2013 to March 2014, 40 patients with irreversible pulpitis of mandibular molars, 18 males and 22 females, aged 18-60 years, 29 left mandibular molars and 11 right mandibular molars, were selected from the Stomatological Hospital of Shandong University. Forty patients were randomly divided into two groups: group A and group A were treated with lower alveolar, buccal and lingual nerve block anesthesia. Group A was anesthetized with 0.75% ropivacaine hydrochloride and group B was anesthetized with 2% lidocaine. The time of injection was recorded. The onset time and duration of anaesthesia effect were recorded at the same time. According to the pain response of the patients and the VAS value, the anesthetic effect was divided into four groups: complete anesthesia, good anaesthesia, anaesthesia effectiveness and anesthesia failure. Except for the failure of anesthesia, the other three levels were recorded as clinical anaesthesia success. The statistical results were processed by software SAS9.1, in which the success rate of clinical anesthesia was processed by Fisher test. The onset time, duration and VAS of anesthesia were processed by ANOVA. Result There was no significant difference in the success rate of 75% in group A and 80% in group B in this experiment. The average onset time of anesthesia in group A (19.5 卤6.26min) was significantly longer than that in group B (8.9 卤3.19min). The average duration of anesthesia in group A was 10.48 卤0.78 h longer than that in group B (2.20 卤0.19 h). The intraoperative VAS value (2.30 卤1.94) was significantly lower than that of preoperative VAS value (4.84 卤2.30) in 31 cases of successful anesthesia, while in 9 cases of failed anesthesia, the intraoperative VAS value of 7.10 卤2.39 was significantly larger than that of preoperative VAS value of 3.93 卤1.99, which could be used as a reference index to evaluate the success or failure of anesthesia. A total of 40 affected teeth were collected, of which 72.5 / 40 were left lower posterior teeth and 27.5 / 40 were right lower posterior teeth. Conclusion Ropivacaine had no significant difference in anesthetic success rate and lidocaine in the treatment of mandibular molar pulpitis, but the anesthetic effect was longer than that of lidocaine, but the effect of ropivacaine was longer than that of lidocaine, but the effect of ropivacaine was longer than that of lidocaine. The treatment of mandibular molars pulpitis needs other research to improve the success rate of anesthesia.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R781.31

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