左旋布比卡因在下颌阻生智齿拔除术中麻醉效果及术后镇痛作用研究

摘要

Objective To compare the anesthetic efficacy of 0.5％ levobupivacaine with 2％ lidocaine in truncal block of the inferior alveolar nerve during the surgical extraction of impacted lower third molars and postoperative pain control. Methods Thirty -four patients underwent removal of symmetrically positioned lower third molars, in 2 separate appointments, under local anesthesia either with 0.5％ levobupivacaine or 2.0％ lidocaine, in a double-blind, randomized, and crossover manner. Ibuprofen sustained release capsules ware administered to all the patients for postoperative pain relief. The study variables for each anesthetic were: latency ( time to action), anesthetic effect, the number of patients who used ibuprofen sustained release capsules for postoperative pain relief.A visual analog scale was used to assess pain during surgery, to evaluate subjectively the anesthetic efficacy of the two solutions. Results For latency, a statistically significant difference was observed between levobupivacaine (6.59 ± 2.20 min) and lidocaine (4.40 ± 1.43 min) (P ＜ 0.05 ) lidocaine, The analgesic effect of levobupivacaine during surgical removal of impacted mandibular third molars was more effective than lidocaince. The difference in VAS scale between the two groups was significant ( P ＜ 0.05 ). The results of this study showed a strikingly better postoperative analgesic effect of levobupivacaine than that of lidocaine (3 out of 34, 16 out of 34,respectively, patients used ibuprofen after oral surgery(P ＜ 0.01 ). No adverse reactions were observed in patients of the two groups.Conclusions Levobupivacaine is more effective than lidocaine both in intraoperative Pain control and postoperative pain control.%目的 观察左旋布比卡因在下颌阻生智齿拔除术中的麻醉效果及术后镇痛作用.方法 选择需拔除双侧下颌阻生智齿34例,采用交叉试验方法,分别使用0.5%左旋布比卡因及2%利多卡因进行下齿槽神经麻醉,观察麻醉药起效时间.采用VAS评分法对两组麻醉效果进行评定,并对术后患者服用镇痛药(芬必得胶囊)情况进行记录.结果 0.5%左旋布比卡因及2%利多卡因麻醉药起效时间分别为(6.59±2.20)min和(4.40±1.43)min,两组差异具有统计学意义(P<0.05);左旋布比卡因组术中VAS评分低于利多卡因组,两组差异具有统计学意义(P<0.05);左旋布比卡因组术后服用镇痛药人数为3人,明显少于利多卡因组16人,差异具有统计学意义(P<0.01).结论 采用左旋布比卡因行下齿槽神经阻滞麻醉拔除下颌阻生智齿,术中麻醉有效,术后镇痛作用较好.