碧兰麻局部浸润麻醉拔除后牙的麻醉效果观察

目的 观察碧兰麻局部粘膜下浸润麻醉拔除后牙的麻醉效果。方法 对102例患者106颗需拔除的后牙行碧兰麻局部浸润麻醉，观察麻醉效果。结果 碧兰麻局部浸润对上磨牙、下双尖牙有效率为100．0％，下磨牙有效率为85．7％。结论 碧兰麻的局部粘膜下浸润麻醉在上磨牙和下双尖牙的拔除术中，可以取代利多卡因的传导阻滞麻醉，而对下磨牙的麻醉效果较差。     

碧兰麻在急性牙髓炎治疗中麻醉效果观察

目的 观察碧兰麻麻醉牙髓的临床效果。方法 把急性牙髓炎患牙随机分为2组,分别使用碧兰麻和利多卡因,对照观察2种麻醉剂的麻醉效果。结果 碧兰麻的无痛治疗率在前牙为100％、前磨牙为95.2％、上磨牙为87.5％、下磨牙效果较差,为46.3％;而利多卡因的无痛治疗率在前牙为88.2％、前磨牙为66.7％、上磨牙为52.9％、下磨牙为58.6％。除下颌磨牙外,两组无痛治疗率有非常显著的差异(P<0.01)。结论 碧兰麻的麻醉效果明显优于利多卡因,可作为牙髓治疗中的首选麻醉剂。     

斯康杜尼局部浸润麻醉在牙髓炎治疗中的临床观察

目的观察斯康杜尼在牙髓炎治疗中的麻醉效果和安全性。方法选择确诊为牙髓炎患者60例，共60颗患牙，根据牙位随机分为碧兰麻组、斯康杜尼组进行局部浸润麻醉，观察其麻醉效果和不良反应；并检测斯康杜尼局麻前和局麻后即刻、3min、5min患者的血压和脉搏值。结果无论是碧兰麻还是斯康杜尼，上前牙、上前磨牙以及下前牙的优良率均达100％，上磨牙的优良率为90．0％，下前磨牙的优良率为75．0％，总有效率均达100％；在下磨牙碧兰麻与斯康杜尼的总有效率虽然均为87．5％，但碧兰麻优良率为75．0％，斯康杜尼则为62．5％。斯康杜尼与碧兰麻在使用后均未发现有明显的不良反应。斯康杜尼局麻前后，患者血压、脉搏的变化没有统计学意义。结论斯康杜尼在治疗牙髓炎中是一种安全可靠、麻醉效果好的局部麻醉剂。     

碧兰麻口腔局部应用的体会

碧兰麻(primacaine)是法国赛特力-碧兰公司制造的阿替卡因/肾上腺素局麻注射剂。作为新型酰胺类口腔专用局部麻醉剂,具有起效快,麻醉力强,持续时间长的特点,无明显不良反应,对血压、心率亦无影响,作用安全可靠。其穿透力强,可采用黏膜下局部浸润麻醉,操作相对简便,有利于保证无菌及减少患者的痛苦[1]。无痛治疗是现代口腔治疗研究的重要方向之一,麻醉效果不良是传统口腔科治疗中患者恐惧就诊的主要原因之一。目前口腔常用局部麻醉剂有2%普鲁卡因、2%利多卡因等,其麻醉效果均不十分理想,特别是牙髓病治疗等有炎症的部位时,麻醉效果不佳,且有…     

碧兰麻用于牙髓镇痛临床疗效观察

以往的局麻药因注射方法、麻药毒副作用及麻药效果不理想等原因 ,给口腔医师在牙髓治疗中带来不便。作者选用碧兰麻局麻注射剂应用于牙髓治疗中 ,取得了良好的镇痛效果 ,现报告如下。1　材料与方法1.1　病例选择　选择年龄在 18～ 6 2岁患者 83例 ,全身健康情况良好 ,无局麻药过敏史。患牙为急、慢性牙髓炎需行牙髓治疗者 ,意外露髓、隐裂牙不能保髓治疗者共 86颗患牙 ,其中前牙 16颗 ,上颌前磨牙 15颗 ,上颌磨牙 2 7颗 ,下颌前磨牙 9颗 ,下颌磨牙 19颗。1.2　药物资料及给药方法1.2 .1　药物　使用法国赛特力—碧兰麻公司生产的复方盐酸阿…     

碧兰麻牙周韧带注射麻醉效果的临床观察

本文通过对120例共130个患牙牙髓治疗的患者使用碧兰麻牙周韧带注射，无痛率可达85％，有一定的实用性。     

碧兰麻髓腔内麻醉的临床应用

乳牙牙髓炎是儿童口腔科临床常见病。我们采用髓腔根管内注射碧兰麻的方法进行牙髓拔除术,可以减轻患儿的痛苦,经临床观察效果满意,现报告如下:1资料和方法1.1一般资料选择急性牙髓炎牙160颗,其中男性98颗,女性62颗,年龄3～8岁,所有患儿全身状况正常,具有清晰的语言表述能力。随机分为2组,试验组80颗(男49颗,女31颗)用碧兰麻(复方盐酸阿替卡因注射液、法国碧兰麻公司)髓腔内注射的麻醉方法;对照组组患牙80颗(男49颗,女31颗)只采用封中药失活剂(本院配制:氧化锌、蟾酥、地卡因、白砒,放置时间24～48h),24h复诊拔髓的方法。1.2方法试验组:确诊…     

碧兰麻临床应用48例分析

目的观察局麻药阿替卡因(碧兰麻)用于口腔局部麻醉的麻醉效果.方法 48例患者用阿替卡因黏膜下浸润麻醉,效果欠佳者可追加其它方式麻醉,2例行神经干阻滞麻醉.结果拔牙组麻醉完全率95.4%,牙髓治疗组麻醉完全率85.7%,均无不良反应.结论阿替卡因用于麻醉效能高、起效快、毒性低,是理想的口腔局麻药.     

碧兰麻用于心电监护拔牙的疗效观察

碧兰麻属于酰胺类麻醉药 ,由于其麻醉起效时间快 ,组织渗透性强 ,毒副作用小 ,麻醉效能高 ,正逐渐在临床推广使用 ,我院于 2 0 0 0年 8月起 ,将碧兰麻用于心电监护拔牙 ,取得了满意的效果。1　临床资料本组资料 2 4例。高血压患者 6例 ,其中男 1例 ,女 5例 ;年龄最大 85岁 ,最小 68岁 ,平均 70岁。心脏病患者 18例 ,其中男 5例 ,女 13例 ,年龄最大 78岁 ,最小 5 0岁 ,平均 67岁。2　应用碧兰麻的时机与疗效碧兰麻主要用于心电监护拔牙麻醉效果不佳时的追加麻醉 ,拔牙麻醉常用 2 0 ｇ/Ｌ利多卡因 + 5ｇ/Ｌ布比卡因以 1∶1的剂量混合液 (简称…     

3620例碧兰麻局部麻醉临床观察

目的 :观察碧兰麻在口腔麻醉中的临床效果。方法 :碧兰麻 1.7ml,采用小针头 ,配电脑控制加压注射器 ,进行口腔局部注射麻醉 ,另设普鲁卡因注射组进行对比研究。结果 :碧兰麻组麻醉显效率为 98.9% ,优于普鲁卡因组。结论 :碧兰麻应用于口腔局部麻醉疗效好 ,用药少 ,无不良反应。     

Supplementary routes to local anaesthesia

The satisfactory provision of many dental treatments, particularly endodontics, relies on achieving excellent pain control. Unfortunately, the administration of a local anaesthetic solution does not always produce satisfactory anaesthesia of the dental pulp. This may be distressing for both patient and operator. Fortunately, failure of local anaesthetic injections can be overcome. This is often achieved by using alternative routes of approach for subsequent injections. Nerves such as the inferior alveolar nerve can be anaesthetized by a variety of block methods. However, techniques of anaesthesia other than the standard infiltration and regional block injections may be employed successfully when these former methods have failed to produce adequate pain control. This paper describes some supplementary local anaesthetic techniques that may be used to achieve pulpal anaesthesia for endodontic procedures when conventional approaches have failed. Although some of these techniques can be used as the primary form of anaesthesia, these are normally employed as 'back-up'. The methods described are intraligamentary (periodontal ligament) injections, intraosseous anaesthesia and the intrapulpal approach. The factors that influence the success of these methods and the advantages and disadvantages of each technique are discussed. The advent of new instrumentation, which permits the slow delivery of local anaesthetic solution has led to the development of novel methods of anaesthesia in dentistry. These new approaches are discussed.     

妊娠期牙髓炎一次性根管预备的疗效观察

目的 探讨孕期牙髓炎一次性根管预备治疗的效果.方法 回顾性研究53例孕期牙髓炎患者,采用盐酸阿替卡因肾上腺素注射液单独麻醉或盐酸阿替卡因肾上腺素注射液和盐酸利多卡因注射液联合麻醉,进行一次性根管预备,Vitapex根管糊剂暂封,待患者顺利生产后再常规根管充填,半年后拍片评价疗效.结果 痊愈46例,有效6例,1例冠根折断后拔除.痊愈率87％,总有效率(痊愈加有效)为98％.结论 使用盐酸阿替卡因肾上腺素注射液和盐酸利多卡因注射液对孕期牙髓炎患者进行一次性根管预备是一种安全、有效的治疗方法,值得推广.     

妊娠期牙髓炎一次性根管预备的疗效观察

目的探讨孕期牙髓炎一次性根管预备治疗的效果。方法回顾性研究53例孕期牙髓炎患者,采用盐酸阿替卡因肾上腺素注射液单独麻醉或盐酸阿替卡因肾上腺素注射液和盐酸利多卡因注射液联合麻醉,进行一次性根管预备,Vitapex根管糊剂暂封,待患者顺利生产后再常规根管充填,半年后拍片评价疗效。结果痊愈46例,有效6例,1例冠根折断后拔除。痊愈率87％,总有效率（痊愈加有效）为98％。结论使用盐酸阿替卡因肾上腺素注射液和盐酸利多卡因注射液对孕期牙髓炎患者进行一次性根管预备是一种安全、有效的治疗方法,值得推广。     

Efficacy of buccal infiltration anaesthesia with articaine for extraction of mandibular molars: a clinical trial

It is hard to provide adequate anaesthesia by infiltration of lidocaine into the mandible because of the thick buccal cortex. An inferior alveolar nerve block is often used but has a high failure rate, which has led research workers to look for an anaesthetic agent that will anaesthetise the lower teeth by buccal infiltration alone. We have assessed the efficacy of buccal infiltration anaesthesia with articaine by designing a double-blind controlled clinical trial in 133 patients who required extraction of mandibular molars. They were randomly divided into two groups and given infiltration anaesthesia with either 4% articaine or 2% lidocaine by a single injection deep into the mucobuccal fold at the site of the tooth. After five minutes the mesial, distal, buccal, and lingual sides of the tooth were probed. Pain at this time or later during dissection of soft tissue by periosteal elevator was considered as failure, and an inferior alveolar nerve block was given. The amount of pain, and the number of patients who developed pain, were significantly greater in the group given 2% lidocaine (p < 0.001). The two groups did not differ significantly in age or sex. Articaine is more successful in providing adequate depth of anaesthesia, but its efficacy was not sufficient to replace an inferior alveolar nerve block for extraction of mandibular molars (Registration code: IRCT2016062627111N2).     

Fatal subarachnoid haemorrhage associated with dental local anaesthesia

A case is described of sudden death occurring after the use of a noradrenaline-containing local anaesthetic. Autopsy revealed a massive subarachnoid haemorrhage following a ruptured cerebral aneurysm. The noradrenaline in the local anaesthetic is thought to be an important factor in the cause of the rupture. It is recommended that preparations containing 1:25,000 noradrenaline not be used.     

A survey of local anaesthesia education in European dental schools

Objective: A survey of European dental schools was conducted in 2006 to determine the curricular structure, techniques and materials used in local anaesthesia teaching to dental students. Materials and methods: A questionnaire was designed to collect information about local anaesthesia education. The questionnaires were sent to the Dean of each dental school in Europe and Israel; 49 returned the completed survey, resulting in a response rate of 18.4%. Results: Results from this survey show that dental schools are managing local anaesthesia education in different ways. At most schools, theoretical teaching begins during the first half of the third year (41%), half a year before the practical instruction (43%). In 37% of the dental schools, students use non‐human objects to practice before they inject an anaesthetic in humans. The first injection in humans, usually a fellow student (61%), is mostly supervised by an oral and maxillofacial surgeon (65%). The number of injections under supervision usually depends on the individual capabilities of the student (41%). Ten per cent of the schools need permission of a medical ethics committee for the practical instruction on fellow students. All dental curricula include teaching of mandibular block anaesthesia. The majority also include instruction of infiltration anaesthesia of the upper (98%) and lower (92%) jaws in addition to infra‐orbital block anaesthesia (57%). Although 82% of the schools are satisfied with the current curriculum with regard to local anaesthesia, 43% are planning changes, frequently the introduction of preclinical training models. Conclusion: Local anaesthesia teaching programmes show considerable variation across the surveyed European dental schools.     

体征不典型的急性牙髓炎临床分析

目的报告一组临床体征不典型的急性牙髓炎病例,分析其临床表现及定位诊断方面的特点。方法回顾性研究11例具有牙髓炎急性发作病史或症状,但就诊时无牙髓温度测验结果异常体征的患者临床资料,统计分析其主要症状、体征。结果①11例中,牙髓温度试验冷热均正常者9例（81.82%）;冷试无反应,热试正常者2例（18.18%）;②其中9例（81.82%）在排除其它患牙后,经试验性备洞检查,在无麻醉条件下开髓,2例（18.18%）观察2日,经检查定位后开髓。5例（45.45%）开髓后疼痛明显缓解;6例（54.55%）常规复诊期内自发痛未再发作或基本消失;③11例中：牙髓完全坏死1例（9.09%）,部分坏死10例（90.91%）。结论①11例均符合急性牙髓炎诊断;但牙髓温度试验均无明显异常;②患牙主要表现为牙髓部分坏死;③排除其它患牙后,试验性备洞检查可准确定位。     

Glycemic effect of administration of epinephrine-containing local anaesthesia in patients undergoing dental extraction, a comparison between healthy and diabetic patients

OBJECTIVES: To compare the effect of administration of epinephrine (in the dental local anesthetic solution) on blood glucose concentration in healthy and diabetic dental patients after extraction. To determine if there is any correlation between blood glucose level changes and the number of carpules injected, number of teeth extracted and the gender of the patient. MATERIALS AND METHOD: An open study of 60 patients (30 healthy and 30 diabetics) visiting the Oral Surgery clinic of Ajman University of Science and Technology. A drop of blood was taken from the tip of the patient's finger and placed on a glucometer strip to determine the pre-operative blood glucose level. Dental local anaesthesia (1.8 ml carpule each) containing 1:80,000 epinephrine was injected either through infiltration or block. Extraction was carried out atraumatically and 10 minutes post-extraction the glucose measurement was taken. RESULTS: The difference in the blood glucose levels pre- and post operatively were not significantly different (p > 0.05) when a comparison was made between the healthy and diabetic groups. Comparison of glucose changes in diabetics who had taken their hypoglycaemic medication and those who had not, showed a significant difference (p < 0.05). Statistical analysis showed no correlation between the blood glucose level changes and the number of carpules used, number of teeth extracted and gender. CONCLUSION: Dental local anaesthetic solution containing epinephrine is safe to use in all healthy and diabetic patients (irrespective of their gender), excepting those diabetics who have not taken their pre-operative hypoglycaemic medication. There is no relation between the post-extraction glucose changes and the number of carpules used, number of teeth extracted or gender.