3％盐酸甲哌卡因与2％利多卡因在高血压患者心电监护拔牙治疗中的比较

【目的比较3％盐酸甲哌卡因与2％利多卡因在高血压患者心电监护拔牙治疗时镇痛效果及对心血管系统的影响。方法在心电监护拔牙患者中抽取150例轻、中度高血压患者，随机分为两组，分别使用3％盐酸甲哌卡因和2％利多卡因进行口腔局部麻醉，记录患者术前、麻醉即刻、麻醉后5min、手术中、手术后血压和心率情况，使用重复测量方差分析比较两种药物心率和血压变化，同时应用视觉模拟评分（Visual Analogue Scale，VAS）评价麻醉即刻及手术中疼痛。结果（1）两组患者血压比较：两种药物间不存在差异（P〉0．05），麻醉即刻与手术中存在差异（P〈0．05）。（2）两组患者心率比较：两种药物间不存在差异（P〉0．05），麻醉即刻与手术中存在显著差异（P〈0．01）。（3）两组VAS评分：麻醉即刻存在显著差异（P〈0．01）。结论3％盐酸甲哌卡因对心血管的影响小，注射时疼痛较轻，不良反应少，可以安全、有效地应用于高血压患者拔牙镇痛。

Comparison of 3 % mepivacaine hydrochloride and 2 % xylocaine during dental extraction in hypertensive patients under ECG monitoring

Objective To compare analgesic effect and influences on cardiovascular system between injecting 3% mepivacaine hydrochloride and 2% xylecaine during dental extraction in hypertensive patients under ECG monitoring. Meth- ods During dental extraction under ECG monitoring, 150 patients with light and mild hypertension were picked and random- ly divided into two groups, one group with 2% xylocaine injection and another with 3% mepivacaine. Blood pressure and heart rate were recorded at pre - surgery,anesthesia instant ,5 minutes after anesthesia~in surgery and post - surgery, and ana- lyzed by data variances from repeated measurements. Meanwhile, patient pain at anesthesia instant and during surgery was e- valuated by VAS. Results （ 1 ） Blood pressure： no difference between 3 % mepivacaine hydrechloride injection and 2% xy- locaine injection （ P 〉 0. 05 ）, significant difference between anesthesia instant and in - surgery for each medicine （ P 〈 0. 05 ）. （2） Heart rate： no difference between two medicines （P 〉 0.05）, significant difference between the moment of anes- thesia and in - surgery for each medicine （ P 〈 0. 01 ）. （3） VAS grades ： significant difference between two kind of medicine injections （ due to different hypodomic needle sizes ） （ P 〈 0. 01 ）. Conclusion With similar effect as 2% xylocaine, 3% mepivacaine can be safely and effectively applied on dental extraction in hypertensive patients under ECG, due to little effect on cardiovascular system, trivial pain and side effects.