颊侧浸润麻醉对上颌磨牙麻醉效果的临床观察

目的：比较颊侧浸润麻醉与传统阻滞麻醉对上颌磨牙牙髓的麻醉效果。方法：选择因上颌磨牙深龋或牙髓炎患者,患牙在局麻下行去龋或开髓、拔髓操作。麻药为含1：80000肾上腺素的2%利多卡因。患者随机分为A、B、C三组,每组各100例。A组采用颊侧黏膜下浸润麻醉,剂量1.8ml;B组采用与A组相同的黏膜下浸润麻醉,剂量0.9ml;C组采用传统阻滞麻醉,剂量1.8ml。以视觉模拟评分法（VAS）对注射和操作的疼痛程度进行评分,以Kruskal-Wallis方法检验各组间差异。结果：①Kruskal-Wallis检验显示注射疼痛,组间有统计学差异（p〈0.05）,而操作疼痛,组间无统计学差异（p〉0.05）;②Nemenyi法进一步比较各组间注射疼痛的差异,A组与B组无显著性差异（p〉0.05）,而A组与C组、B组和C组之间存在显著性差异（p〈0.05）。结论：对于上颌磨牙的麻醉,颊侧浸润麻醉（1.8ml或0.9ml）与传统的阻滞麻醉在操作疼痛评分中无显著性差异,但是注射疼痛显著低于阻滞麻醉。提示0.9ml含1：80000肾上腺素的2%利多卡因颊侧浸润麻醉即可获得较好的上颌磨牙牙髓麻醉效果。

The clinical pulpal anesthetic efficacy of buccal infiltration to maxillary molars

Objective:To compare the pulpal anesthetic efficacy with the buccal infiltration and traditional block injection. Method:First-visit patients with caries or pulpitis in maxillary molars were chosen,which performed caries-removal,pulp chamber exposure and pulp extirpation. 2% lidocaine with 1:80000 epinephrine was used. The patients were randomly assigned in three groups,100 teeth per group. Group A:1.8 ml anesthetic was injected as submucous infiltration anesthesia. Group B:the injection method was the same as group A,but the dosage was 0.9 ml. Group C:1.8 ml anesthetic was used as block anesthesia. Visual analogue scale (VAS) was used to assess the pain degree during the injection and operating procedure. Data were analyzed using Kruskal-Wallis test and Nemenyi test. Result:For the injection pain assessmentthere were difference among the groups(p<0.05). Nemenyi test showed that significant difference existed between group A and C,B and C(p<0.05). For the operating pain assessment,there was no difference among the groups(p>0.05). Conclusion:For the pulpal anaesthesia of maxillary molars,the buccal infiltration with 0.9 ml 2% lidocaine with 1:80000 epinephrine could get anesthetic efficacy.