【摘要】 目的讨论拔除上颌恒牙时不给予腭侧麻醉的可行性。方法拔除双侧上颌恒牙的患者63例,进行双侧对照试验,试验组予4%盐酸阿替卡因(含1∶100000肾上腺素)1.7mL唇颊侧前庭沟浸润麻醉,5min后拔牙;对照组颊侧注射同前,同时腭侧追加上述局麻药0.4mL浸润麻醉,5min后拔牙。所有患者麻醉后和拔牙后分别完成注射及拔牙疼痛视觉模拟量表(visual analogue scale,VAS)和语言评价量表(verbal response scale,VRS)测试。结果注射疼痛评价VAS值试验组为(26.3±8.1)mm,对照组为(37.9±6.7)mm,二者差异有统计学意义(P<0.05);拔牙疼痛评价VAS值试验组为(15.3±6.9)mm,对照组为(13.3±5.7)mm,两组差异无统计学意义(P>0.05),所有患者认为拔牙为"可接受"。结论上颌恒牙拔除行腭侧浸润麻醉给患者带来更多不适,仅行4%盐酸阿替卡因唇颊侧浸润麻醉拔牙的方法可行。更多还原

【Abstract】 Objective To demonstrate if palatal injection produced a more painful experience while articaine HCl with vasoconstrictor was administered to the palate as routine use and if permanent maxillary tooth removal without palatal injection was possible. Methods Sixty-three patients requiring the removal of bilateral permanent maxillary teeth were enrolled. On the experimental side:1.7 mL of 4% articaine/HCl with 1∶100 000 epinephrine was injected into the buccal vestibule of the tooth. After 5 min the extraction was performed. On the control side: A similar protocol was applied with palatal injection. All patients completed a Visual Analogue Scale (VAS) and Verbal Response Scale (VRS) after injection and extraction, respectively. Results According to the VAS scores, the difference between buccal infiltration without a separate palatal injection and routine administration with additional palatal injection was statistically significant (P<0.05). However, the VAS scores for permanent maxillary tooth removal showed no significant difference between two types of injection (P>0.05). All patients described both extractions as "acceptable". Conclusion The routine use of a palatal injection for removal of permanent maxillary tooth is likely to result in greater discomfort to the patient. Only utilizing articaine as buccal infiltration for extraction is possible.更多还原