本文選題：鹽酸羅卡因 + 鹽酸利多卡因　； 參考：《山東大學(xué)》2014年碩士論文

【摘要】：目的 比較鹽酸羅哌卡因與利多卡因在下頜磨牙不可逆性牙髓炎患者行下牙槽、頰、舌神經(jīng)阻滯麻醉后牙髓治療過程中的麻醉效果。 材料與方法 收集2013年3月至2014年3月期間在山東大學(xué)口腔醫(yī)院就診的下頜磨牙不可逆性牙髓炎患者40名,男性18名,女性22名,年齡18-60歲,左下頜磨牙29顆,右下頜磨牙11顆,采用簡單隨機(jī)分組方法將40名患者分為A、B兩組,均行下牙槽、頰、舌神經(jīng)阻滯麻醉。A組采用0.75%鹽酸羅哌卡因麻醉,B組采用2%利多卡因麻醉,麻藥注射完畢記錄該時(shí)刻,同時(shí)記錄起效時(shí)間及麻醉效果的持續(xù)時(shí)間。根據(jù)治療過程中患者的疼痛反應(yīng)以及結(jié)合VAS值評價(jià)麻醉效果分為麻醉完全有效、麻醉良好、麻醉有效和麻醉失敗四級(jí)。除麻醉失敗一級(jí)外,其余三級(jí)均記作臨床麻醉成功。統(tǒng)計(jì)結(jié)果由軟件SAS9.1處理,其中臨床麻醉成功率通過Fisher檢驗(yàn)處理。麻醉起效時(shí)間、麻醉持續(xù)時(shí)間和VAS值通過方差分析處理完成。 結(jié)果 A組75%的成功率較B組80%的成功率在本實(shí)驗(yàn)中沒有顯著差異(P0.05)。平均起效時(shí)間A組19.5±6.26min較B組8.9±3.19min有所延緩(P0.05)。A組麻醉平均持續(xù)時(shí)間10.48±0.78h較B組平均持續(xù)時(shí)間2.20±0.19h明顯延長(P0.0001)。麻醉成功的31例中,術(shù)中VAS值2.30±1.94比術(shù)前VAS值4.84±2.30明顯減小(P0.05)；而麻醉失敗的9例中,術(shù)中VAS值7.10±2.39較術(shù)前VAS值3.93±1.99則明顯變大(P0.01),VAS值可以作為一個(gè)衡量麻醉成敗的參考指標(biāo)。共收集40例患牙,其中左下后牙占72.5%(29/40),右下后牙占27.5%(11/40)。 結(jié)論 羅哌卡因在治療下頜磨牙不可逆性牙髓炎行下牙槽、頰、舌神經(jīng)阻滯麻醉的麻醉成功率和利多卡因無明顯差異,其起效時(shí)間略長,但麻醉效果持續(xù)時(shí)間明顯長于利多卡因,在很大程度上可以緩解術(shù)后疼痛；治療下頜磨牙牙髓炎尚需其他研究來提高其麻醉成功率。
[Abstract]:Purpose To compare the anesthetic effect of ropivacaine hydrochloride and lidocaine during pulp treatment after lower alveolar, buccal and lingual nerve block in patients with irreversible pulpitis of mandibular molar. Materials and methods From March 2013 to March 2014, 40 patients with irreversible pulpitis of mandibular molars, 18 males and 22 females, aged 18-60 years, 29 left mandibular molars and 11 right mandibular molars, were selected from the Stomatological Hospital of Shandong University. Forty patients were randomly divided into two groups: group A and group A were treated with lower alveolar, buccal and lingual nerve block anesthesia. Group A was anesthetized with 0.75% ropivacaine hydrochloride and group B was anesthetized with 2% lidocaine. The time of injection was recorded. The onset time and duration of anaesthesia effect were recorded at the same time. According to the pain response of the patients and the VAS value, the anesthetic effect was divided into four groups: complete anesthesia, good anaesthesia, anaesthesia effectiveness and anesthesia failure. Except for the failure of anesthesia, the other three levels were recorded as clinical anaesthesia success. The statistical results were processed by software SAS9.1, in which the success rate of clinical anesthesia was processed by Fisher test. The onset time, duration and VAS of anesthesia were processed by ANOVA. Result There was no significant difference in the success rate of 75% in group A and 80% in group B in this experiment. The average onset time of anesthesia in group A (19.5 鹵6.26min) was significantly longer than that in group B (8.9 鹵3.19min). The average duration of anesthesia in group A was 10.48 鹵0.78 h longer than that in group B (2.20 鹵0.19 h). The intraoperative VAS value (2.30 鹵1.94) was significantly lower than that of preoperative VAS value (4.84 鹵2.30) in 31 cases of successful anesthesia, while in 9 cases of failed anesthesia, the intraoperative VAS value of 7.10 鹵2.39 was significantly larger than that of preoperative VAS value of 3.93 鹵1.99, which could be used as a reference index to evaluate the success or failure of anesthesia. A total of 40 affected teeth were collected, of which 72.5 / 40 were left lower posterior teeth and 27.5 / 40 were right lower posterior teeth. Conclusion Ropivacaine had no significant difference in anesthetic success rate and lidocaine in the treatment of mandibular molar pulpitis, but the anesthetic effect was longer than that of lidocaine, but the effect of ropivacaine was longer than that of lidocaine, but the effect of ropivacaine was longer than that of lidocaine. The treatment of mandibular molars pulpitis needs other research to improve the success rate of anesthesia.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R781.31

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