程立军 1夏继川 1李江明 2于久越 2魏泽全 1蒋煜鑫1
作者信息
- 1. 河北医科大学第三医院口腔颌面外科,石家庄 050051
- 2. 北京欢乐口腔医疗集团种植与牙槽外科中心,北京 100025
- 折叠
摘要
Abstract
Objective:To evaluate the anesthetic efficacy and safety of modified infiltration anesthesia for the extraction of impacted mandibular third molars.Methods:A randomized split-mouth,self-controlled study was conducted.A total of 140 patients who underwent bilateral impacted mandibular third molar extraction in the Department of Oral and Maxillofacial Surgery,the Third Hospital of Hebei Medical University,between August 2023 and August 2024 were enrolled.One side was randomly assigned to receive modified infiltration anesthesia,while the contralateral side received conventional inferior alveolar nerve block anesthesia,with a 2-week interval between the two procedures.Pain intensity was assessed using the visual analogue scale(VAS)at different time points during anesthetic injection and up to 7 days postoperatively.Changes in blood pressure and heart rate during anesthetic injection and tooth extraction,anesthesia onset time,the incidence of supplemental anesthesia,lower lip and lingual numbness and anesthesia-related adverse reactions were compared between the two sides.Results:VAS scores changed significantly over time in both groups(P<0.001).Compared with the inferior alveolar nerve block group,the modified infiltration anesthesia group had significantly lower VAS scores during anesthetic injection and tooth extraction(both P<0.001),whereas no significant differences were observed at any postoperative time point(all P>0.05).Systolic and diastolic blood pressures during anesthesia injection were significantly lower in the modified infiltration anesthesia group than in the inferior alveolar nerve block group(both P<0.01),while no significant differences in blood pressure or heart rate were found between the two groups at the remaining time points(all P>0.05).The modified infiltration anesthesia group showed a shorter anesthesia onset time and lower incidences of supplemental anesthesia,lower lip numbness,lingual numbness,bleeding or hematoma at the injection site,and positive aspiration(all P<0.05).No cases of trismus,facial paralysis,transient diplopia or blindness,or systemic adverse reactions were observed in either group.Conclusion:Modified infiltration anesthesia for impacted mandibular third molar extraction effectively reduces pain during anesthetic injection and tooth extraction,shortens anesthesia onset time,decreases the need for supplemental anesthesia,lower lip and lingual numbness,and anesthesia-related local adverse reactions,demonstrating favorable safety and clinical value.关键词
下颌阻生第三磨牙/浸润麻醉/下牙槽神经阻滞麻醉/盐酸阿替卡因肾上腺素注射液Key words
impacted mandibular third molar/infiltration anesthesia/inferior alveolar nerve block anesthesia/articaine hydrochloride and epinephrine injection分类
医药卫生
