术前口服用药对不可逆性牙髓炎患者下牙槽神经阻滞影响的研究
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摘要
纳入汉中市中心医院口腔科150例不可逆性牙髓炎患者,采用VAS评分后,将患者随机分为3组(n=50),分别口服酮咯酸片(KETO组),双氯芬酸钾片(DP组),纤维素粉片剂(placebo组), 3组均服药后1 h给予2%的含1∶200 000肾上腺素的利多卡因行下牙槽神经阻滞(IANB)。IANB注射成功采用冷试验进行评估,患者牙髓麻醉的成功率以牙髓治疗时患者痛觉判定。结果表明:3组患者年龄、性别及服药前VAS评分无显著性差异(P>0.05),所有患者术后疼痛评分较术前均显著降低(P<0.0001)。VAS评分顺序为,KETO组 150 patients with irreversible pulpitis were included and randomly divided into 3 groups(n=50) and treated with oral tablets of ketorolac(KETO), diclofenac pottasium(DP) and cellulose powder(placebo) respectively 1 h prior to administration of inferior alveolarnerve block(IANB) with 2% lidocaine containing 1 ∶200 000 epinephrine. Lip numbness and cold test were used for the determination of IANB injection success. The pain related to dental pulp treatment was used as the failure of IANB for pulp anesthesia. Bere treatment no significant difference of age, gender and VAS score was found among the 3 groups(P>0.05). Patients of all the 3 groups reported a significant decrease in active pain after IANB(P<0.000 1). The order of VAS values was KETO
引文
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[15] Kasatkin AA,Urakov AA,Lukoyanov IA.Nonsteroidal anti- inflammatory drugs causing local inflammation of tissue at the site of injection[J].J Pharmacol Pharmacother,2016,7(1):26-28.
[16] Wells JE,Bingham V,Rowland KC,et al.Expression of Nav1.9 channels in human dental pulp and trigeminal ganglion[J].J Endod,2007,33(10):1172-1176.
[17] 王霄燕,鲍喆煊,郝梅,等.酮咯酸氨丁三醇在牙周治疗手术中的镇痛效果研究[J].实用口腔医学杂志,2015,31(6):866-868.
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[19] 卢启海,毛小强,王伟.双氯芬酸钾栓联合丁溴东莨菪碱治疗肾绞痛疗效观察[J].山东医药,2014,54(2):73-74.
[20] Gan TJ.Diclofenac:An update on its mechanism of action and safety profile[J].Curr Med Res Opin,2010,26(7):1715-1731.
[21] Simmons DL,Botting RM,Hla T.Cyclooxygenase isozymes:The biology of prostaglandin synthesis and inhibition[J].Pharmacol Rev,2004,56(3):387-437.
[2] 孙小娜,宋爱梅,杨丕山.非甾体类抗炎药在牙周病治疗中的作用[J].国际口腔医学杂志,2014,41(2):228-231.
[3] Simpson M,Drum M,Nusstein J,et al.Effect of combination of preoperative ibuprofen/acetaminophen on the success of the inferior alveolar nerve block in patients with symptomatic irreversible pulpitis[J].J Endod,2011,37(5):593-597.
[4] 罗薇,杨秩,赖文莉.视觉模拟评分法评价多个临床因素对正畸初始疼痛的影响[J].实用口腔医学杂志,2007,23(6):867-870.
[5] 郝树立.一次法与多次法根管治疗不可复性牙髓炎的术后疼痛和放射学疗效比较[J].中华全科医学,2014,12(8):1230-1232.
[6] Claffey E,Reader A,Nusstein J,et al.Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with irreversible pulpitis[J].J Endod,2004,30(8):568-571.
[7] 芦碧含,张文雯,李丽,等.炎症痛模型大鼠背根神经节神经元动作电位改变[J].中国疼痛医学杂志,2015,21(9):658-661.
[8] Modaresi J,Dianat O,Soluti A.Effect of pulp inflammation on nerve impulse quality with or without anesthesia[J].J Endod,2008,34(4):438-441.
[9] Mikesell P,Nusstein J,Reader A,et al.A comparison of articaine and lidocaine for inferior alveolar nerve blocks[J].J Endod,2005,31(4):265-270.
[10] Nusstein J,Kennedy S,Reader A,et al.Anesthetic efficacy of the supplemental X- tip intraosseous injection in patients with irreversible pulpitis[J].J Endod,2003,29(11):724-728.
[11] Averbach M,Katzper M.Baseline pain and response to analgesic medication of flurbiprofen[J].J Am Med Assoc,2010,80(Suppl 3A):41-49.
[12] Nagarathna C,Shakuntala BS,Jaiganesh I.Efficiency and reliability of thermal and electrical tests to evaluate pulp status in primary teeth with assessment of anxiety levels in children[J].J Clin Pediatr Dent,2015,39(5):447-451.
[13] 张子川,李晓燕.利多卡因与阿替卡因对下颌磨牙不可复性牙髓炎麻醉疗效比较[J].解放军医药杂志,2015,27(7):81-84.
[14] Tortamano IP,Siviero M,Costa CG,et al.A comparison of the anesthetic efficacy of articaine and lidocaine in patients with irreversible pulpitis[J].J Endod,2009,35(2):165-168.
[15] Kasatkin AA,Urakov AA,Lukoyanov IA.Nonsteroidal anti- inflammatory drugs causing local inflammation of tissue at the site of injection[J].J Pharmacol Pharmacother,2016,7(1):26-28.
[16] Wells JE,Bingham V,Rowland KC,et al.Expression of Nav1.9 channels in human dental pulp and trigeminal ganglion[J].J Endod,2007,33(10):1172-1176.
[17] 王霄燕,鲍喆煊,郝梅,等.酮咯酸氨丁三醇在牙周治疗手术中的镇痛效果研究[J].实用口腔医学杂志,2015,31(6):866-868.
[18] Yoon JU,Byeon GJ,Cheon JH,et al.Post- operative intravenous patient- controlled analgesic efficacy of morphine with ketorolac versus nefopam after laparoscopic gynecologic surgery:A randomized non- inferiority trial[J].Korean J Anesthesiol,2016,69(2):161-166.
[19] 卢启海,毛小强,王伟.双氯芬酸钾栓联合丁溴东莨菪碱治疗肾绞痛疗效观察[J].山东医药,2014,54(2):73-74.
[20] Gan TJ.Diclofenac:An update on its mechanism of action and safety profile[J].Curr Med Res Opin,2010,26(7):1715-1731.
[21] Simmons DL,Botting RM,Hla T.Cyclooxygenase isozymes:The biology of prostaglandin synthesis and inhibition[J].Pharmacol Rev,2004,56(3):387-437.