在内牙科期间,达到顶端透度是否会增加术后疼痛?
Rachel Strickland1, Luca Licheri2, David Edwards3
1Newcastle Dental Hospital, Claremont Road, Newcastle upon Tyne, NE2 4AZ, UK. rachel.strickland@nhs.net.
Evidence-based dentistry
|October 10, 2024
概括
在根管治疗期间保持尖端通透性可以显著减少最初的术后疼痛. 然而,由于本次元分析中的高异质性和可变证据质量,研究结果需要谨慎解释.
科学领域:
- 牙周内科医院 牙周内科医院 牙周内科医院
- 牙科手术 牙科手术
- 疼痛管理 疼痛管理
背景情况:
- 根管治疗的目的是消除内感染并防止再感染.
- 顶端透视,保持一个清晰的顶端孔隙,是内牙科的一个有争议的程序步骤.
- 顶端通透度对术后疼痛的影响仍然不完全理解.
研究的目的:
- 系统地审查和分析顶透度对术后疼痛和根管治疗后止痛药的作用.
- 评估顶端透视度对患者报告的内牙手术结果的影响.
主要方法:
- 在多个数据库 (PubMed,Scopus,Embase,Web of Science,Cochrane Library) 和灰色文献中进行了全面的文献搜索,截至2023年5月.
- 纳入了12项随机对照试验 (RCT),这些试验涉及未患有系统性疾病且接受根管治疗的患者.
- 数据使用RevMan 5.4软件进行分析,对二分法和连续数据采用适当的统计测试,并使用固定或随机效应建模.
主要成果:
- 在手术后24小时,1天和2天 (P <0.05) 间,上穿透率与术后疼痛显著减少有关.
- 在维持或不维持顶点通透度的组之间,没有观察到疼痛缓解剂使用的显著差异 (P = 0.42).
- 研究的质量各不相同,有很高的异质性和不准确性,特别是在疼痛测量和止痛药的使用方面.
结论:
- 在根管治疗后的早期术后疼痛减轻的显著益处.
- 这些发现虽然有希望,但由于相当多样性和可变的证据质量,应谨慎解释.
- 将患者报告的结果 (如疼痛减轻) 与传统的成功指标相结合,支持维持顶端通透性的临床理由.
相关概念视频
01:23Peripheral Artery Disease V: Postoperative Nursing Management
4
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
4
01:25Analgesia and Pain Management
540
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
540
01:13Local Anesthetics: Pharmacokinetics
738
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
738
01:22Aneurysm IV: Nursing Management
3
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
3
01:30Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
984
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
984
01:26Tonsillitis II: Management
103
This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
103