立即术后麻醉用利多卡因或布皮瓦卡因:短期的临床反应
Jessica D Koster1, David E Deas1, Archontia Palaiologou1
1Department of Periodontics, UT Health San Antonio School of Dentistry, San Antonio, Texas, USA.
Journal of periodontology
|March 28, 2025
概括
与安慰剂相比,手术后注射布皮瓦卡因或利多卡因在牙周膜手术后并没有显著减少疼痛. 在这项临床试验中,所有三组的疼痛水平和止痛药的使用都相似.
科学领域:
- 麻醉学 麻醉学
- 牙周病学 牙周病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 手术后的疼痛管理在牙周皮手术后至关重要.
- 长效局部麻醉剂如布皮瓦卡因经常用于缓解疼痛.
- 将布皮瓦卡因与利多卡因和安慰剂进行比较对于优化疼痛控制很重要.
研究的目的:
- 为了比较术后布皮瓦卡因注射与利多卡因在经过牙周皮手术后控制疼痛的疗效.
- 评估局部麻醉剂与安慰剂在治疗术后疼痛方面的有效性.
- 为了确定布皮瓦卡因与利多卡因相比是否提供更好的止痛.
主要方法:
- 一个随机的,三臂临床试验,涉及76名接受牙周皮手术的患者.
- 患者接受了手术后局部注射0.5%的布皮瓦卡因,2%的利多卡因或0.9%的化 (安慰剂).
- 使用数值评分表 (NRS-21) 评估疼痛,并通过手机应用程序在多个时间点记录止痛药的使用,直至手术后48小时.
主要成果:
- 与安慰剂组相比,布皮瓦卡因和利多卡因组都显示出减少疼痛的趋势.
- 在布皮瓦卡因,利多卡因和安慰剂组之间没有观察到疼痛评分的统计学上显著差异.
- 在任何测量的时间点上,三组治疗群体之间的止痛药消耗没有显著差异.
结论:
- 术后注射的布皮瓦卡因和利多卡因在经过牙周皮手术后的疼痛管理方面并不比安慰剂更有效.
- 当前的疼痛管理方案可能需要对这种手术程序进行重新评估.
- 可能需要进一步的研究来探索替代性或多模式性疼痛缓解策略.
相关概念视频
Local Anesthetics: Pharmacokinetics
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...
Local Anesthetics: Common Agents and Their Applications
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
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...
Local Anesthetics: Clinical Application as Spinal Anesthesia
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
Local Anesthetics: Clinical Application as Epidural Anesthesia
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...


