麻醉下前带有症状的不可逆转的胸膜炎 - - 哪个神经阻塞最好?
1Department of Oral & Maxillofacial Surgery, Dumfries & Galloway Royal Infirmary, Dumfries, Scotland, UK. ellis.hayes2@nhs.scot.
Evidence-based dentistry
|April 21, 2025
概括
精神神经阻塞 (MNB) 和下膜神经阻塞 (IANB) 在麻醉带前和有症状的不可逆转脉 (SIP) 中表现出类似的有效性. 对于第一前,MNB更有效,而约30%的患者需要额外的麻醉.
科学领域:
- 牙周内科医院 牙周内科医院 牙周内科医院
- 牙科麻醉 牙科麻醉
- 疼痛管理 疼痛管理
背景情况:
- 在下前中出现的症状不可逆转的胸膜炎 (SIP) 对实现充分局部麻醉提出了挑战.
- 下膜神经阻塞 (IANB) 是一种常见的技术,但它的有效性可能是可变的.
- 像精神神经阻断 (MNB) 这样的替代技术正在探索,以提高麻醉成功率.
研究的目的:
- 为了比较MNB与IANB在下第一个和第二个前的麻醉效果,用SIP.
- 为了确定一个技术是否优越,以促进这些牙的内牙治疗.
- 对于每个阻断技术来说,研究第一前和第二前之间的潜在疗效差异.
主要方法:
- 一个随机的,双盲的平行组临床试验,涉及120名在下前中患有SIP的患者.
- 患者被随机分配给接受MNB或IANB,使用1.8毫升Articaine 4%与1:100,000上腺素.
- 在内牙治疗的各个阶段,使用数值评分表 (NRS) 评估疼痛评分.
主要成果:
- 无论是MNB还是IANB,总体成功率约为70%,两种技术之间没有统计学上显著的差异.
- 在统计学上,MNB证明了第一前 (76.9%) 与第二前 (64.7%) 相比的成功率更高.
- IANB显示,第一 (71.4%) 和第二 (68.8%) 前的成功率相似. 在这两组中,大约30%的患者需要补充麻醉.
结论:
- MNB和IANB在SIP的下前中实现麻醉的整体疗效相似.
- 对于麻醉第一前而言,MNB技术可能比第二前更有利.
- 很大一部分患者 (约30%) 需要补充麻醉,无论使用的主要神经阻断技术.
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