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在下第一个牙和不可逆转的胸膜中进行口内透:证据足够吗?
1Professor, Department of Oral and Maxillofacial Surgery, College of Dentistry, Mosul University, Mosul, Iraq. omerwaleedmajid@uomosul.edu.iq.
Evidence-based dentistry
|May 6, 2025
概括
阿尔蒂卡因口腔透 (BI) 提供了可比的麻醉成功利多卡因下膜神经阻塞 (IANB) 对下第一个牙与不可逆转的脉. 需要进一步的研究,但BI是IANB的潜在替代品.
科学领域:
- 牙科 牙科是指牙科的专业.
- 麻醉学 麻醉学
- 牙周内科医院 牙周内科医院 牙周内科医院
背景情况:
- 在下第一个牙中出现症状的不可逆转的脉,往往需要有效的脉麻醉.
- 用利多卡因进行下膜神经阻塞 (IANB) 是一种传统的技术,但其成功率可能是可变的.
- 正在探索替代麻醉技术,以改善患者的治疗结果.
研究的目的:
- 系统地审查和元分析 4% 的麻醉成功率 articaine 口腔透 (BI) 与 2% 利多卡因下膜神经阻塞 (IANB) 相比.
- 评估articaine BI作为初级注射药物在下第一个牙中治疗症状性不可逆转的胸膜炎的疗效.
主要方法:
- 随机临床试验 (RCT) 的系统审查和元分析,遵循PRISMA指南.
- 纳入标准侧重于在下第一个牙中出现症状的不可逆转的胸膜炎的成年人,接受 either articaine BI或 lidocaine IANB.
- 麻醉成功被定义为在牙科手术期间的VAS疼痛评分<4;数据使用固定效应模型进行了聚合,评估了异质性和出版偏差.
主要成果:
- 包括5项涉及405名患者的RCT,比较了articaine BI (72.2%的成功率) 与利多卡因IANB (68.1%的成功率).
- 分析显示,两种技术之间的麻醉成功率没有显著差异 (RR=1.06,95% CI:0.93-1.20).
- 试验序列分析表明,由于样本规模不足,结果不确切,GRADE评估将证据确定性评为中等.
结论:
- 适度的证据表明,4%的articaine口腔透与2%的利多卡因下膜神经块一样有效,可以在带有症状的不可逆转的胸膜炎的下第一个牙中实现脉麻醉.
- 阿尔蒂卡因BI可以作为传统IANB的可行替代品.
- 需要额外的高质量的RCT来证实这些发现并提高证据的确定性.
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