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目的:观察左旋布比卡因在活髓牙预备中的麻醉效果及对血压、心率的影响。方法:选择下颌施行烤瓷固定桥修复且基牙为活髓牙病例120例,随机分为两组,每组60例。实验组采用0.5%左旋布比卡因下齿槽神经阻滞麻醉,对照组采用2%利多卡因下齿槽神经阻滞麻醉。以VAS标尺法由患者对牙体预备时疼痛程度进行打分,由口腔医生评价麻醉效果。观测患者在麻药使用前、即刻、10min、20min、30min的血压和心率。结果:VAS评分:左旋布比卡因组0.96±2.21;利多卡因组2.92±2.76,麻醉效果左旋布比卡因组优于利多卡因组,结果具有统计学意义(P<0.01)。两组麻醉持续时间左旋布比卡因组(4.92±1.52h)明显高于利多卡因组(2.17±0.70h),P<0.01。两种麻药起效时间、对血压和心率影响无统计学意义(P>0.05)。结论:左旋布比卡因是一种长效的、安全的麻醉剂。在无肾上腺素添加的情况下也可维持较长的麻醉时间,适合于不便使用肾上腺素患者耗时较长的牙体预备。
Objective: To observe the effects of levobupivacaine anesthesia and blood pressure and heart rate in vital pulp preparation. Methods: One hundred and twenty patients with mandibular teeth whose mandibles were repaired with porcelain fixed bridge were selected and randomly divided into two groups (60 in each group). The experimental group was anesthetized with 0.5% levobupivacaine alveolar nerve block, while the control group received 2% lidocaine hypoglossal nerve block anesthesia. VAS scale method by the patient when the preparation of dental pain when the degree of scoring, by the dentist to evaluate the effect of anesthesia. Observe the blood pressure and heart rate of patients before anesthesia use, immediately, 10min, 20min, 30min. Results: The VAS score was 0.96 ± 2.21 in levobupivacaine group and 2.92 ± 2.76 in lidocaine group. The anesthetic effect of levobupivacaine group was better than that of lidocaine group (P <0.01). The duration of anesthesia in levobupivacaine group (4.92 ± 1.52h) was significantly higher than that in lidocaine group (2.17 ± 0.70h), P <0.01. Two kinds of anesthetic onset time, the impact on blood pressure and heart rate was not statistically significant (P> 0.05). Conclusion: Levobupivacaine is a long-acting, safe anesthetic. In the absence of epinephrine addition can also maintain a longer anesthesia time, suitable for inconvenient use of epinephrine patients time-consuming dental preparation.