不同局部麻醉劑用於下齒槽神經阻斷麻醉控制牙髓疼痛之比較

Comparison of Local anesthetics for controlling endodontic pain with inferior alveolar nerve block

介紹：局部麻醉劑對於控制疼痛扮演重要的角色。對於不可逆牙髓炎之患者欲達到充分的牙髓麻醉是困難的。本篇研究藉由文獻回顧的方式，探討臨床上如何藉由局部麻醉劑搭配下齒槽神經阻斷麻醉，達到不可逆牙髓炎之下顎大臼齒的疼痛控制。研究方法：使用關鍵字「局部麻醉」、「局部麻醉劑」、「牙髓痛」搜尋電子資料庫，並以人工審閱方式搜尋牙髓病相關文獻。結論：對於不同局部麻醉劑用於下齒槽神經阻斷麻醉控制牙髓疼痛之比較，大多數文獻中4% articaine和2% lidocaine沒有顯著差異；當使用下齒槽神經阻斷麻醉控制牙髓疼痛失敗時，可使用頰神經浸潤麻醉作為輔助。

Introduction: Local anesthetics represent an important component in pain control. It is difficult to achieve profound pulpal anesthesia in patients with irreversible pulpitis. The purpose of this review is to determine the clinical performance of local anesthetics for controlling endodontic pain in mandibular molar with pulpitis. Methods: Electronic database MEDLINE via Ovid, PubMed, Sciencedirect, and Cochrane databases (January 2011-December 2014) were searched. Hand searching was performed through reference lists of endodontic endodontic-related journals, and Results: Most investigations on the success of anesthesia in the oral cavity have focused on inferior alveolar nerve block (IANB) techniques and employed various anesthetic solutions. Several investigations have compared a combination of anesthetic techniques so that they know how to achieve higher success rates of anesthesia. Conclusions: There is no significant difference between 4% articaine and 2% lidocaine in inferior alveolar nerve block (IANB). Supplemental buccal infiltration with 4% articaine was one strategy to enhance pulpal anesthesia when LANB failed.