Gömülü Alt Üçüncü Molar Diş Çekiminde Levobupivakain ve Artikainin Postoperatif Ağrı Giderme ve Lokal Anestezik Etkinliğinin Karşılaştırılması

Burak Ergüder, Özlem AKKEMİK KIPÇAK, Ramazan Köymen
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Abstract

Objective: A comparison of postoperative pain relief and clinical anesthetic efficacy of 2% articaine and 0.5% levobupivacaine in impacted third molar dental surgery. Material-Method: Fifty-three patients underwent the removal of symmetrically positioned lower third molars in 2 separate appointments under local anesthesia either with 2% articaine or 0.5% levobupivacaine in a double-blinded, randomized and crossover study. Neither anesthetic agent contained a vasoconstrictor. The time to onset of anesthesia, duration of surgery, intraoperative bleeding, hemodynamic parameters, the duration of postoperative analgesia and anesthesia as well as postoperative visual analogue scale (VAS) scores were evaluated.Results: The time to onset of anesthesia with articaine (80.28 ± 19.27 seconds) was significantly less compared to levobupivacaine (136.69 ± 33.52 seconds). The average duration of postoperative anesthesia for levobupivacaine and articaine was 8 hours and 3 hours, respectively (p = 0.000). The mean duration of postoperative analgesia for levobupivacaine and articaine was 7-8 hours and 3 hours, respectively (p = 0.000). Additionally, VAS scores with levobupivacaine were significantly lower than articaine up to the 4th postoperative hour. Significantly less bleeding was seen in the surgeries performed with levobupivacaine.Conclusion: 0.5% Levobupivacaine resulted in a longer period of postoperative anesthesia and analgesia, a longer time to onset of anesthesia, and less postoperative pain compared to 2% articaine.
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目的:比较2%阿替卡因和0.5%左布比卡因在阻生第三磨牙手术中的镇痛效果和临床麻醉效果。材料-方法:在一项双盲、随机和交叉研究中,53例患者在2%阿替卡因或0.5%左布比卡因局部麻醉下,分2次分别切除对称定位的下第三磨牙。两种麻醉剂都不含血管收缩剂。评估麻醉起效时间、手术持续时间、术中出血量、血流动力学参数、术后镇痛麻醉持续时间及术后视觉模拟评分(VAS)。结果:阿替卡因麻醉起始时间(80.28±19.27 s)明显少于左布比卡因(136.69±33.52 s)。左布比卡因和阿替卡因术后平均麻醉时间分别为8小时和3小时(p = 0.000)。左布比卡因和阿替卡因术后平均镇痛时间分别为7 ~ 8小时和3小时(p = 0.000)。此外,到术后第4小时,左布比卡因的VAS评分明显低于阿替卡因。用左布比卡因进行的手术出血明显减少。结论:与2%阿替卡因相比,0.5%左布比卡因术后麻醉镇痛时间更长,麻醉起效时间更长,术后疼痛减轻。
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