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A randomized anesthethic potency comparison between ropivacaine and bupivacaine on the perioperative regional anesthesia in lower third molar surgery
背景与目的
通过局部麻醉控制围手术期疼痛是外科实践的一个重要组成部分。本研究旨在评估罗哌卡因与布比卡因在下颌水平第三磨牙手术中的麻醉效果。
方 法
本次临床试验主要纳入的研究对象为年龄在18-70岁（平均年龄：26.48±3.66）行下颌水平第三磨牙手术的男女门诊患者。I组使用0.75%罗哌卡因对下颌骨进行麻醉，II组使用0.5%布比卡因进行麻醉，III组使用利多卡因联合1:100000肾上腺素进行麻醉，后对麻醉相关变量进行监测：麻醉质量评分（QAS）、局麻成功率（SLA）、麻醉起效时间（OT）、麻醉持续时间（DA）和术中疼痛程度（IIP）(VAS以mm为单位)。同时测量血压和脉搏。
结 果
本研究共纳入90名患者，将其随机分为三组。罗哌卡因组具有统计学意义（P<0.05）的变量为：QAS为1.77±0.68，IIP为18.90±6.11 mm（P<0.05）。罗哌卡因组、利多卡因肾上腺素1:100000组和布比卡因组实现局部麻醉SLA分别为96.6%、93.3%和86.6%。I组、II组和III组的OT分别为151.50±80.93s、168.27±79.73s和89.80±27.91s。罗哌卡因的DA为412.17±110.04 min，布比卡因和利多卡因加肾上腺素1:100000分别为376.30±98.51 min和216.13±47.69 min。因血流动力学参数变化导致不良反应增加方面，组间比较差异无显著性。
结 论
与0.5%布比卡因和2%利多卡因加肾上腺素相比，0.75%罗哌卡因局部麻醉成功率为96.6%，麻醉效果较好，起效快，持续时间长（412.17±110.04min），术中疼痛程度较低。
原始文献摘要
Tijanic M, Buric N. A randomized anesthethic potency comparison between ropivacaine and bupivacaine on the perioperative regional anesthesia in lower third molar surgery.[J] .J Craniomaxillofac Surg, 2019, undefined: undefined.
Background: Perioperative pain control by means of local anesthesia is an intrinsic part of surgical practice.
Aim: To evaluate the anesthetic potencies between ropivacaine and bupivacaine in the surgery of mandibular horizontally impacted teeth.
Material and method: Outpatients of both sexes, in the age range from 18 to 70 yrs. of age (mean age: 26.48 ± 3.66), participated in this clinical study. After mandibular conduction anesthesia of 0.75% ropivacaine in group I, 0.5% bupivacaine in group II, and 2% lidocaine with 1:100000 epinephrine in group III, the following anesthetics variables were measured: quality of anesthesia score (QAS), success rate of local anesthesia (SLA), onset time of anesthesia (OT), duration of anesthesia (DA), intensity of intraoperative pain (IIP) (VAS scale in mm). Blood pressure, and pulse were measured.
Results: Ninety patients, divided into three equal groups, were enrolled for the study. Ropivacaine gained statistically signifificant (p < 0.05) variables: QAS of 1.77 ± 0.68 and IIP was 18.90 ± 6.11 mm (p < 0.05). The SLA of the achieved local anesthesia was 96.6%, 93.3% and, 86.6% for ropivacaine, lidocaine with epinephrine 1:100000, and bupivacaine groups, respectively. OT was 151.50 ± 80.93, 168.27 ± 79.73, and 89.80 ± 27.91 sec, for groups I, II and III, respectively. The DA for ropivacaine was 412.17 ± 110.04 min, while the one for bupivacaine and lidocaine with epinephrine 1:100000 was 376.30 ± 98.51 min., and 216.13 ± 47.69 min., respectively. Hemodynamic parameters were insignifificant to cause side effects.
Conclusion: 0.75% ropivacaine provided successful local anesthesia in 96.6% of the patients, better quality and onset of anesthesia with the duration of anesthesia of 412.17 ± 110.04 min and lower intraoperative pain than in the case of 0.5% bupivacaine and 2% lidocaine with epinephrine.
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