比较4%阿替卡因与4%阿替卡因或2%利多卡因下牙槽神经阻滞(IANB)用于下颌磨牙有症状的不可逆性牙髓炎的口腔浸润(BI)的麻醉效果。
PubMed,科克伦,WebofScience,Scopus,使用MESH术语和特定关键字搜索ClinicalTrials.gov。纳入的文章是随机临床试验(RCTs),比较了4%阿替卡因BI与常规IANB的牙髓麻醉效果和成功率。根据Cochrane偏倚风险评估工具对纳入研究进行质量评估。使用固定或随机效应模型对研究进行定量评估。
在756篇文章中,纳入5项RCT研究,共500例患者:4%阿替卡因BI组231例,2%利多卡因IANB组150,4%阿替卡因IANB组119例。我们的荟萃分析结果显示,与2%利多卡因IANB相比,4%阿替卡因BI麻醉的患者具有相似的成功率[合并RD:0.14(95%CI,-0.01至0.29);P=.08]。同样,与4%阿替卡因IANB相比无显著差异[RD:-0.01(95%CI,-0.13~0.11;P=0.86)].与IANB(4%阿替卡因或2%利多卡因)相比,使用4%阿替卡因BI麻醉的患者的疼痛评分相当[合并MD:-0.14(95%CI,-0.38至0.11);P=.27]。关于质量评估,3项研究被认为具有低偏倚风险,一项研究有不清楚的偏见风险,一项研究有很高的偏倚风险。
4%阿替卡因BI与2%利多卡因IANB或4%阿替卡因IANB相比,在疼痛缓解和成功率方面具有可比性。然而,由于纳入研究的数量有限,样本量小,这些发现应该仔细考虑,需要进一步的研究来证实我们的发现。
OBJECTIVE: To compare the anesthetic efficacy of buccal infiltration (BI) using 4%
articaine vs 4%
articaine or 2% lidocaine inferior alveolar nerve block (IANB) for mandibular molars with symptomatic irreversible pulpitis.
METHODS: PubMed, Cochrane, Web of Science, Scopus, and ClinicalTrials.gov were searched using MESH terms and specific keywords. Included articles were Randomized Clinical Trials (RCTs), which compared 4% articaine BI vs conventional IANB in terms of the efficacy of pulpal anesthesia and success rate. The quality assessment of included studies was done according to the Cochrane risk of bias assessment tool. Studies were quantitatively assessed using fixed or random effect models.
RESULTS: Out of 756 articles, 5 RCT studies were included with a total number of 500 patients: 231 in 4% articaine BI group, 150 in 2% lidocaine IANB group, and 119 in 4%
articaine IANB group. Our meta-analysis results showed that patients anesthetized with 4% articaine BI had a similar success rate compared to 2% lidocaine IANB [pooled RD: 0.14 (95% CI, -0.01 to 0.29); P = .08]. Similarly, there was non-significant difference when compared to 4% articaine IANB [RD:-0.01 (95% CI, -0.13 to 0.11; P = .86)]. Patients anesthetized with 4%
articaine BI presented comparable pain scores compared to IANB (4%
articaine or 2% lidocaine) [pooled MD: -0.14 (95% CI, -0.38 to 0.11); P = .27]. Regarding quality assessment, 3 studies were considered to have a low risk of bias, one study has an unclear risk of bias, and one study has a high risk of bias.
CONCLUSIONS: 4% articaine BI showed comparable results in terms of pain relief and success rate in comparison with 2% lidocaine IANB or 4%
articaine IANB. However, due to the limited number and small sample size of included studies, these findings should be considered carefully, and further studies are required to confirm our findings.