不同局麻方法在老年高血压患者拔牙术中应用的比较

doi:10.3969/j.issn.1674-490X.2021.02.007

摘要/Abstract

摘要： 目的评价3种局麻方法对老年高血压患者拔牙手术的影响。方法将60例老年高血压患者按随机数字表法分为注射器组(卡局式注射器局麻)、Easy-II组(阳光笑脸Easy-II局部麻醉助推仪局麻)和STA组(STA无痛口腔局麻注射仪局麻),注射后和拔牙后由患者通过视觉模拟标尺表(visual analogue scale,VAS)评价注射时和拔牙时的疼痛度;监测注射前、注射中、注射后3 min、拔牙术中及术后的SBP、DBP、HR;用改良牙科焦虑量表(modified dental anxiety scale,MDAS)评定患者拔牙手术前后的MDAS值。结果 Easy-II组和STA组局麻注射疼痛度和麻醉效果差异无统计学意义,且均优于注射器组(P<0.05);注射器组术中SBP和DBP波动明显,而Easy-II组和STA组术中均较平稳;注射器组和Easy-II组在拔牙术中HR出现升高现象,STA组较平稳;注射器组术后MDAS值高于术前(P<0.05),STA组术后MDAS值低于术前(P<0.05)。结论 Easy-II局部麻醉助推仪和STA无痛口腔局麻注射仪能够减轻注射疼痛,减少高血压患者拔牙术中各项生理指标的波动,降低风险发生。

关键词: 局部麻醉, 无痛, 老年患者, 高血压, 焦虑, 拔牙

Abstract: Objective To evaluate the effects of three local anesthesia methods on tooth extraction in elderly patients with hypertension. Methods Sixty elderly patients with hypertension were randomly divided into three groups: syringe group( anesthesia with syringe), Easy-II group(anesthesia with Easy-II local anesthesia booster)and STA group(anesthesia with STA local anesthesia injection device). After injection and extraction, the degrees of pain of the patients were evaluated by visual analog scale(VAS). Their systolic blood pressure(SBP), diastolic blood pressure(DBP)and heart rate(HR)were recorded before, in the course and 3 minutes later after injection for tooth extraction. The modified dental anxiety scale(MDAS)was used to evaluate the MDAS of patients pre- and post-operation. Results There was no statistical significance in the injection pain and anesthetic effect between Easy-II group and STA group, but they were better than those of syringe group(P<0.05). SBP and DBP of syringe group fluctuated significantly(P<0.05), while Easy-II group and STA group were stable during operation. The HR during tooth extraction was increased in the syringe group and Easy-II group, while it was more stable in STA group. The postoperative MDAS value in the syringe group was higher than preoperative value(P<0.05), while the postoperative MDAS value in STA group was lower than preoperative value(P<0.05). Conclusion Easy-II local anesthesia booster and STA local anesthesia injection device can reduce patients' pain, keep the physiological indexes stable, and reduce the risk.

Key words: local anesthesia, painless anesthesia, elderly patients, hypertension, dental anxiety, tooth extraction

中图分类号:

李丹, 杨坤, 许力心. 不同局麻方法在老年高血压患者拔牙术中应用的比较[J]. 医学研究与教育, 2021, 38(2): 36-40.

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