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首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >Reversing the Effects of 0.5% Bupivacaine Using Phentolamine Mesylate: A Preliminary Randomized Controlled Clinical Trial
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Reversing the Effects of 0.5% Bupivacaine Using Phentolamine Mesylate: A Preliminary Randomized Controlled Clinical Trial

机译：使用植物甲磺酸盐逆转0.5％Bupivacaine的影响：初步随机对照临床试验

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摘要

Phentolamine mesylate is the only commercially available dental local anesthetic reversal agent. It has been proven safe and effective for reversing most local anesthetics used in dentistry but was never tested with bupivacaine. The aim of this project was to evaluate the effectiveness of 0.4-mg phentolamine mesylate in reversing an inferior alveolar nerve block (IANB) with 0.5% bupivacaine, 1:200,000 epinephrine. Sixty-six participants were recruited and were administered an IANB with bupivacaine. After confirmation of anesthesia, they were randomized into 1 of 2 groups (phentolamine mesylate or control). Participants in the phentolamine mesylate group received a second injection with 1.7-mL OraVerse (0.4-mg phentolamine mesylate), while participants in the control group received a second injection with 1.7-mL sterile saline water. Participants were trained to self-assess sensation (lower lip and tongue) and function (drinking, speaking, and smiling), which they did every 20 minutes, and they recorded the time when sensation/function returned to normal. Comparative analysis was completed using independent sample t-tests, univariate linear regressions, and Pearson chi-square. Forty-three participants were randomized, and 34 completed the study (phentolamine mesylate, n = 15; control, n = 19). There was a statistically significant difference between the 2 treatment groups for return of normal sensation to the lower lip (mean difference of 2 hours and 17 minutes; P = .027) and the tongue (mean difference of 1 hour and 35 minutes; P = .046) in favor of the phentolamine mesylate group. The results indicate that phentolamine mesylate hastens the return to normal sensation of an IANB with bupivacaine.
机译：甲磺酸酚妥拉明是唯一一种商用牙科局部麻醉剂逆转剂。它已被证明是安全有效的，可以逆转牙科中使用的大多数局部麻醉剂，但从未用布比卡因进行过试验。本项目的目的是评估0.4毫克甲磺酸酚妥拉明在用0.5%布比卡因、1:200000肾上腺素逆转下牙槽神经阻滞（IANB）中的有效性。招募了66名参与者，并用布比卡因进行IANB治疗。在确认麻醉后，他们被随机分为2组（甲磺酸酚妥拉明组或对照组）中的1组。甲磺酸酚妥拉明组的参与者第二次注射1.7毫升口服液（0.4毫克甲磺酸酚妥拉明），而对照组的参与者第二次注射1.7毫升无菌盐水。参与者每20分钟接受一次自我评估感觉（下唇和舌头）和功能（饮酒、说话和微笑）的培训，并记录感觉/功能恢复正常的时间。使用独立样本t检验、单变量线性回归和皮尔逊卡方检验完成比较分析。43名参与者被随机分组，34人完成了研究（甲磺酸酚妥拉明，n=15；对照组，n=19）。两个治疗组在下唇（平均差异2小时17分钟；P=0.027）和舌头（平均差异1小时35分钟；P=0.046）恢复正常感觉方面有统计学显著差异，有利于甲磺酸酚妥拉明组。结果表明，甲磺酸酚妥拉明可加速使用布比卡因的IANB恢复正常感觉。

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