阿替卡因肾上腺素联合STA系统在妊娠期哺乳期牙髓炎患者中的无痛麻醉效果及药学服务模式实践

Painless Anesthesia Effect and Pharmaceutical Service Mode Practice of Articaine Adrenaline Combined with STA System in Pulpitis Patients during Pregnancy and Lactation

关键词:  妊娠期  哺乳期  牙髓炎  疼痛管理  阿替卡因肾上腺素  STA系统  药学服务  多学科协作

Key words:  Pregnancy  lactation  pulpitis  pain management  articaine with adrenaline  STA system  pharmaceutical care  multidisciplinary collaboration.

摘要:

目的 探讨阿替卡因肾上腺素注射液联合计算机控制局部麻醉系统(STA)在妊娠期哺乳期牙髓炎患者中应用的效果、安全性及药学服务的干预价值,为特殊人群口腔疼痛管理提供真实世界证据。方法 回顾性分析2025年绍兴市妇幼保健院口腔科收治的31例妊娠期哺乳期牙髓炎患者临床资料,所有患者均采用上述麻醉方案,且由药师牵头实施“多学科协作+全流程药学服务”模式,观察麻醉安全性、有效性及操作适配性,采用相应统计学方法分析数据。结果 31例患者中,妊娠期23例、哺乳期8例,牙髓炎轻/中/重度分别为5例、25例、1例,基线资料均衡。安全性方面,仅1例(3.2%,95%CI：0.1%-16.7%)出现轻微头晕,无严重不良反应,发生率显著低于传统麻醉方式；治疗前VAS评分(7.6±1.3)分,治疗后(1.0±0.6)分,差异具有统计学意义(Z=-5.82,P<0.001,Cohen"s d=2.1),治疗完成率100%(95%CI：89.7%-100%),患者满意度96.8%。STA给药剂量CV=6.3%,操作耗时(10.2±2.1)min,患者注射恐惧感低于传统麻醉,药师用药审核及术后随访率均为100%。结论 阿替卡因肾上腺素联合STA系统用于该人群无痛麻醉安全有效、操作可重复,可显著减少患者注射恐惧感及术后不良反应；全流程药学服务通过多学科协作实现用药精准管控与风险预警,具有临床推广价值。

Abstract:

OBJECTIVE To investigate the clinical efficacy, safety and intervention value of pharmaceutical care of Articaine Hydrochloride and Epinephrine Injection combined with the Single Tooth Anesthesia (STA) in the treatment of pregnant and lactating patients with pulpitis, so as to provide real-world evidence for oral pain management in special populations. METHODS A retrospective analysis was conducted on the clinical data of 31 pregnant and lactating patients with pulpitis admitted to the Department of Stomatology, Shaoxing Maternity and Child Health Care Hospital in 2025. All patients received the above-mentioned anesthesia regimen, and the mode of "multidisciplinary collaboration plus whole-process pharmaceutical care" was implemented under the leadership of clinical pharmacists. The safety, efficacy and operational adaptability of anesthesia were observed, and corresponding statistical methods were used for data analysis. RESULTS Among the 31 patients, 23 were in pregnancy and 8 in lactation; 5 cases had mild pulpitis, 25 moderate and 1 severe, with well-balanced baseline data. In terms of safety, only 1 case (3.2%, 95%CI: 0.1%-16.7%) had mild dizziness, no severe adverse reactions occurred, and the incidence was significantly lower than that of traditional anesthesia methods. The Visual Analogue Scale (VAS) score was (7.6±1.3) before treatment and (1.0±0.6) after treatment, with a statistically significant difference (Z=-5.82, P<0.001, Cohen's d=2.1). The treatment completion rate was 100% (95%CI: 89.7%-100%), and the patient satisfaction rate was 96.8%. The coefficient of variation (CV) of drug delivery dose via STA was 6.3%, the total operation time was (10.2±2.1) minutes, and patients' fear of injection was significantly lower than that in traditional anesthesia. The rates of pharmacist-conducted medication review and postoperative follow-up both reached 100%. CONCLUSION Articaine Hydrochloride and Epinephrine Injection combined with STA system is safe, effective and reproducible for painless anesthesia in pregnant and lactating patients with pulpitis, and it can significantly reduce patients' fear of injection and postoperative adverse reactions. Whole-process pharmaceutical care achieves precise medication control and risk early warning through multidisciplinary collaboration, which has important value for clinical promotion.