Effect of transcutaneous acupoint electrical stimulation on inferior alveolar nerve block in patients with irreversible pulpitis

doi:10.3877/cma.j.issn.1674-1366.2021.02.004

Abstract

Abstract:

Objective

To evaluate the effect of percutaneous acupoint electrical stimulation (TEAS) on the success rate of alveolar nerve block (IANB) , pain and anxiety in the treatment of irreversible pulpitis of mandibular molars.

Methods

A total of 48 patients from the Department of Stomatology, Xuzhou Central Hospital from October 2020 to January 2021 who had irreversible pulpitis were randomly divided into experimental group (24 cases) and control group (24 cases) at ratio of 1∶1 using STATA 12.0. The information of group and treatment method was put into an opaque envelope numbered 1 to 48, and the patients meeting the inclusion criteria were recruited. Before their TEAS treatment, the information keeper handed them over to the acupuncturist and implemented the grouping scheme in the envelope. The experimental group was given bilateral Hegu and Laogong acupoints stimulated by TEAS, and the intensity was the maximum that the patients could tolerate. The stimulus intensity in the control group was 0 mA. Heft-Parker Visual Analog Scale (HP-VAS) values were recorded before TEAS stimulation (T0) , after stimulation (T1) and during myelectomy (T2) to calculate pain scores. Visual Anxiety Scale (VAS-A) was used to record anxiety scores and IANB success rate of patients at T0 and T1. Chi-square test was used for the success rate of patients and two independent sample t test was applied for the remaining data.

Results

The success rate of IANB in the experimental group (79.2%) was significantly higher than that in the control group (33.3%) , the difference was statistically significant (χ² = 10.243, P = 0.001) . The T1 pain score of the experimental group [ (66.2 ± 5.2) mm] was lower than that of the control group (88.0 ± 6.0) mm, and the difference was statistically significant (t = 2.745, P = 0.009) . Compared with the control group T2[ (65.4 ± 5.6) mm], the T2 pain score of the experimental group (43.7 ± 5.4) mm was also lower, the difference was statistically significant (t=2.786, P=0.008) .Compared with the control group, T0 pain score (92.1 ± 6.8) mm, T1 and T2 pain score of the control group decreased, the difference was statistically significant (t_T1 = 3.951, P_T1 = 0.000; t_T2 = 3.035, P_T2 = 0.004) . There was no significant difference in pain scores between T1 (88.0 ± 6.0) mm and T0 (92.1 ± 6.8) mm in the control group (t = 0.446, P = 0.685) . At T1, the anxiety score of the control group (3.0 ± 0.2) was higher than that of the experimental group (1.1±0.2) , and the difference was statistically significant (t = 6.379, P<0.001) . Anxiety scores in the experimental group were significantly decreased after TEAS treatment [T0 (2.1 ± 0.4) cm, T1 (1.1 ± 0.2) cm] (t = 2.288, P = 0.027) .

Conclusion

The application of TEAS before pulpitis can relieve pain, improve anxiety and improve the success rate of IANB in patients with irreversible pulpitis of mandibular molars.

Key words: Pulpitis, Mandibular nerve, Nerve block, Transcutaneous electrical acupoint stimulation

Haoran Wang, Junjie Guan, Ying Wang, Na Li, Jingqiu Wang, Liangyu Ge, Jian Meng. Effect of transcutaneous acupoint electrical stimulation on inferior alveolar nerve block in patients with irreversible pulpitis[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2021, 15(02): 85-91.

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References 26

[1]	Mousavi SA, Sadaghiani L, Shahnaseri S，et al. Effect of magnesium sulphate added to lidocaine on inferior alveolar nerve block success in patients with symptoms of irreversible pulpitis：a prospective，randomized clinical trial[J]. Int Endod J，2020，53（2）：145-153. DOI：10.1111/iej.13186.
[2]	Parirokh M, Sadr S, Nakhaee N，et al. Efficacy of supplementary buccal infiltrations and intraligamentary injections to inferior alveolar nerve blocks in mandibular first molars with asymptomatic irreversible pulpitis：a randomized controlled trial[J]. Int Endod J，2014，47（10）：926-933. DOI：10.1111/iej.12236.
[3]	Shadmehr E, Aminozarbian MG, Akhavan A，et al. Anaesthetic efficacy of lidocaine/clonidine for inferior alveolar nerve block in patients with irreversible pulpitis[J]. Int Endod J，2017，50（6）：531-539. DOI：10.1111/iej.12659.
[4]	Aggarwal V, Singla M, Miglani S. Comparative Evaluation of Anesthetic Efficacy of 2% Lidocaine，4% Articaine，and 0.5% Bupivacaine on Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis：A Prospective，Randomized，Double-blind Clinical Trial[J]. J Oral Facial Pain Headache，2017，31（2）：124-128. DOI：10.11607/ofph.1642.
[5]	Fowler S, Drum M, Reader A，et al. Anesthetic Success of an Inferior Alveolar Nerve Block and Supplemental Articaine Buccal Infiltration for Molars and Premolars in Patients with Symptomatic Irreversible Pulpitis[J]. J Endod，2016，42（3）：390-392. DOI：10.1016/j.joen.2015.12.025.
[6]	Nusstein JM. Preoperative oral use of Ibuprofen or dexamethasone may improve the anesthetic efficacy of an inferior alveolar nerve block in patients diagnosed with irreversible pulpitis[J]. J Evid Based Dent Pract，2013，13（3）：102-103. DOI：10.1016/j.jebdp.2013.07.007.
[7]	Shahi S, Mokhtari H, Rahimi S，et al. Effect of premedication with ibuprofen and dexamethasone on success rate of inferior alveolar nerve block for teeth with asymptomatic irreversible pulpitis：a randomized clinical trial[J]. J Endod，2013，39（2）：160-162. DOI：10.1016/j.joen.2012.10.011.
[8]	Brignardello-Petersen R. Cryotherapy may increase the success rate of inferior alveolar nerve block in patients with symptomatic irreversible pulpitis who undergo endodontic treatment[J]. J Am Dent Assoc，2019，150（12）：e221. DOI：10.1016/j.adaj.2019.07.009.
[9]	Oleson M, Drum M, Reader A，et al. Effect of preoperative ibuprofen on the success of the inferior alveolar nerve block in patients with irreversible pulpitis[J]. J Endod，2010，36（3）：379-382. DOI：10.1016/j.joen.2009.12.030.
[10]	金文渊，刘育辰，张安英，等.抗类风湿关节炎天然产物研究进展[J].中成药，2020，42（7）：1851-1857. DOI：10.3969/j.issn.1001-1528.2020.07.034.
[11]	Hsiao HB, Wu JB, Lin WC. Anti-arthritic and anti-inflammatory effects of（-）-Epicatechin-3-O-β-d-allopyranoside，a constituent of Davallia formosana[J]. Phytomedicine，2019，52：12-22. DOI：10.1016/j.phymed.2018.09.192.
[12]	韩济生.针麻镇痛研究[J].针刺研究，2016，41（5）：377-387. DOI：10.13702/j.1000-0607.2016.05.001.
[13]	Brignardello-Petersen R. Acupuncture seems to result in a higher reduction in pain compared with a single 400 milligram dose of ibuprofen in patients with irreversible pulpitis[J]. J Am Dent Assoc，2018，149（7）：e108. DOI：10.1016/j.adaj.2018.01.042.
[14]	Jalali S, Moradi Majd N, Torabi S，et al. The Effect of Acupuncture on the Success of Inferior Alveolar Nerve Block for Teeth with Symptomatic Irreversible Pulpitis：A Triple-blind Randomized Clinical Trial[J]. J Endod，2015，41（9）：1397-1402. DOI：10.1016/j.joen.2015.04.026.
[15]	周鹏，宋雨桐，张阔，等.经皮穴位电刺激对大脑神经功能活动影响研究进展[J].航天医学与医学工程，2019，32（5）：463-470. DOI：10.16289/j.cnki.1002-0837.2019.05.013.
[16]	王海燕，王慧，韩冲芳，等.肩胛上神经阻滞联合经皮穴位电刺激治疗粘连性肩关节囊炎的疗效观察[J].中国疼痛医学杂志，2020，26（10）：778-781. DOI：10.3969/j.issn.1006-9852.2020.10.011.
[17]	Johnson M, Martinson M. Efficacy of electrical nerve stimulation for chronic musculoskeletal pain：a meta-analysis of randomized controlled trials[J]. Pain，2007，130（1-2）：157-165. DOI：10.1016/j.pain.2007.02.007.
[18]	Bjordal JM, Johnson MI, Ljunggreen AE. Transcutaneous electrical nerve stimulation（TENS）can reduce postoperative analgesic consumption. A meta-analysis with assessment of optimal treatment parameters for postoperative pain[J]. Eur J Pain，2003，7（2）：181-188. DOI：10.1016/S1090-3801(02)00098-8.
[19]	晁敏，梁丰，王尊，等.经皮穴位电刺激在慢性病中的临床应用研究进展[J].中国康复医学杂志，2016，31（6）：710-714. DOI：10.3969/j.issn.1001-1242.2016.06.023.
[20]	Stamenkovic DM, Rancic NK, Latas MB，et al. Preoperative anxiety and implications on postoperative recovery：what can we do to change our history[J]. Minerva Anestesiol，2018，84（11）：1307-1317. DOI：10.23736/S0375-9393.18.12520-X.
[21]	李永强，张明秀，张艳芬，等.术前口服用药对不可逆性牙髓炎患者下牙槽神经阻滞影响的研究[J].实用口腔医学杂志，2019，35（3）：464-467. DOI：10.3969/j.issn.1001-3733.2019.03.034.
[22]	陶然，蒋勇.电压门控钠离子通道Nav1.8在人牙髓组织中表达的初步研究[J].中华口腔医学杂志，2012，47（3）：177-181. DOI：10.3760/cma.j.issn.1002-0098.2012.03.012.
[23]	Coward K, Plumpton C, Facer P，et al. Immunolocalization of SNS/PN3 and NaN/SNS2 sodium channels in human pain states[J]. Pain，2000，85（1-2）：41-50. DOI：10.1016/s0304-3959(99)00251-1.
[24]	Wang MC, Vinall-Collier K, Csikar J，et al. A qualitative study of patients′ views of techniques to reduce dental anxiety[J]. J Dent，2017，66：45-51. DOI：10.1016/j.jdent.2017.08.012.
[25]	Wiles MD, Mamdani J, Pullman M，et al. A randomised controlled trial examining the effect of acupuncture at the EX-HN3（Yintang）point on pre-operative anxiety levels in neurosurgical patients[J]. Anaesthesia，2017，72（3）：335-342. DOI：10.1111/anae.13785.
[26]	Melzack R, Wall PD. Pain mechanisms：a new theory[J]. Science，1965，150（3699）：971-979. DOI：10.1126/science.150.3699.971.

项目		对照组	实验组	检验值	P值
性别[例（%）]				χ² = 0.333	0.564
	女	11（45.8）	13（54.2）
	男	13（54.2）	11（45.8）
年龄（岁，±s）		44.9 ± 15.7	42.2 ± 17.5	t = 0.563	0.159
体质量指数（kg/m²，±s）		24.4 ± 3.3	24.2 ± 3.3	t = 0.21	0.835
术前疼痛（mm，±s）		92.1 ± 33.1	98.8 ± 31.5	t = -0.99	0.322
术前焦虑（mm，±s）		1.6 ± 1.7	2.1 ± 1.9	t = -1.011	0.317
MDAS分级[例（%）]				χ² = 1.804	0.071
	Ⅰ级	17（70.8）	11（45.8）
	Ⅱ级	6（25.0）	10（41.7）
	Ⅲ级	1（4.2）	2（8.3）
	Ⅳ级	0（0.0）	1（4.2）

项目		对照组	实验组	检验值	P值
性别[例（%）]				χ² = 0.333	0.564
	女	11（45.8）	13（54.2）
	男	13（54.2）	11（45.8）
年龄（岁，±s）		44.9 ± 15.7	42.2 ± 17.5	t = 0.563	0.159
体质量指数（kg/m²，±s）		24.4 ± 3.3	24.2 ± 3.3	t = 0.21	0.835
术前疼痛（mm，±s）		92.1 ± 33.1	98.8 ± 31.5	t = -0.99	0.322
术前焦虑（mm，±s）		1.6 ± 1.7	2.1 ± 1.9	t = -1.011	0.317
MDAS分级[例（%）]				χ² = 1.804	0.071
	Ⅰ级	17（70.8）	11（45.8）
	Ⅱ级	6（25.0）	10（41.7）
	Ⅲ级	1（4.2）	2（8.3）
	Ⅳ级	0（0.0）	1（4.2）

组别	T0	T1	t值	P值
对照组	1.6 ± 0.4	3.0 ± 0. 2	3.436	0.001
实验组	2.1 ± 0.4	1.1 ± 0.2	2.288	0.027
t值	1.011	6.379
P值	0.317	<0.001

组别	T0	T1	t值	P值
对照组	1.6 ± 0.4	3.0 ± 0. 2	3.436	0.001
实验组	2.1 ± 0.4	1.1 ± 0.2	2.288	0.027
t值	1.011	6.379
P值	0.317	<0.001

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