全身麻酔と局所麻酔がインパクトのある第三大臼歯手術後の術後疼痛に及ぼす影響

Influence of General and Local Anesthesia on Postoperative Pain after Impacted Third Molar Surgery.

抄録

この研究では，第三大臼歯抜歯後の術後疼痛レベルに対する全身麻酔の影響を局所麻酔と比較して検討した．このレトロスペクティブ研究では，全身麻酔または局所麻酔で4回の第三大臼歯の同時抜歯を行い，術後の痛みのレベル（visual analog scale，VAS）の記録がある患者を対象とした．痛みのレベルは、初期（術後日；POD＜＃3）と後期（POD＃3-7）に分けて判定した。手術時間と最近修正された難易度指数を分析して、抜歯の均質な状態を検証した。227名の男性入院患者（年齢20.9±1.3歳）のうち，172名と55名が，それぞれ局所麻酔と全身麻酔で第三大臼歯の抜歯を行った．年齢と難易度指数は等しく分布していたが，手術時間は全身麻酔のほうが局所麻酔よりも長かった（< 0.001）。痛みについては、初期と後期で同様の結果が得られた。手術時間は全期間と相関し，その相関係数は0.271であった（< 0.001）。以上の結果から，第三大臼歯抜歯後の痛みは，麻酔方法よりも手術時間に関連していた。

This study examined the effects of general anesthesia on the postoperative pain level after third molar extractions compared to local anesthesia. This retrospective study included patients who underwent four simultaneous third molar extractions under general or local anesthesia and had records of their postoperative pain levels (visual analog scale, VAS). The pain level was determined in the early (Postoperative day; POD < #3) and late (POD #3-7) periods. The operation time and recently modified difficulty index were analyzed to validate the homogenous condition of the extraction. Of the 227 male inpatients (aged 20.9 ± 1.3 years), 172 and 55 patients underwent third molar extractions under local and general anesthesia, respectively. The age and difficulty index were distributed equally, but the operation time was longer in general anesthesia than in local anesthesia ( < 0.001). The early and late periods featured similar pain outcomes. The operation time correlated with the total periods with a correlation coefficient of 0.271 ( < 0.001). In conclusion, the postoperative pain following whole third molar extraction was related to the operation time rather than the anesthetic methods.