盐酸阿替卡因(Articaine Hydrochloride) - 药物靶点：SCNA_在研适应症：麻醉_专利_临床

概要

基本信息

药物类型

小分子化药

别名

Articaine、Articaine hydrochloride (JAN/USP)

+ [5]

靶点

SCNA

作用机制

SCNA阻滞剂(钠通道α亚基家族阻滞剂)、中枢神经系统调节剂

治疗领域

其他疾病

在研适应症

麻醉

非在研适应症-

原研机构-

在研机构

American Genomics, LLC

非在研机构-

最高研发阶段批准上市

首次获批日期-

最高研发阶段(中国)批准上市

特殊审评-

结构

分子式C13H21ClN2O3S

InChIKeyGDWDBGSWGNEMGJ-UHFFFAOYSA-N

CAS号23964-57-0

查看全部结构式(2)

关联

113

项与盐酸阿替卡因相关的临床试验

NCT06353815 / Not yet recruitingN/AIIT

Clinical Evaluation of Anaesthetic Efficacy of 4% Articaine Buccal Infiltration Versus Inferior Alveolar Nerve Block for Restorative Dental Treatment in Mandibular First Permanent Molars: A Randomized Clinical Tria

Clinical evaluation of anaesthetic efficacy of 4% articaine buccal infiltration versus inferior alveolar nerve block during restorative dental treatment in mandibular first permanent molars

开始日期2024-07-01

申办/合作机构

Cairo University

CTRI/2024/04/065122 / Not yet recruiting临床3期

Comparative Evaluation of Anesthetic Efficacy of two different Local Anesthetic Agents in Maxillary Posterior Teeth with Irreversible Pulpitis: A Prospective Randomized Double-Blind Study - Nil

开始日期2024-04-10

申办/合作机构-

CTRI/2024/04/065021 / Not yet recruiting临床2期

Comparative evaluation of efficacy of lignocaine (2%) and articaine (4%) at two different temperature on tooth with irreversible pulpitis-double blind randomised control trial - NIL

开始日期2024-04-08

申办/合作机构-

100 项与盐酸阿替卡因相关的临床结果

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100 项与盐酸阿替卡因相关的转化医学

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100 项与盐酸阿替卡因相关的专利（医药）

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718

项与盐酸阿替卡因相关的文献（医药）

2024-05-01·International Endodontic Journal

Effect of preemptive use of a nonsteroidal anti‐inflammatory drug and a corticosteroid on the efficacy of inferior alveolar nerve blockade and postoperative pain control in endodontic treatment of molars with symptomatic pulpitis: A randomized double‐blind placebo‐controlled clinical trial

Article

作者: Rodrigues, Guilherme Araujo ; Bronzato, Juliana Delatorre ; Hizatugu, Ruy ; Frozoni, Marcos ; de-Jesus-Soares, Adriana

AbstractAimThe anaesthetic success rate of an inferior alveolar nerve block (IANB) in mandibular molars with irreversible symptomatic pulpitis can be low, and postoperative pain control in teeth with this diagnosis can be challenging. This study aimed to evaluate the influence of preemptive use of dexamethasone and oral potassium diclofenac on the success of IANB. The influence of these drugs on the intensity of postoperative pain was assessed as a secondary outcome.MethodologyEighty‐four patients with mandibular molars diagnosed with irreversible symptomatic pulpitis recorded preoperative pain intensity using a cold thermal test and a modified Numerical Rating Scale (mNRS). Sixty minutes before the anaesthetic procedure, patients were randomly assigned to one of three groups based on the medication they received: dexamethasone (4 mg), diclofenac potassium (50 mg), or placebo. All patients received IANB with 4% articaine (1:200 000 epinephrine), and 15 min later, they were evaluated for pain intensity using the cold thermal test. Anaesthetic success was analysed. The pain intensity was then recorded, and endodontic treatment and provisional restoration of the tooth were executed in a single session. Patients were monitored for 6, 12, 24, 48 and 72 h using the mNRS to assess the intensity of postoperative pain.ResultsThere was a statistically significant increase in anaesthetic success when 4 mg dexamethasone (39.3%) or 50 mg diclofenac potassium (21.4%) was used compared to the placebo group (3.6%) (p < .001), with no significant difference between the two drugs. Regarding postoperative pain, dexamethasone was superior to placebo at 6 h (p < .001), with diclofenac having an intermediate behaviour, not differing between dexamethasone and placebo (p > .05). There was no significant difference amongst the groups at 12 h (p > .05). At 24, 48 and 72 h, the effectiveness of dexamethasone and diclofenac were comparable, and both were superior to placebo (p < .001).ConclusionThe use of dexamethasone or diclofenac potassium was favourable in terms of increasing the success rate of inferior alveolar nerve block in cases of mandibular molars with irreversible symptomatic pulpitis and decreased the occurrence of postoperative pain when compared to the use of a placebo.

2024-04-01·Journal of Endodontics

Efficacy of the TuttleNumbNow Intraosseous Method for Pulpal Anesthesia in the Mandibular First Molar: A Prospective, Randomized, Crossover Study

Article

作者: Fowler, Sara ; Dolphin, Tyler ; Drum, Melissa ; Draper, John ; Reader, Al ; Nusstein, John

INTRODUCTIONPrevious studies on intraosseous (IO) anesthesia as a primary injection have shown high success rates. The TuttleNumbNow (TNN; Orem, UT) is a new primary IO injection technique that has not been scientifically evaluated. Therefore, the purpose of this prospective randomized, crossover study was to evaluate the anesthetic efficacy of the TNN IO technique using the Septoject Evolution needle (Septodont, Saint-Maur-des-Fosses, France) compared with buccal infiltration for pulpal anesthesia in mandibular first molars.METHODSOne hundred four healthy subjects were randomly assigned to 2 treatment groups separated by at least 2 weeks. One set of injections consisted of buccal infiltration of the mandibular first molar using 1.8 mL 4% articaine with 1:100,000 epinephrine followed by a mock TNN injection distal to the mandibular first molar. The other set of injections was a mock buccal infiltration of the mandibular first molar followed by a TNN injection of 1.8 mL 4% articaine with 1:100,000 epinephrine distal to the mandibular first molar. Statistical analyses were performed.RESULTSFor the mandibular first molar, which had a 42% anesthetic success rate (highest 80 reading) with buccal infiltration compared with 49% with the TNN, no statistically significant difference in success was observed (P = .2115).CONCLUSIONSThe TNN technique has been advocated as an IO injection. However, the inability to deliver anesthetic solution to the cancellous bone resulted in an anesthetic success rate of 49%. The success was statistically similar to a buccal infiltration (42%) and would not provide adequate pulpal anesthesia as a primary injection.

2024-03-14·International Journal of Clinical Pediatric Dentistry

A Comparative Evaluation of Pain Experience and Time of Onset of 2% Lignocaine and 4% Articaine in Inferior Alveolar Nerve Block among Pediatric Population: A Clinical Study

Article

作者: Singh, Shivani S ; Koul, Monika

AimThe objective of this research was to conduct a comparison and evaluate the pain perception and time of onset of 2% lignocaine 1:80,000 epinephrine with 4% articaine 1:100,000 epinephrine in the pediatric population.Materials and methodsA split-mouth randomized control trial was conducted on 50 children aged 9-14 years who required inferior alveolar nerve block (IANB) anesthesia for bilateral dental treatment in the mandibular arch. The time of onset was recorded when no sensation was reported even when maximum electrical stimulus was applied in an electric pulp testing (EPT). The pain perception was assessed using a visual analog scale (VAS) rated by the patient for subjective symptoms and face, legs, activity, cry, and consolability (FLACC) scale for objective pain rated by the operator.ResultsThe mean onset of time, pain-VAS, and FLACC score decreased by 1.31, 12.07, and 18.39%, respectively in 4% articaine as compared to 2% lignocaine but the difference did not reach statistical significance (p > 0.05), that is, found to be statistically the same.In conclusion, it can be inferred that the utilization of 4% articaine is as potent as 2% lignocaine solution but showed slightly better onset of anesthesia and pain experience among the children although the findings were not statistically significant.Clinical significanceLocal anesthesia (LA) is one of the main methods of pain management in pediatric practice which makes it essential to choose an LA agent with a shorter time of onset and less pain on administration.How to cite this articleSingh SS, Koul M. A Comparative Evaluation of Pain Experience and Time of Onset of 2% Lignocaine and 4% Articaine in Inferior Alveolar Nerve Block among Pediatric Population: A Clinical Study. Int J Clin Pediatr Dent 2024;17(1):67-71.

1

项与盐酸阿替卡因相关的新闻（医药）

2022-06-29

·丁香园

注意！开医嘱不向医保病人确认这点，会有法律风险

本文作者：Acca最近，深圳市人大常委会表决通过了《深圳经济特区医疗条例》修订稿（下称深圳《条例》）。在药物使用这一块，一处规定引发热议。深圳《条例》规定，针对「采用药品说明书未明确的用法使用药品的；开具本医疗机构用药目录外药品或者为医疗保险患者开具自费药品的」这两种情况，应当取得患方明确同意。其实，针对「自费药需要取得患者同意」这个点，临床医生并不陌生。既然如此，为何深圳将「自费药应取得医保患者明确同意」纳入新政？这一流程到底意味着什么？医生怎么做，才算「做到了明确同意」？并不新的新政2021 年 2 月 29 日，《医疗保障基金使用监督管理条例》明确提到「除急诊、抢救等特殊情形外，提供医疗保障基金支付范畴以外的医药服务，应当经参保人员或者其他亲属、监护人同意」。他山之石，前车之鉴。早在全国性医保条例出台之前，上海、广西等地均出台相关办法，要求使用自费药品时，经治医生应当书面告知参保人员并经参保人员或近亲属签字同意后方可使用。图源：《关于进一步加强医疗机构临床药事管理规范自费药品采购和使用管理的通知》[2]图源：《广西基本医疗保险定点医疗机构管理暂行办法》[3]「事实上，临床一直这么做的，开具自费药前要求向医保患者征求同意。」浙江某三甲医院精神科医生王元水（化名）提到，「自打有医保起，都会有这样一项流程。」北京某三甲感染科医生李木（化名）提到，对住院患者会采取纸质告知的形式，「我们在常规谈话中会告知自费项目。因为自费药品比较贵，住院又采取预交的模式，如果没有提前告知，对病人来讲不公平，这好像医生剥夺了患者的『知情权』。」不过，李木也提及，「在门诊中，我们会主要采取口头同意的形式。」门诊环境里，不同医院会有不同的做法。除了口头的知情同意，有的医院会要求医生采取书面知情同意的形式。广东某三甲医院妇科医生赵天（化名）提到，他会在病历本上写明因何种原因使用自费药物，并要求患者签字表示知情理解。自费药知情，不仅是「告知」先说为什么要用自费药。自费药，指代基本医疗保险药品目录之外的药物。针对医保患者，医生会优先在医保范围内考虑药物，以此在保证诊疗效果的前提下，减轻患者的经济负担。使用自费药的考虑之一是药物的「可替代性」。由于医保定位在保障参保人的基本医疗需求，自费药大都属于重大疾病药品、创新药、进口药，以满足临床治疗的不同需求。以麻醉药为例，研究《 2016 - 2017 年口腔专科医院自费药品应用分析》指出，「由于国产阿替卡因/肾上腺素注射液配套使用的注射针头不能很好满足儿童患者的局部麻醉要求，我院儿童口腔科只好退而求其次选择自费药品进口的甲哌卡因/肾上腺素注射液来进行儿童口腔手术局部麻醉。」图源：参考资料[4]另一个原因是新药进入医保周期较长。根据 2021 年《医保药品管理改革进展与成效》蓝皮书，新药进入医保的时间从五年缩短到不到两年的时间。相对于患者治疗疗程，时间依然漫长。「一些先进的药物从获批上市到被纳入医保，需要很长的时间。但这个时间区间，对患者来说是滞后的，毕竟病情不会等。所以说，如果患者希望使用这些药物，只能自费。」曾在浙江某三甲医院肿瘤科任职的曹昀（化名）介绍道。也因此，确认自费药有利于治疗，并做好知情同意，医生要做的远不仅是「告知」。为什么这么说？王元水医生告诉丁香园，「征求患者同意，是一个考验医生水平的事情。」当医生开具自费药时，已经为患者打了一道算盘。医生不仅需要向患者介绍自费药的诊治效果，也需要介绍医保政策，帮助患者了解「为什么可用医保的情况下，仍需要使用自费药」。「医生没必要让患者一定用自费药，治疗与选择的权力是属于病人的。尽管自费药的初衷是为病人考虑，但需要讲究策略。如果把知情同意做得像推卸责任，这样对医患关系反而有所影响。」王元水医生总结道。这里的讲究策略，意思是医生在沟通中关注这些方面：经济能力、专业理解、医患信任。「征求自费药同意，一是看医生是否有足够能力做出有利于患者的方案；二是看医生是否全面考虑到患者的经济、态度、对疾病的理解等；三是医生与患者之间的互相信任。一个足够专业、并为患者着想的医生，其接诊的患者才更可能同意医保外的用药。」王元水解释了她的看法。赵天告诉丁香园，一些预后不好的晚期肿瘤患者可能会在被告知后拒绝自费药的使用，「因为他们面临的问题不仅是疾病本身、药物费用，还有背后的家庭及生活上的压力。所以，我们往往会在充分告知的情况下，尊重患者的意愿，给予适当的心理安慰。」对医保的差异理解，也容易造成患者的误识。「有医保却仍需自费」始终是医生要跟患者沟通的重要内容。赵天表示，在三线城市工作的同事，常常有更大的沟通压力，甚至会遇到一些患者，偏执地认为无法报销是不合理的。当患者接受自费使用药物后，也会面临其他问题：患者对治疗疗效存在过度预期。曹昀将这种矛盾解读为「信息不对称」，「对肿瘤科来说，没有能够达到 100% 药效的药物。但这件事容易被患者理解为药物无效。不是每位患者都能接受『治疗不绝对有好结果』的事实。许多病人会把预期效果跟药物费用挂钩。」基于此，曹昀认为，相关规范出台的最大好处是「便于解决纠纷」，不会影响医生制定治疗方案。以往当医疗纠纷需要举证时，医生容易面临口说无凭的尴尬处境，只能靠一纸同意保护自己，「这听起来挺讽刺的。」如何做到「明确同意」？再来看「明确同意」：什么是同意，什么是明确同意？2020 年 5 月 28 日通过的《中华人民共和国民法典》就医生告知义务给以说明。由原来的「书面同意」修改为「明确同意」。这一转变表现出医学告知的更高要求。一方面，医生可以采取更多样形式来履行告知义务，比如可以采取录音录像形式，表明自己告知到位；另一方面，医生也应让患者对治疗内容充分了解。但是，从执行层面上考虑，书面形式仍是最可行的手段。「明确同意还是建议采取书面形式，要求患者在纸质材料上签字」，北京京师（上海）律师事务所的毛云峰律师认为。「深圳《条例》是一个地方性的法规，是对全国性医疗法律法规的细化和补充。就全国性法规来说，根据《医疗纠纷预防和处理条例》第 13 条，对患者行特殊治疗需取得患者书面同意。个人理解深圳《条例》将使用自费药这一情形单独立法予以规定，其立法本意是要将该情形归入上述『特殊治疗』一类，需医生书面告知。」那么在明确同意中，应该告知患者何种信息？毛云峰律师提到，应当将使用自费药的理由，有无其他备选药物告知患者，如有便宜但疗效有差异的药物也应供其选择。「缺少告知的环节，将导致患者对诊疗方案产生怀疑，对医务人员不信任，甚至诱发一定的法律风险。」具体到医保患者使用自费药这一场景里，《医疗保障基金使用监督管理条例》明确指出，如果未经参保人员或者其近亲属、监护人同意开具自费药，将会面临约谈、罚款的处理。图源：《医疗保障基金使用监督管理条例》[1]对在医保开具自费药如何履行告知义务，毛云峰律师也给出建议。「建议在纸质模板中，将诊疗方案、不使用医保范围内药物而用自费药的理由、可能的药物不良反应等写清楚，并通过沟通，让患者在表示知悉的情况下，对纸质文件进行签署。关于自费药的价格、用药或治疗的备选方案，也应给予全面告知。」医院虽然是治病救人的地方，但由于医患关系的复杂性，用药建议仅由医生包办并不能规避法律风险。「作为医生，一定要知道，患者有知情权，有选择权。患者要为自己的健康负责，而不是医生。」策划：Acca, carollero监制：gyouza题图来源：视觉中国参考资料：[1] http://www.gov.cn/zhengce/2021-02/24/content_5588618.htm[2] http://wsjkw.sh.gov.cn/yzgl4/20190128/0012-63135.html[3] https://www.guilin.gov.cn/ggfw/mslyggbmfw/shbx/ylbx_63447/zcfgjjd_63678/202005/t20200508_1769001.shtml[4]李佳, 王建莉, 赵科, & 赵少峰. (2018). 2016-2017年口腔专科医院自费药品应用分析. 中国医院用药评价与分析, 018(011), 1539-1542.[5]中国药学会 & 中国医疗保险研究会. (2021),《中国医保药品管理改革进展与成效蓝皮书》丁香园招聘岗位名称：新媒体运营（丁香园）独立完成原创内容策划协助运营丁香园公众号微博工作地点：杭州点此直接投递简历也可将简历投至邮箱hujiafeng@dxy.cn邮件标题：投递岗位名称-姓名

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100 项与盐酸阿替卡因相关的药物交易

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KEGG	Wiki	ATC	Drug Bank
D02991	盐酸阿替卡因	N01BB08	DB09009

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麻醉	临床3期	美国	American Genomics, LLC	2020-09-03

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


Pubmed \| Br J Ophthalmol	N/A	白内障	65	4% articaine	壓壓願簾糧艱鑰齋憲顧(鹽衊鹽鹹構鏇鏇鹽觸膚) = Patients and surgeons rated the analgesic effect as comparable in either group 製構糧蓋衊壓觸製網鹽 (夢糧糧簾夢鑰衊鏇糧願 ) 更多	积极	2008-04-01
				2% lidocaine and 0.5% levobupivacaine mixture
Pubmed \| J Endod	N/A	牙髓炎	82	1.8 mL articaine	積壓蓋獵鹹糧壓糧願襯(鑰膚壓壓鹽壓膚遞簾選) = 艱襯餘範壓廠鹽觸鹽憲鹹膚衊壓選簾齋構廠齋 (觸襯選蓋憲鬱夢獵鬱構 )	-	2015-09-01
				3.6 mL articaine	積壓蓋獵鹹糧壓糧願襯(鑰膚壓壓鹽壓膚遞簾選) = 選餘構構醖蓋夢鏇簾獵鹹膚衊壓選簾齋構廠齋 (觸襯選蓋憲鬱夢獵鬱構 )
Pubmed \| Clin Oral Investig	N/A	-	180	2% Articaine	遞艱繭鏇壓簾淵淵艱艱(簾廠遞網鬱醖鏇構鑰糧) = 衊廠獵構顧遞遞窪齋醖積構製齋網餘衊襯廠簾 (鏇構蓋膚襯製衊鬱遞鹽 )	-	2019-09-01
				2% Lignocaine	遞艱繭鏇壓簾淵淵艱艱(簾廠遞網鬱醖鏇構鑰糧) = 齋鑰觸鹹鹹鹽鬱蓋廠窪積構製齋網餘衊襯廠簾 (鏇構蓋膚襯製衊鬱遞鹽 )
NCT01496846 (Pubmed \| J Endod)	临床4期	牙髓炎	100	4% articaine	選齋醖鏇壓構糧範觸鏇(艱壓壓鬱願餘願鑰製鹽) = 憲鬱廠築獵糧廠襯選網範淵簾積顧築膚遞憲鬱 (壓選艱艱積壓蓋鬱獵醖 ) 更多	-	2014-06-01
				2% lidocaine	觸構鹽簾鹽簾憲鹹糧鏇(簾餘餘襯窪衊醖窪壓襯) = 選糧獵鏇願艱衊壓鏇鹽餘選簾觸蓋襯醖簾簾壓 (餘艱願衊繭衊鏇衊範積 )
Pubmed	N/A	神经溶解块	30	4% articaine	積網艱積醖遞襯鹹艱願(淵願衊築壓積顧鬱膚遞) = 餘鑰鑰艱夢壓窪壓艱繭鹹窪願鬱範鑰壓鏇衊構 (簾廠遞醖鑰獵簾鹽簾鬱 )	-	2007-03-01
				2% lidocaine	積網艱積醖遞襯鹹艱願(淵願衊築壓積顧鬱膚遞) = 艱醖窪鹹顧鏇壓製鏇壓鹹窪願鬱範鑰壓鏇衊構 (簾廠遞醖鑰獵簾鹽簾鬱 )
Pubmed	N/A	-	-	Articaine	糧醖壓積糧簾餘鹹鏇淵(膚艱鏇襯鹽廠膚餘獵衊) = The local tolerance of articaine HCl was good to very good 淵淵選衊構鏇衊憲膚鑰 (鹹獵簾鑰鑰襯獵獵顧鑰 )	-	2011-12-28
				Septanest SP
NCT01496846 (Pubmed \| J Endod)	临床4期	牙髓炎	201	4% articaine	壓夢簾繭蓋糧齋鹽積廠(選窪膚鏇選壓簾積憲築) = 淵蓋夢醖簾網廠鹽繭網衊構顧糧壓製鹹醖遞鹹 (鑰積積遞積鹽築網壓蓋 )	-	2018-04-01
Phase 3 (ARVO2022)	临床3期	-	120	AG-920	(鏇糧壓鹹壓範襯襯顧積) = 9% vs 10% 醖鹹壓糧襯襯夢糧夢鏇 (壓鑰鏇遞壓鏇醖鹽衊製 ) 更多	积极	2022-05-01
				Placebo
NCT04189198 (Pubmed)	临床1期	-	117	Articaine 2%	繭憲網糧築願網觸窪蓋(繭夢憲醖製餘窪鹹鏇憲) = 遞鏇淵餘網網糧製構壓願遞窪範簾壓齋餘鬱選 (蓋製夢淵遞醖齋廠鹽築 ) 更多	-	2020-01-01
				Bupivacaine 0.5%	繭憲網糧築願網觸窪蓋(繭夢憲醖製餘窪鹹鏇憲) = 糧窪遞遞膚膚壓觸築廠願遞窪範簾壓齋餘鬱選 (蓋製夢淵遞醖齋廠鹽築 )
NCT01912755 (not provided, Pubmed \| Int Endod J)	临床4期	牙髓炎	50	4% articaine buccal infiltration	(繭繭廠繭夢壓蓋構鬱齋) = 鑰醖窪憲範齋餘窪窪膚衊鹽繭壓簾鹽艱顧鏇鬱 (憲觸獵艱壓鏇鑰醖廠鹹 )	-	2015-02-01
				2% lidocaine inferior alveolar nerve block	(繭繭廠繭夢壓蓋構鬱齋) = 鑰廠夢憲範蓋壓夢襯獵衊鹽繭壓簾鹽艱顧鏇鬱 (憲觸獵艱壓鏇鑰醖廠鹹 )