Okamoto Y, Takasugi Y, Moriya K, Furuya H
Department of Anesthesiology, Nippon Dental University, School of Dentistry at Tokyo, 2-3-16 Fujimi, Chiyoda-ku, Tokyo 102-8158, Japan.
Anesth Prog. 2000 Winter;47(4):130-3.
We studied the spread of local anesthetic solution in the inferior alveolar nerve block by the injection of local anesthetic solution into the pterygomandibular space anterior to the mandibular foramen (anterior technique). Seventeen volunteers were injected with 1.8 mL of a mixture containing lidocaine and contrast medium utilizing the anterior technique. The course of spread was traced by fluoroscopy in the sagittal plane, and the distribution area was evaluated by lateral cephalograms and horizontal computed tomography. The results indicate that the contrast medium mixture spreads rapidly in the pterygomandibular space to the inferior alveolar nerve in the subjects who exhibited inferior alveolar nerve block effect. We concluded that the anesthetic effect due to the anterior technique was produced by the rapid distribution of anesthetic solution in the pterygomandibular space toward the mandibular foramen, and individual differences in the time of onset of analgesia may be due to differences in the histologic perineural tissues.
我们通过在下颌孔前方的翼下颌间隙注射局部麻醉溶液（前入路技术），研究了下牙槽神经阻滞中局部麻醉溶液的扩散情况。17名志愿者采用前入路技术注射了1.8 mL含利多卡因和造影剂的混合溶液。通过矢状面荧光透视追踪扩散过程，并通过侧位头影测量片和水平计算机断层扫描评估分布区域。结果表明，在表现出下牙槽神经阻滞效果的受试者中，造影剂混合溶液在翼下颌间隙迅速扩散至下牙槽神经。我们得出结论，前入路技术产生的麻醉效果是由于麻醉溶液在翼下颌间隙中迅速向下颌孔分布，而镇痛起效时间的个体差异可能归因于神经周围组织学的差异。
