Ngeow Wei Cheong, Shim Chen Kiong, Chai Wen Lin
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.
J Can Dent Assoc. 2006 Dec;72(10):927-31.
Unintended intravascular injection from inferior alveolar nerve blocks can result in frustrating distant complications affecting such structures as the middle ear and eyes. Possible complications affecting the eyes include blurring of vision, diplopia, mydriasis, palpebral ptosis and amaurosis (temporary or permanent). In this article, we present a complication that has been reported only rarely. Two patients developed transient loss of power of accommodation of the eye resulting in blurred vision after routine inferior alveolar nerve blocks on the ipsilateral side. Clear vision returned within 10-15 minutes after completion of the blocks. The possible explanation for this phenomenon is accidental injection into the neurovascular bundle of local anesthetic agents, which were carried via the blood to the orbital region. This resulted in paralysis of a branch of cranial nerve III, the short ciliary nerves that innervate the ciliary muscle, which controls accommodation.
下牙槽神经阻滞意外血管内注射可导致令人沮丧的远处并发症，影响中耳和眼睛等结构。影响眼睛的可能并发症包括视力模糊、复视、瞳孔散大、睑下垂和黑矇（暂时或永久性）。在本文中，我们介绍一种很少被报道的并发症。两名患者在同侧进行常规下牙槽神经阻滞后出现暂时性眼调节能力丧失，导致视力模糊。阻滞完成后10 - 15分钟内视力恢复清晰。对此现象的可能解释是局部麻醉剂意外注入神经血管束，这些麻醉剂通过血液输送到眼眶区域。这导致了支配睫状肌的颅神经III的一个分支——短睫状神经麻痹，睫状肌控制着眼的调节功能。
