Padhye Mukul, Gupta Savina, Chandiramani Girish, Bali Rati
Department of Oral and Maxillofacial Surgery, Padmashree Dr. D Y Patil Dental College and Hospital, Navi Mumbai, India.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Dec;112(6):e39-43. doi: 10.1016/j.tripleo.2011.04.046. Epub 2011 Sep 16.
Routine use of posterior superior alveolar (PSA) nerve block or maxillary infiltration for the removal of maxillary molars has been validated.
The present study was undertaken to determine the relative contribution of posterior superior alveolar (PSA) block in cases of anesthesia required for maxillary molars.
One hundred patients requiring removal of maxillary second and third molars were enrolled. These patients were divided into 2 groups. One group received infiltration for anesthesia and other group received PSA nerve block using lignocaine with vasoconstrictor. All extractions were performed using a consistent technique of intraalveolar extraction. Data relating to the pain during extraction obtained on a visual analog scale and a verbal response scale, requirement of repeated injection for anesthesia, efficacy of these injections in localized infections, and requirement of rescue analgesics 3 hours after extraction.
Statistical data confirmed clinical equivalence between infiltration and PSA nerve block.
Considering the difficulty in mastering the technique of PSA nerve block, and the possibility of more complications associated with it (compared with infiltration); it may not be necessary for anesthesia of maxillary molars.
上颌后上牙槽（PSA）神经阻滞或上颌浸润麻醉用于拔除上颌磨牙的常规应用已得到验证。
本研究旨在确定在上颌磨牙麻醉所需病例中，后上牙槽（PSA）阻滞的相对作用。
纳入100例需要拔除上颌第二和第三磨牙的患者。这些患者被分为两组。一组接受浸润麻醉，另一组接受含血管收缩剂的利多卡因PSA神经阻滞。所有拔牙均采用一致的牙槽内拔牙技术。收集与拔牙过程中的疼痛相关的数据，这些数据通过视觉模拟量表和言语反应量表获得，包括麻醉时重复注射的需求、这些注射在局部感染中的疗效以及拔牙后3小时的急救镇痛药需求。
统计数据证实浸润麻醉和PSA神经阻滞在临床上等效。
考虑到掌握PSA神经阻滞技术的难度以及与之相关的更多并发症的可能性（与浸润麻醉相比），上颌磨牙麻醉可能无需采用PSA神经阻滞。
