Kriangcherdsak Yutthasak, Raucharernporn Somchart, Chaiyasamut Teeranut, Wongsirichat Natthamet
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Mahidol University, Bangkok, Thailand.
J Dent Anesth Pain Med. 2016 Jun;16(2):111-116. doi: 10.17245/jdapm.2016.16.2.111. Epub 2016 Jun 30.
Inferior alveolar nerve block (IANB) of the mandible is commonly used in the oral cavity as an anesthetic technique for dental procedures. This study evaluated the success rate of the first IANB administered by dental practitioners.
Volunteer dental practitioners at Mahidol University who had never performed an INAB carried out 106 INAB procedures. The practitioners were divided into 12 groups with their advisors by randomized control trials. We recorded the success rate via pain visual analog scale (VAS) scores.
A large percentage of the dental practitioners (85.26%) used the standard method to locate the anatomical landmarks, injecting the local anesthetic at the correct position, with the barrel of the syringe parallel to the occlusal plane of the mandibular teeth. Further, 68.42% of the dental practitioners injected the local anesthetic on the right side by using the left index finger for retraction. The onset time was approximately 0-5 mins for nearly half of the dental practitioners (47.37% for subjective onset and 43.16% for objective onset), while the duration of the IANB was approximately 240-300 minutes (36.84%) after the initiation of numbness. Moreover, the VAS pain scores were 2.5 ± 1.85 and 2.1 ± 1.8 while injecting and delivering local anesthesia, respectively.
The only recorded factor that affected the success of the local anesthetic was the administering practitioner. This reinforces the notion that local anesthesia administration is a technique-sensitive procedure.
下颌下牙槽神经阻滞(IANB)常用于口腔牙科手术的麻醉技术。本研究评估了牙科医生首次进行IANB的成功率。
玛希隆大学从未进行过INAB的志愿牙科医生进行了106次INAB手术。通过随机对照试验将医生与他们的指导教师分为12组。我们通过疼痛视觉模拟量表(VAS)评分记录成功率。
很大比例的牙科医生(85.26%)使用标准方法定位解剖标志,在正确位置注射局部麻醉剂,注射器针筒与下颌牙齿的咬合平面平行。此外,68.42%的牙科医生使用左手食指牵拉,在右侧注射局部麻醉剂。近一半的牙科医生(主观起效为47.37%,客观起效为43.16%)的起效时间约为0 - 5分钟,而IANB的持续时间在麻木开始后约为240 - 300分钟(36.84%)。此外,在注射和给予局部麻醉时,VAS疼痛评分分别为2.5±1.85和2.1±1.8。
唯一记录到的影响局部麻醉成功的因素是实施手术的医生。这强化了局部麻醉给药是一项技术敏感程序的观念。