Ravi Kiran B Sarat, Kashyap Vinay M, Uppada Uday Kiran, Tiwari Prabhat, Mishra Ashank, Sachdeva Akanksha
1Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, India.
2Department of Oral and Maxillofacial Surgery, Oxford Dental College, Bangalore, India.
J Maxillofac Oral Surg. 2018 Dec;17(4):570-575. doi: 10.1007/s12663-018-1092-5. Epub 2018 Feb 26.
Traditionally, the "Halstead block" has been widely used to provide anesthesia in mandibular teeth. Two other techniques, the Gow Gates mandibular nerve block and the Akinosi Vazirani closed-mouth mandibular nerve block, are reliable alternatives to the conventional inferior alveolar nerve block. The purpose of this study is to evaluate the onset of anesthesia, anesthetic success and incidence of positive aspiration during administration of local anesthetic solution using the Halstead, Vazirani Akinosi and Gow Gates techniques.
The study involves 210 subjects, divided into three different groups of 70 subjects each receiving Gow Gates, Vazirani Akinosi and conventional inferior alveolar nerve blocks. The onset of anesthesia, positive aspiration and anesthetic success was evaluated.
In Vazirani Akinosi technique group, patients showed highest anesthetic success of 95.71%; there was a significant difference seen between the Gow Gates and Vazirani Akinosi techniques ( = 0.0241*). The mean value of the onset of anesthesia in Gow Gates technique showed the longest 343.71 ± 153.20 s, in Halstead technique it was 177.43 ± 59.94 s, and in Vazirani Akinosi technique it was 192.86 ± 61.20 s. There was a significant difference seen between Gow Gates and Vazirani Akinosi techniques ( = 0.0001*) and Gow Gates and inferior alveolar nerve block techniques ( = 0.0001*).
The Vazirani Akinosi technique was found to be significantly better than the other two techniques with respect to both onset and success of anesthesia. Positive aspirations were slightly higher in the conventional IANB technique compared to the other two, but did not reach statistical significance.
传统上，“哈尔斯特德阻滞法”已被广泛用于下颌牙齿的麻醉。另外两种技术，即戈氏下颌神经阻滞法和阿金诺西·瓦齐拉尼闭口下颌神经阻滞法，是传统下牙槽神经阻滞法可靠的替代方法。本研究的目的是评估使用哈尔斯特德法、瓦齐拉尼·阿金诺西法和戈氏法注射局部麻醉溶液时的麻醉起效时间、麻醉成功率及回抽阳性发生率。
本研究涉及210名受试者，分为三组，每组70名受试者，分别接受戈氏法、瓦齐拉尼·阿金诺西法和传统下牙槽神经阻滞法。评估麻醉起效时间、回抽阳性情况及麻醉成功率。
在瓦齐拉尼·阿金诺西技术组中，患者的麻醉成功率最高，为95.71%；戈氏法和瓦齐拉尼·阿金诺西法之间存在显著差异（P = 0.0241*）。戈氏技术组麻醉起效时间的平均值最长，为343.71 ± 153.20秒，哈尔斯特德技术组为177.43 ± 59.94秒，瓦齐拉尼·阿金诺西技术组为192.86 ± 61.20秒。戈氏法与瓦齐拉尼·阿金诺西法之间（P = 0.0001*）以及戈氏法与下牙槽神经阻滞法之间（P = 0.0001*）存在显著差异。
在麻醉起效和成功率方面，发现瓦齐拉尼·阿金诺西技术明显优于其他两种技术。与其他两种方法相比，传统下牙槽神经阻滞法的回抽阳性率略高，但未达到统计学意义。
