University of Niš, School of Medicine and Stomatology, Department of Oral Surgery, Niš, Serbia.
Intern, Clinic of Stomatology, Niš, Serbia.
J Craniomaxillofac Surg. 2020 Jun;48(6):607-615. doi: 10.1016/j.jcms.2020.03.010. Epub 2020 Mar 31.
Ambulatory painless surgery is dependent on local anesthesia effectiveness.
Evaluating the anesthetic efficacy of the angulated needle approach (ANA) for the inferior alveolar nerve block (IANB).
Group I received direct IANB; group II received indirect IANB; group III received the IANB with ANA. The quality of anesthesia score (QAS), numerical pain intensity score (NRS), onset time of full anesthesia (OT), and perianesthetic complications were measured.
Ninety patients (mean age: 37.47 ± 18.90, p = 0.027) of both sexes were split into three equal groups. Group III had the lowest QAS value with the success rate of 93.3%, compared to the statistically significantly worse QAS values of group II, with the success rate of 80% (p = 0.016). Group II had the statistically significant highest NRS values relative to group I (p = 0.002) and group III (p = 0.000001). The shortest OT occurred in group I, when compared to group II (p = 0.000484) and group III (p = 0.000498). The transient syncope and positive aspiration occurred in single cases.
The ANA for the IANB could successfully serve as a "first choice", or as an "addendum technique" in the cases of multiple failed attempts for direct and indirect IANB techniques.
门诊无痛手术依赖于局部麻醉的效果。
评估倾斜针进路（ANA）用于下牙槽神经阻滞（IANB）的麻醉效果。
第 I 组接受直接 IANB；第 II 组接受间接 IANB；第 III 组接受 ANA 下的 IANB。测量麻醉质量评分（QAS）、数字疼痛强度评分（NRS）、完全麻醉起效时间（OT）和围手术期并发症。
90 名患者（平均年龄：37.47±18.90，p=0.027）分为三组。第 III 组的 QAS 值最低，成功率为 93.3%，与成功率为 80%的第 II 组相比，QAS 值显著更差（p=0.016）。第 II 组的 NRS 值明显高于第 I 组（p=0.002）和第 III 组（p=0.000001）。与第 II 组（p=0.000484）和第 III 组（p=0.000498）相比，第 I 组的 OT 最短。仅在单个病例中出现短暂性晕厥和阳性抽吸。
对于直接和间接 IANB 技术多次尝试失败的情况，ANA 可成功作为 IANB 的“首选”或“附加技术”。
