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用于下颌第一和第二磨牙拔除时麻醉下牙槽神经、舌神经和颊长神经的单次注射技术:一项前瞻性研究

Single-insertion technique for anesthetizing the inferior alveolar nerve, lingual nerve, and long buccal nerve for extraction of mandibular first and second molars: a prospective study.

作者信息

Joseph Benny, Kumar Nithin, Vyloppilli Suresh, Sayd Shermil, Manojkumar K P, Vijaykumar Depesh

机构信息

Department of Oral and Maxillofacial Surgery, Kunhitharuvai Memorial Charitable Trust (KMCT) Dental College, Calicut, India.

Department of Oral Surgery, Dental Faculty, Tishk International University, Erbil, Iraq.

出版信息

J Korean Assoc Oral Maxillofac Surg. 2020 Dec 31;46(6):403-408. doi: 10.5125/jkaoms.2020.46.6.403.

DOI:10.5125/jkaoms.2020.46.6.403
PMID:33377465
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7783187/
Abstract

OBJECTIVES

Appropriate and accurate local anesthetic (LA) techniques are indispensable in the field of oral and maxillofacial surgery to obtain a satisfactory outcome for both the operating surgeon and the patient. When used alone, the inferior alveolar nerve block (IANB) technique requires supplemental injections like long buccal nerve block for extraction of mandibular molars leading to multiple traumatic experiences for the patient. The aim of this study was to anesthetize the inferior alveolar, lingual, and long buccal nerves with single-needle penetration requiring a minimal skillset such as administering a conventional IANB through introduction of the Benny Joseph technique for extraction of mandibular molars.

MATERIALS AND METHODS

This was a prospective study conducted in the Department of Oral and Maxillofacial Surgery, Kunhitharuvai Memorial Charitable Trust (KMCT) Dental College, Calicut, India. The duration of the study was 6 months, from June to November 2017, with a maximum sample size of 616 cases. The LA solution was 2% lignocaine with 1:100,000 adrenaline. The patients were selected from a population in the range of 20 to 40 years of age who reported to the outpatient department for routine dental extraction of normally positioned mandibular right or left first or second molars.

RESULTS

Of the 616 patients, 42 patients (6.8%) required re-anesthetization, a success rate of 93.2%. There were no complications such as hematoma formation, trismus, positive aspiration, and nerve injuries. None of the cases required re-anesthetization in the perioperative period.

CONCLUSION

The Benny Joseph technique can be employed and is effective compared with conventional IANB techniques by reducing trauma to the patient and also requires less technique sensitivity.

摘要

目的

在口腔颌面外科领域,恰当且准确的局部麻醉(LA)技术对于手术医生和患者获得满意的手术效果而言不可或缺。单独使用时,下牙槽神经阻滞(IANB)技术在拔除下颌磨牙时需要额外注射,如颊长神经阻滞,这会给患者带来多次创伤体验。本研究的目的是通过单针穿刺麻醉下牙槽、舌和颊长神经,这只需具备最低限度的技能,例如通过引入本尼·约瑟夫技术进行常规IANB操作来拔除下颌磨牙。

材料与方法

这是一项在印度科泽科德昆希萨鲁瓦伊纪念慈善信托(KMCT)牙科学院口腔颌面外科进行的前瞻性研究。研究持续时间为6个月,从2017年6月至11月,最大样本量为616例。局部麻醉溶液为含1:100,000肾上腺素的2%利多卡因。患者选自年龄在20至40岁之间、因常规拔除正常位置的下颌右侧或左侧第一或第二磨牙前来门诊部就诊的人群。

结果

616例患者中,42例(6.8%)需要再次麻醉,成功率为93.2%。未出现血肿形成、牙关紧闭、回抽阳性和神经损伤等并发症。围手术期内无一例需要再次麻醉。

结论

与传统IANB技术相比,本尼·约瑟夫技术可以采用且有效,它减少了对患者的创伤,并且对技术敏感性要求更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30c2/7783187/bccc9b33868a/jkaoms-46-403-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30c2/7783187/6251fe0bfc3e/jkaoms-46-403-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30c2/7783187/af2ba3aa1077/jkaoms-46-403-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30c2/7783187/40c3d31d53bd/jkaoms-46-403-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30c2/7783187/bccc9b33868a/jkaoms-46-403-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30c2/7783187/6251fe0bfc3e/jkaoms-46-403-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30c2/7783187/af2ba3aa1077/jkaoms-46-403-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30c2/7783187/40c3d31d53bd/jkaoms-46-403-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30c2/7783187/bccc9b33868a/jkaoms-46-403-f4.jpg

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A basic review on the inferior alveolar nerve block techniques.关于下牙槽神经阻滞技术的基础综述。
Anesth Essays Res. 2014 Jan-Apr;8(1):3-8. doi: 10.4103/0259-1162.128891.
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Inferior alveolar nerve block: Alternative technique.下牙槽神经阻滞:替代技术。
Anesth Essays Res. 2012 Jan-Jun;6(1):53-7. doi: 10.4103/0259-1162.103375.
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Inferior alveolar nerve block anesthesia via the retromolar triangle, an alternative for patients with blood dyscrasias.经磨牙后三角行下牙槽神经阻滞麻醉,是血液系统疾病患者的一种替代方法。
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