Head of Department, Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai.
Resident, Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai.
J Oral Maxillofac Surg. 2021 Nov;79(11):2247-2256. doi: 10.1016/j.joms.2021.05.005. Epub 2021 May 15.
Infiltration techniques are used as an adjuvant to regional anesthesia. In this study, we evaluated the efficacy of the superficial cervical plexus nerve block, as an alternative to local infiltration techniques; in the management of mandibular fractures and peri-mandibular space infections.
A prospective randomized controlled trial was conducted on 24 patients having either mandibular fractures or peri-mandibular space infections; and were scheduled for surgery under regional anesthesia (eg, inferior alveolar nerve block, long buccal nerve block). The control group involved delivering a combination of regional anesthesia along with local infiltration. The experimental group received regional anesthesia with a superficial cervical plexus nerve block. The following parameters were studied: pain, onset and duration of anesthesia, time interval until first analgesic request, pulse rate and blood pressure [at different time intervals].
Intergroup comparison was done using unpaired t-test. Intragroup comparison was done using repeated measures ANOVA (for >2 observations), followed by a post hoc test. The superficial cervical plexus nerve block group showed highly statistically significant (P < .01) improvement in terms of intra-operative pain at 30 minutes, duration of anesthesia, intraoperative anesthetic requirement, time interval until first analgesic request and intraoperative diastolic blood pressure at 10 minutes.
It can be concluded that the combination of a regional anesthesia technique with a superficial cervical plexus nerve block is an alternative and safe technique for patients undergoing surgery for mandible fractures and perimandibular space infections, with clear advantages over local infiltration.
浸润技术被用作区域麻醉的辅助手段。在这项研究中，我们评估了浅表颈丛神经阻滞作为局部浸润技术替代的效果；用于下颌骨骨折和下颌周围间隙感染的治疗。
对 24 例拟行区域麻醉（如下颌神经阻滞、长颊神经阻滞）下手术的下颌骨骨折或下颌周围间隙感染患者进行前瞻性随机对照试验。对照组采用区域麻醉联合局部浸润。实验组接受浅表颈丛神经阻滞的区域麻醉。研究了以下参数：疼痛、麻醉的起效和持续时间、首次要求镇痛的时间间隔、脉搏率和血压[在不同时间间隔]。
采用非配对 t 检验进行组间比较。采用重复测量方差分析（用于>2 次观察），然后进行事后检验。与局部浸润相比，浅表颈丛神经阻滞组在 30 分钟时的术中疼痛、麻醉持续时间、术中麻醉需求、首次要求镇痛的时间间隔和 10 分钟时的术中舒张压方面具有高度统计学意义（P<.01）。
可以得出结论，区域麻醉技术联合浅表颈丛神经阻滞是一种替代和安全的技术，适用于接受下颌骨骨折和下颌周围间隙感染手术的患者，与局部浸润相比具有明显优势。
