Wang Yu-Hao, Wang Dian-Ri, Liu Ji-Yuan, Pan Jian
State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
J Dent Sci. 2021 Oct;16(4):1055-1065. doi: 10.1016/j.jds.2020.12.003. Epub 2020 Dec 17.
Local anesthesia (LA) is the most important pain management process in oral and maxillofacial surgery. Safe and effective LA not only enable patients to obtain high-quality treatment, but also relieve the anxiety of patients when they come to the clinic. The choices of local anesthetic and injection methods determine the success of LA to a great extent. At present, in most countries or regions, common local anesthetics used in oral and maxillofacial surgery belong to amides and they are injected into patients' body mainly through block or infiltration anesthesia. In addition, the operators' technique level, patient's subjective psychology and anatomical variation of maxillofacial structure also have a strong influence on LA in dental clinic. Due to the existence of above factors, the worldwide success rates of LA in oral and maxillofacial surgery is very different. There are no specific LA methods that ensure 100% successful LA rates. Fortunately, the development of new local anesthetic and injection technology are providing us with new ideas to solve this problem. This review mainly report the new research progress on LA in oral and maxillofacial surgery in recent decades and help clinicians with dental LA operation.
局部麻醉是口腔颌面外科最重要的疼痛管理方法。安全有效的局部麻醉不仅能使患者获得高质量的治疗，还能缓解患者就诊时的焦虑情绪。局部麻醉剂和注射方法的选择在很大程度上决定了局部麻醉的成功率。目前，在大多数国家或地区，口腔颌面外科常用的局部麻醉剂属于酰胺类，主要通过阻滞或浸润麻醉注入患者体内。此外，操作者的技术水平、患者的主观心理以及颌面结构的解剖变异对牙科诊所的局部麻醉也有很大影响。由于上述因素的存在，全球口腔颌面外科局部麻醉的成功率差异很大。目前尚无确保局部麻醉成功率达100%的特定局部麻醉方法。幸运的是，新型局部麻醉剂和注射技术的发展为我们解决这一问题提供了新思路。本文综述主要报道近几十年来口腔颌面外科局部麻醉的新研究进展，以帮助临床医生进行牙科局部麻醉操作。
