Marques Aline Louise Nascimento, Figueroba Sidney R, Mafra Marco Antonio Tridapalli, Groppo Francisco Carlos
Department of Biosciences, Piracicaba Dental School, University of Campinas - UNICAMP - Piracicaba, São Paulo, Brazil.
J Dent Anesth Pain Med. 2022 Jun;22(3):227-231. doi: 10.17245/jdapm.2022.22.3.227. Epub 2022 May 27.
Although rare, complications can occur with anesthetic procedures. The posterior superior alveolar nerve (PSAN) block anesthetic technique has a high success rate, but positive aspiration can cause bruising, transient diplopia, blurred vision, and temporary blindness in approximately 3% cases. When edema occurs, it is occasionally massive, especially in the infratemporal fossa, and the resulting hematoma is usually unsightly. A 20-year-old woman presented with massive edema followed by hematoma in the upper right jaw immediately after PSAN block administration, which subsequently spread to the oral mucosa. The patient did not report any complications during the anesthetic procedure. However, after the injection was administered, the patient experienced anesthetic sensations, which rapidly evolved to facial edema. There was mild pain, but without intraoral or extraoral bleeding. The patient was prescribed medicines and instructed to perform contrast therapy. Although hematomas and edema are rare, they are difficult to prevent. The choice of local anesthetic and appropriate application of the anesthetic technique can minimize their occurrence.
尽管罕见,但麻醉操作可能会出现并发症。上牙槽后神经(PSAN)阻滞麻醉技术成功率很高,但回抽阳性可能会导致约3%的病例出现瘀斑、短暂性复视、视力模糊和暂时性失明。当出现水肿时,有时会很严重,尤其是在颞下窝,由此产生的血肿通常很难看。一名20岁女性在接受PSAN阻滞麻醉后,右上颌立即出现大量水肿,随后发展为血肿,并蔓延至口腔黏膜。患者在麻醉过程中未报告任何并发症。然而,注射后,患者出现麻醉感觉,迅速发展为面部水肿。有轻微疼痛,但口腔内或口腔外均无出血。给患者开了药,并指导其进行对照治疗。尽管血肿和水肿很少见,但很难预防。选择局部麻醉剂并适当应用麻醉技术可以将其发生几率降至最低。