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改良口腔外上颌-下颌神经阻滞用于牙槽手术的麻醉效果及分布:一项前瞻性队列研究。

Effectiveness and Distribution of Anesthesia for a Modified Extra Oral Maxillo-Mandibular Nerve Block for Dento-Alveolar Procedures: A Prospective Cohort Study.

作者信息

Fauziya Dastagir, Anantanarayanan Parameswaran, Shankar D Prabhu

机构信息

Department of Oral & Maxillofacial Surgery, Meenakshiammal Dental College & Hospital, Alappakkam Main Road, Madhuravoyal, Chennai 600095 India.

出版信息

J Maxillofac Oral Surg. 2024 Jun;23(3):561-567. doi: 10.1007/s12663-022-01755-w. Epub 2022 Jul 11.

Abstract

AIM

To evaluate the effectiveness of a modified maxillo-mandibular nerve block technique that includes anesthetizing the maxillary and mandibular nerve with single injection.

MATERIALS AND METHODS

A prospective, clinical cohort study was carried out including patients who presented for surgical removal of maxillary and mandibular third molars. All patients were administered maxilla-mandibular nerve block through a single injection on one side. Three clinical neurosensory tests were used for mapping the area of anesthesia and to assess and grade objectively the effect of the block. Light touch (LT), two-point discrimination (TPD), pin prick (PP) and Electric pulp testing (EPT) were used for all branches of maxillary and mandibular nerve. An extra oral mapping chart for depth of anesthesia was maintained for each patient to categorize the grades as nil, intermediate and highly anesthetized areas.

RESULTS

62 patients were assessed in the study. EPT showed greater depth of pulpal anesthesia in posterior teeth than the anterior in both maxilla and mandible. PP and TPD tests also showed that the anesthetic effect varied between posterior divisions demonstrating extreme anesthesia compared to the anterior divisions.

CONCLUSION

This technique was found to be successful for surgical extractions involving the maxillary and mandibular regions.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12663-022-01755-w.

摘要

目的

评估一种改良的上颌-下颌神经阻滞技术的有效性,该技术包括通过单次注射对上颌神经和下颌神经进行麻醉。

材料与方法

开展一项前瞻性临床队列研究,纳入因手术拔除上颌和下颌第三磨牙前来就诊的患者。所有患者均通过在一侧进行单次注射接受上颌-下颌神经阻滞。使用三项临床神经感觉测试来绘制麻醉区域,并客观评估和分级阻滞效果。对上颌神经和下颌神经的所有分支均使用轻触觉(LT)、两点辨别觉(TPD)、针刺觉(PP)和牙髓电活力测试(EPT)。为每位患者保存一张用于麻醉深度的口外绘图图表,以将分级分为无麻醉区域、中度麻醉区域和高度麻醉区域。

结果

本研究共评估了62例患者。EPT显示,在上颌和下颌中,后牙的牙髓麻醉深度均大于前牙。PP和TPD测试还表明,后支的麻醉效果与前支相比差异明显,后支表现出极度麻醉。

结论

该技术被发现对于涉及上颌和下颌区域的外科拔牙手术是成功的。

补充信息

在线版本包含可在10.1007/s12663-02...获取的补充材料。 (注:原文链接中的数字不完整,翻译时保留原文形式)

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