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口外与口内下颌神经阻滞在牙弓夹板固定治疗下颌骨折中的疗效比较研究

A Comparative Study of Efficacy for Extra-Oral vs. Intra-Oral Mandibular Nerve Block in Arch Bar Fixation for Management of Mandibular Fractures.

作者信息

Gupta Monika, Nazir Aaquib, Sharma Atul, Bali Amit

机构信息

MDS (Oral and Maxillofacial Surgery), Maharishi Markandeshwar College of Dental Sciences and Research, Mullana, Ambala, Haryana 133207 India.

出版信息

J Maxillofac Oral Surg. 2024 Oct;23(5):1182-1189. doi: 10.1007/s12663-024-02306-1. Epub 2024 Aug 17.

Abstract

PURPOSE

The aim of the study was to evaluate and compare the efficacy of extra-oral mandibular nerve block (infra-zygomatic approach/lateral approach) vs. intra-oral (Gow-Gates) mandibular nerve block in arch bar fixation for management of mandibular fractures.

METHODOLOGY

A total of 200 patients reported with maxillofacial fractures. Out of them, 50 patients who required arch bar fixation for management of mandibular fractures were divided into two groups: Group I: Extra-oral and Group II: Intra-oral mandibular nerve blocks. The intra-operative pain, time of onset of anaesthesia, volume of drug administered, depth of needle insertion, repetition of injections and postoperative complications were analysed.

RESULTS

In Group I (Extra-oral nerve block), the time of onset of anaesthesia, volume of anaesthesia administered, needle depth, number of repetition of injections and postoperative complications were more as compared to Group II. No significant difference was observed in intra-operative pain score between two groups.

CONCLUSION

Intra-oral approach with Gow-Gates technique seemed to be efficient and easy to operate as compared to extra-oral approach, for arch bar fixation of mandibular fractures in an output door setting, as extra-oral approach is more technique-sensitive and may lead to certain complications which require operation theatre setting with medical attention.

摘要

目的

本研究旨在评估并比较口外下颌神经阻滞(颧下途径/外侧途径)与口内(Gow-Gates)下颌神经阻滞在颌骨骨折牙弓夹板固定术中的疗效。

方法

共有200例颌面骨折患者前来就诊。其中,50例需要进行牙弓夹板固定术治疗下颌骨折的患者被分为两组:第一组:口外组;第二组:口内下颌神经阻滞组。分析术中疼痛、麻醉起效时间、给药量、进针深度、注射次数及术后并发症。

结果

与第二组相比,第一组(口外神经阻滞)的麻醉起效时间、麻醉给药量、进针深度、注射次数及术后并发症更多。两组术中疼痛评分无显著差异。

结论

在门诊环境下,对于下颌骨折的牙弓夹板固定术,与口外途径相比,采用Gow-Gates技术的口内途径似乎更有效且易于操作,因为口外途径对技术要求更高,可能会导致某些并发症,需要在手术室环境并接受医疗护理。

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