Robiony M, Demitri V, Costa F, Politi M, Cugini U
Department of Maxillofacial Surgery, University of Udine, Italy.
Br J Oral Maxillofac Surg. 1998 Oct;36(5):389-91. doi: 10.1016/s0266-4356(98)90653-2.
We present our experience of transcutaneous truncal anaesthesia of the maxillary nerve in association with transmucosal anaesthesia of the sphenopalatine ganglion in surgically assisted rapid maxillary expansion. Twelve patients with a skeletal transverse discrepancy of the maxilla were treated in our department from 1994 to 1995. Maxillary transcutaneous nerve block was done with a Quincke 8 cm spinal needle together with transmucosal anaesthesia of the sphenopalatine ganglion. Mepivacaine without adrenaline and sodium bicarbonate 1/10 was used for truncal anaesthesia and lidocaine-prilocaine cream for transmucosal anaesthesia. A Le Fort I osteotomy, lateral nasal wall osteotomy, pterygomaxillary osteotomy, and a palatal osteotomy were done for all patients before the maxillary expansion. Total anaesthesia of the maxillary area facilitated the operations and appreciably reduced the amount of postoperative pain. The ease of achieving effective anaesthesia before and after operation and the absence of side-effects make this form of anaesthetic particularly useful in surgically assisted rapid maxillary expansion.
我们介绍了在外科辅助快速上颌扩弓中，上颌神经经皮截段麻醉联合蝶腭神经节经粘膜麻醉的经验。1994年至1995年，我们科室治疗了12例上颌骨骨骼横向差异的患者。使用8厘米长的Quincke脊髓穿刺针进行上颌经皮神经阻滞，并对蝶腭神经节进行经粘膜麻醉。用于截段麻醉的是不含肾上腺素和1/10碳酸氢钠的甲哌卡因，用于经粘膜麻醉的是利多卡因-丙胺卡因乳膏。所有患者在进行上颌扩弓前均进行了Le Fort I型截骨术、鼻侧壁截骨术、翼上颌截骨术和腭部截骨术。上颌区域的全身麻醉便于手术操作，并明显减轻了术后疼痛。术前术后易于实现有效麻醉且无副作用，使得这种麻醉方式在外科辅助快速上颌扩弓中特别有用。
