3种下牙槽神经阻滞麻醉方法的临床应用与评价

Clinical application and evaluation of three types of block anesthesia of inferior alveolar nerve

目的评价传统下牙槽神经阻滞麻醉(直接麻醉)、Akinosi法麻醉与Gow-Gates法麻醉对下牙槽神经阻滞麻醉效果。方法2007年3月至2008年12月在山西医科大学第一医院口腔颌面外科对需拔除下颌智齿患者420例。分别施行直接麻醉、Akinosi法麻醉或Gow-Gates法麻醉,比较其麻醉成功率和优缺点。结果直接麻醉法A级118例(占84.3%);Gow-Gates法A级136例(占97.1%);Akinosi-Vazirani法A级133例(占95%)。直接麻醉法有23例注射麻药前回抽有血,经改变方向后重新注射;Gow-Gates法与Akinosi-Vazirani法无回抽有血病例。结论Gow-Gates法和Akinosi-Vazirani法均可替代直接麻醉方法。其中Akinosi-Vazirani法尤其适用于张口受限和精神紧张患者。

0bjective Evaluating three types of block anesthesia of inferior alveolar nerve.Methods Traditional block anesthesia of inferior alveolar nerve,Gow-Gates anesthesia and Akinosi-Vazirani anesthesia were performed on the pa-tients who needed third molar surgery.Compare the strengths and weaknesses and the success rate of anesthesia.Results Rank A of traditional block anesthesia was 84.3%;rank A of Gow-Gates anesthesia was 97.1%;rank A of Akino-si-Vazirani anesthesia was 95%.Totally 23 cases of traditional block anesthesia had pumpback blood,needing to change direction and reinject.No case of Gow-Gates anesthesia and Akinosi-Vazirani anesthesia had pumpback blood.Conclu-sion Gow-Gates anesthesia and Akinosi-Vazirani anesthesia could substitute the traditional block anesthesia.Akino-si-Vazirani anesthesia is especially suitable for limitation of mouth opening and psychentonia patient.