A 40-years-old female patient with severe right facial pain with a throbbing component along the mandibular division of the trigeminal nerve resistant to medical management. Continuous inferior alveolar nerve block wi...A 40-years-old female patient with severe right facial pain with a throbbing component along the mandibular division of the trigeminal nerve resistant to medical management. Continuous inferior alveolar nerve block with local anesthetics using an indwelling catheter provided a complete pain resolution for the patient for 2 weeks, after which the catheter got infected and was removed. A trial of balloon occlusion of the right internal maxillary artery provided complete resolution of the throbbing component of the patient’s pain. This was followed by permanent embolization with multiple coils.展开更多
目的:探讨低浓度利多卡因行下牙槽、舌、颊神经一次阻滞麻醉的效果。方法:采用自身对照研究,前瞻性分析3 mL 1%利多卡因1∶100000肾上腺素(低浓度组)或3 mL 2%利多卡因1∶100000肾上腺素(高浓度组)行下牙槽、舌、颊神经阻滞麻醉拔除下...目的:探讨低浓度利多卡因行下牙槽、舌、颊神经一次阻滞麻醉的效果。方法:采用自身对照研究,前瞻性分析3 mL 1%利多卡因1∶100000肾上腺素(低浓度组)或3 mL 2%利多卡因1∶100000肾上腺素(高浓度组)行下牙槽、舌、颊神经阻滞麻醉拔除下颌智牙的差异。患者术后经过21 d的洗脱期,选择对应浓度的利多卡因拔除对侧阻生牙。分析2组间注射时疼痛水平(疼痛评估量表,NRS)、麻醉起效时间、麻醉深度及麻醉持续时间的差异。采用SPSS 17.0软件包对数据进行统计学分析。结果:21例患者(平均年龄24岁)完成试验,其中62%为女性。低浓度组的疼痛水平(1.09,95%CI,0.77~1.41)显著低于高浓度组(1.66,95%CI,1.33-1.99)(P=0.010)。低浓度组下牙槽、颊、舌神经阻滞麻醉起效时间(52~63 s)显著快于高浓度组(259~335 s)(P=0.000)。下牙槽、舌、颊神经麻醉深度2组之间未见显著差异(P=0.751)。在疼痛NRS值为1~3的患者中,低浓度组,9例(100%)均在分牙时疼痛(下牙槽神经麻醉深度浅);高浓度组3例(43%)分牙时疼痛,4例(57%)翻瓣时疼痛(颊神经麻醉深度浅)(P=0.019)。高浓度组麻醉持续时间比低浓度组平均长61 min(52~69 min)(P=0.000)。结论:用低浓度利多卡因组行下牙槽、舌、颊神经阻滞麻醉起效快,注射时疼痛水平低,术后下唇麻木不适感消失快。术中轻微疼痛,高浓度组常因颊神经麻醉深度较浅引起,低浓度组因下牙槽神经麻醉深度较浅引起。展开更多
文摘A 40-years-old female patient with severe right facial pain with a throbbing component along the mandibular division of the trigeminal nerve resistant to medical management. Continuous inferior alveolar nerve block with local anesthetics using an indwelling catheter provided a complete pain resolution for the patient for 2 weeks, after which the catheter got infected and was removed. A trial of balloon occlusion of the right internal maxillary artery provided complete resolution of the throbbing component of the patient’s pain. This was followed by permanent embolization with multiple coils.
