A Novel Technique of Ultrasound-Guided Selective Mandibular Nerve Block With a Lateral Pterygoid Plate Approach

“…TG has been blindly blocked through foramen ovale and in order to reduce the complications and to increase the accuracy of the block, the fluoroscopy-guided techniques were employed. Mandibular nerve, the third branch of the TG, can be selectively blocked by fluoroscopy or ultrasound guidance as well (5)(6)(7). Ultrasound guidance provides excellent visualization of these bony and soft tissue structures.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound guidance provides excellent visualization of these bony and soft tissue structures. Moreover, the artery and vein, which accompany the nerves, can easily be identified and avoided by the US-guided techniques (5,(8)(9)(10)(11)(12). This block was used for reliving spasm during anesthesia and intubation (4), treatment of trigeminal neuralgia (6), and pain management in the intra-or post-operative phases (1,11).…”

Section: Discussionmentioning

confidence: 99%

Mastication Muscle Suppression by the Mandibular Branch of Trigeminal Nerve Catheter-Based, Ultrasound-Guided Block: A Case Report

2020

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Introduction: Ultrasound-guided nerve blocks have enhanced our abilities to selectively and effectively suppress certain nerves to accomplish specific goals, including blockade a localized seizure muscle movement without affecting the seizure threshold or level of the consciousness. Case Presentation: This is a case report of the blockade of the movement of a chewing muscle by the continuous (catheter-based) mandibular nerve block in a 27 years old man with high-frequency partial seizures in facial muscles who was a candidate for seizure focus ablation. An out-of-plane approach was used to insert a catheter near the mandibular nerve to provide intermittent or continuous peripheral nerve block. This report demonstrated that a continuous block of the mandibular nerve could effectively facilitate the seizure focus mapping and ablation. Conclusions: We can selectively suppress the contractures of a certain muscle in partial seizures by a continuous block of the responsible nerve. This blockade can facilitate seizure focus mapping and ablation.

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“…Recently, a novel technique of ultrasound-guided mandibular nerve block (MNB) has been developed, in which a local anesthetic is injected into the lateral pterygoid plate using an extraoral approach [ 37 ]. Ultrasound-guided MNB using 5–6 mL of 0.375% ropivacaine enabled the management of general anesthesia for mandibular sequestrectomy with a lower dose of opioid and decreased the need for analgesics for 3 days after surgery [ 38 ].…”

Section: Pain Control By Local Anesthesia For Implant Surgerymentioning

confidence: 99%

Considerations for Satisfactory Sedation during Dental Implant Surgery

Ito

Utsumi

Baba

et al. 2023

JPM

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Implant surgery is a lengthy dental procedure, and sedation is often used to reduce discomfort. The effectiveness of sedation has traditionally been evaluated in terms of patient and surgeon satisfaction, but the most important goal is not to induce a deep sleep in the patient, but rather to ensure that the surgery is performed safely and as planned. Additionally, adequate pain control is a necessary requirement for patient and surgeon satisfaction. Most patients undergoing implant surgery are middle-aged or older, and a relatively large number of them have cardiovascular disease. Infiltration anesthesia using articaine or lidocaine in combination with adrenaline is widely used, but its use in patients with cardiovascular disease is limited because of adrenaline’s effects on the cardiovascular system. The use of long-acting local anesthetics and the potential efficacy of ultrasound-guided jaw nerve block have been investigated to enhance analgesia without resorting to adrenaline. Midazolam and propofol are usually used for sedation, but dexmedetomidine, which causes less respiratory depression, and the ultrashort-acting benzodiazepine remimazolam are emerging as potential alternatives. Monitoring of anesthetic depth using electroencephalography is effective in maintaining a constant level of sedation. In addition, sedation promotes the stabilization of heart rate and blood pressure, reducing the risks associated with adrenaline and allowing for safer management.

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A Novel Technique of Ultrasound-Guided Selective Mandibular Nerve Block With a Lateral Pterygoid Plate Approach

Abstract: This study was registered at the Thai Clinical Trials Registry (ClinicalTrials.in.th), identifier TCTR20160601004.

Cited by 7 publications

References 11 publications

Local Anesthesia in Oral and Maxillofacial Surgery

Local Anesthesia in Oral and Maxillofacial Surgery

Mastication Muscle Suppression by the Mandibular Branch of Trigeminal Nerve Catheter-Based, Ultrasound-Guided Block: A Case Report

Considerations for Satisfactory Sedation during Dental Implant Surgery

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