口内入路下颌角截骨整形术局部麻醉的效果

目的探索一种安全、简便、有效的下颌角截骨手术的麻醉方法。方法根据43例要求行口内入路下颌角截骨整形术的患者的意愿,手术在局麻下进行。患者术前行平卧位口内含水状态下呼吸和吞咽训练,能耐受20min。术中经口进行下齿槽神经、舌神经与颊神经的局部阻滞,同时进行下颌角下缘、后缘的局部浸润麻醉。显效后进行下颌角截骨整形术。结果43例患者的86侧麻醉首次成功83侧,成功率为96．5％,余3侧2次注射成功。所有患者均顺利完成手术,手术过程中无需追加麻醉药。结论局部神经阻滞及浸润麻醉能够满足口内入路下颌角截骨整形术的需要,安全、简便、有效,有利于口内入路下颌角截骨整形术的广泛开展。

Application of local anesthesia for the mandibular angle osteotomy plasty through the intraoral approach

Objective To search a kind of safe, simple and effective local anesthesia for the mandibular angle osteotomy plasty through the intraoral approach.Methods According to the inclination of the forty-three patients who desired to undergo the mandibular angle osteotomy plasty through the intraoral approach,authors did the operations by using local anesthesia. The patients were trained to respire and swallow under the condition of containing some water in their mouthes until they can stand for twenty minutes.During the operations,the inferior alveolar nerve,lingual nerve and the buccal nerve were blocked,and the lower border and the posteromargin of the mandible were infiltrated by Lidocaine. After the anesthesia had taken effect,the osteotomy of the mandibular angle was performed.Results The anesthesia succeed on eighty-three sides of total eighty-six sides with the first injection. The success rate was ninty-six point five percents. The anesthesia on other three sides succeed with the second injection. All the operations were successfully done and the anesthesia needn't be boosted.Conclusion The local nerve blocking and infiltrating anesthesia can satisfied the need of the mandibular angle osteotomy plasty through the intraoral approach.It is safe,simple and effective.With the use of the method, the mandibular angle osteotomy plasty through the intraoral approach can be extensively carried out.