Development of continuos Maxilla and Mandibular block and these application of oral surgery patient and oro-facial pain patient

本研究的目的是发展连续上颌和下颌神经阻滞，并将该方法应用于口腔手术患者或口腔-面部疼痛患者。我们研制了三种连续三叉神经阻滞的导管套件，包括导管、导管引入器、给药连接接头。导管直径分别为28G （A型）、26G （B型）和24G （C型）。我们对我院施行口腔手术的患者（共16例，下颌神经阻滞11例，上颌神经阻滞5例）应用连续上颌神经阻滞。对14例局麻侧三叉神经病变感觉少的部位观察阻滞的效果。在两例中，由于导管放置错误，局部麻醉后三叉神经病变的感觉仍然存在。术中及术后留置导管以缓解术后疼痛。在所有有效病例中，术后均通过导管使用局麻药缓解疼痛。1例下颌骨病变癌性疼痛患者应用该导管，经导管局部麻醉维持疼痛缓解7天，最后经导管给予纯酒精进行永久性下颌骨神经阻滞。C型导管似乎更适合使用，因为它易于插入并通过导管给药。留置时间可达2周左右，无并发症发生。结果表明，采用原导管组进行上下颌连续阻滞的方法在手术期间和术后疼痛缓解及难治性口腔-面部疼痛方面是有效的。

The aim of this study was to develop the continuos maxilla and mandibular nerve block and to apply the methods to patient that performed oral surgery or to oro-facial pain patients.We developed three kinds of catheter kits of continuos trigeminal nerve block which were consisted of catheter, catheter introducer, connective adapter for administration of drug. The diameter of each catheter was 28G (Type A), 26G (Type B) and 24G (Type C).We applied the continuos maxilla or mandibular nerve block to the patient (16cases total ; 11cases of mandibular block, 5 cases of maxilla block) performed oral surgery in our hospital. The efficacy of the block was seen in 14 cases the points of less of sensation of trigeminal lesion in local anesthetics administered side. In two cases the sensations of trigeminal lesion in administered side were remained even after given local anesthetics, due to wrong catheter placement.The catheters were dwelled during operation and post operative period for purpose of post operative pain relief. In all of effective cases, postoperative pain relief were obtained by using local anesthetics through the catheter.One case who suffered from cancer pain in mandibular lesion were applied this catheter and maintained pain relief for 7days by local anesthetic administration through the catheter, and then finally permanent mandibular nerve block were performed by given pure alcohol through the catheter. The type C catheter appeared to be preferable to use since it was easy to insert and to administer the drug through the catheter.Long period of dwelling the catheter about 2 weeks was possible, and no complication was not occurred.It was concluded that the method of continuos maxilla and mandibullar block using the original catheter kit was useful and effective during operative period and postoperative pain relief and intractable oro-facial pain.