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

本研究的目的是研制三叉神经连续阻滞器，并将其应用于口腔外科手术患者或口腔面疼痛患者。每根导管直径分别为28G(A型)、26G(B型)和24G(C型)。对16例患者(其中下颌神经阻滞11例，上颌神经阻滞5例)在本院施行口腔外科手术。局麻药给药侧三叉神经病变感觉较轻者14例，有效14例。2例局麻药给药后，由于导管放置不当，给药侧仍有三叉神经损伤感觉，术中及术后留置导管，以减轻术后疼痛。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7d后，再经导管给予无水乙醇永久下颌神经阻滞。C型导尿管插管方便，便于插管给药，留置时间可长达2周左右，无并发症发生。结论：采用原导尿管套装进行上下颌关节持续封闭，可有效缓解手术及术后顽固性口面部疼痛。

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.