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上下颌神经连续阻滞，并将其应用于口腔外科手术或口面部疼痛患者，我们研制了三种三叉神经连续阻滞导管套件，包括导管、导管导引器和给药接头。导管直径分别为28 G（A型）、26 G（B型）和24 G（C型）。局麻药侧三叉神经病变感觉减退点阻滞14例有效。2例因导管放置错误，局部麻醉后仍有给药侧三叉神经损伤感觉，术中及术后均留置导管，以减轻术后疼痛。所有有效病例术后均经导管局部麻醉止痛，1例下颌骨癌性疼痛患者经导管局部麻醉维持止痛7d，最后经导管注入无水酒精行永久性下颌神经阻滞。C型导管插入方便，给药方便，可长时间留置导管2周左右，无并发症发生，是一种有效的上、下颌骨连续阻滞方法。

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.