Analgesic effect of ultrasound-guided extraoral mandibular nerve block compared to intraoral conductive block of the inferior alveolar nerve after lower third molar alveolectomy: a clinical prospective study

Authors

Marija Martinus, Department of Anesthesiology, Reanimatology, and Intensive Medicine, Varazdin General Hospital, 1 I. Mestrovica Street, Varazdin, 42000, Croatia.
Slobodan Mihaljevic, Clinic of Anesthesiology, Reanimatology, Intensive Care and Pain Therapy, University Clinical Hospital Centre Zagreb, Zagreb, Croatia.
Kresimir Reiner, Clinic of Anesthesiology, Reanimatology, Intensive Care and Pain Therapy, University Clinical Hospital Centre Zagreb, Zagreb, Croatia.
Zeljko Verzak, University of Zagreb School of Dental Medicine, Zagreb, Croatia.
Monika Kocman Panic, Department of Anesthesiology, Reanimatology, and Intensive Medicine, Varazdin General Hospital, 1 I. Mestrovica Street, Varazdin, 42000, Croatia.
Aleksandra Strahija, Department Otorhinolaryngology, Varazdin General Hospital, Varazdin, Croatia.
Vicko Gluncic, Advocate Health - Midwest
Ivan Kresimir Lukic, Catholic University of Croatia, Zagreb, Croatia.
Anita Lukic, Department of Anesthesiology, Reanimatology, and Intensive Medicine, Varazdin General Hospital, 1 I. Mestrovica Street, Varazdin, 42000, Croatia. lukic.anita@yahoo.com.

Recommended Citation

Martinus M, Mihaljevic S, Reiner K, et al. Analgesic effect of ultrasound-guided extraoral mandibular nerve block compared to intraoral conductive block of the inferior alveolar nerve after lower third molar alveolectomy: a clinical prospective study. BMC Oral Health. 2024;24(1):1041. Published 2024 Sep 4. doi:10.1186/s12903-024-04787-5

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Background:The analgesia after lower third molar alveolectomy is based on the use of non-steroidal anti-inflammatory drugs (NSAIDs) that have significant risks, and are contraindicated in the third trimester of pregnancy. Aiming to reduce NSAIDs use after this surgery, we quantified analgesic effects of ultrasound (US)-guided extraoral mandibular nerve block.

Methods:Thirty-six patients were equally allocated to the experimental or control group, based on their willingness to receive experimental US-guided extraoral mandibular nerve block for postoperative analgesia. The experimental block applied prior to lower third molar alveolectomy, was followed by standard intraoral inferior alveolar nerve block. In the control group, patients received only intraoral block of inferior alveolar nerve. All patients reported pain level (visual analogue scale, VAS) right after the application of blocks. The next day, patients reported duration of pain-free time and the use of analgesic.

Results:The US-guided extraoral mandibular nerve block prolonged the pain-free time to 8 h (vs. 4 in control group, P < 0.001) and reduced NSAIDs use (12 patients needed analgesic in experimental vs. 17 patients in control group, P = 0.038). The application of experimental block was less painful (VAS = 2) than the application of intraoral inferior alveolar nerve block (VAS = 4, P = 0.011). In 8/18 patients in the experimental group US-guided extraoral mandibular nerve block solely achieved adequate surgical anesthesia.

Conclusion:US-guided extraoral mandibular nerve block prolonged pain-free period and reduced the use of NSAIDs after lower third molar alveolectomy, thus proving to be successful analgesia method for this dental surgery.

Clinical trial registration:https://classic.

Clinicaltrials:gov/ct2/show/NCT06009302 , identification number: NCT06009302 , date of registration: 18/08/2023.

Document Type

Article

PubMed ID

39232703