文档介绍：Nerve Block Anesthesia in Dentistry
Dept. of Oral & Maxillofac Surg.
Affiliated Ninth People’s Hospital
Shanghai Second Medical University
Xudong Wang, DDS,MD
2017/11/11
Local Anesthesia
REVIEW
Topical Anesthesia(表面麻醉)
Local Infiltration( 局部浸润麻醉)
small area anesthetized (one or two teeth)
solution deposited near terminal nerve endings
8 8 , 2 2 extractions
Nerve Block ( 阻滞麻醉)
deposited near large nerve trucks
2017/11/11
Advantages of nerve block
Larger analgesia area & avoid several injections
Less dosage & long--lasting
Away from the lesion -- avoid spreading of infection & tumor seeding
Less tissue deformity post-injection -- plastic surgery
Better Anesthetic Effectiveness
2017/11/11
Ophthalmic Nerve
Maxillary Nerve
Mandibular Nerve
Anatomy of Trigeminal Nerve
(三叉神经)
2017/11/11
Maxillary Nerve Anesthesia
Posterior superior alveolar block(上牙槽后神经)
Infraorbital block (眶下神经)
Greater palatine block (腭大神经)
Nasopalatine block(鼻腭神经)
Less dense bone/ less anatomic variation
Mandibular Nerve Anesthesia
Nerve Block Anesthesia
{
{
al
Palatal
2017/11/11
Posterior Superior Alveolar Block (PSA Block 上牙槽后神经阻滞, Tuberosity Injection上颌结节注射法)
Spread of analgesia 麻醉范围
876
678
Pulp & alveolar process
al
- gingiva(牙龈)
- periodontium (牙周膜)
- periosteum (骨膜)
(al root)
2017/11/11
Posterior Superior Alveolar Block (PSA Block)
Injection site
7
7
distal apex
al fold
Angulation
Target area
2017/11/11
Posterior Superior Alveolar Block (PSA Block)
Depth of ration
Average adult 16-20 mm
Small adult and children 14mm
-2ml
Injection amount
Pterygoid plexus(翼丛)
Time to effect
5-10 min
Aspiration(回抽)
Hematoma(血肿)
2017/11/11
Posterior Superior Alveolar Block
2017/11/11
Infraorbital Block (IO Block 眶下神经阻滞)
Indications
5
5
dental procedure
Upper lip & Paranasal Minor Surgery
Landmark of
Infraorbital foramen(眶下孔)
5-10mm below the infraorbital rim
1-4mm medial to the pupil of the eye
2017/11/11