文档介绍：LocalLocal AnesthesiaAnesthesia TechniquesTechniques inin
OralOral andand MaxillofacialMaxillofacial SurgerySurgery
SeanSean . Healy,Healy, .
Oral and Maxillofacial Surgery
FrancisFrancis . Quinn,Quinn, .
Otolaryngology – Head and Neck Surgery
UniversityUniversity ofof TexasTexas MedicalMedical BranchBranch
October 2004
Overview:Overview:
•• PurposePurpose ofof locallocal anesthesiaanesthesia
•• AnatomyAnatomy ofof maxillarymaxillary andand mandibularmandibular
nervousnervous innervationinnervation
•• TechniquesTechniques ofof locallocal anesthesiaanesthesia blocksblocks
•• monly usedused locallocal anestheticsanesthetics
•• plications withwith locallocal anesthesiaanesthesia
LocalLocal Anesthetics:Anesthetics:
•• Role:Role:
–– DecreaseDecrease intraoperativeintraoperative andand postoperativepostoperative
painpain
–– DecreaseDecrease amountamount ofof generalgeneral anestheticsanesthetics usedused
inin thethe OROR
–– IncreaseIncrease patientspatients cooperationcooperation
–– DiagnosticDiagnostic testing/examinationtesting/examination
AnatomicalAnatomical considerations:considerations:
•• TrigeminalTrigeminal nerve:nerve:
– Sensory divisions:
• Ophthalmic division V1
• Maxillary division V2
• Mandibular division V3
– Motor division:
• Masticatory- masseter, temporalis, medial and lateral
pterygoids
• Mylohyoid
• Anterior belly of the digastric
• Tensor tympani
• Tensor veli palatini
MaxillaryMaxillary DivisionDivision (V2):(V2):
•• ExitsExits thethe craniumcranium viavia foramenforamen rotundumrotundum ofof thethe
greatergreater wingwing ofof thethe sphenoidsphenoid
•• TravelsTravels atat thethe superiorsuperior mostmost aspectaspect ofof thethe
pterygopalatinepterygopalatine fossafossa justjust posteriorposterior toto thethe
maxillamaxilla
•• BranchesBranches divideddivided byby location:location:
– Inter-cranial
– Pterygopalatine
– Infraorbital
– Facial