The patient was made to lie down in supine position in operation table below the operators elbow level. Patients were not under sedation and not under premedication. Internal suspension wiring, Intermaxillary fixation, reduction of zygoma and plate fixation at lateral wall of orbit were the surgical procedures done under nerve lock.Īfter infiltration in mucosa, and the path of the puncture with 2% lidocaine with epinephrine 1:80,000 the block was performed with a 25G and 1–5/8 inch long needle. After approval by the Hospital Ethics Committee and with the consent of patients, the maxillary nerve block was performed in seven adult patients, ASA I-II, aged between 20 and 45 year who underwent open reduction and fixation for maxillary and zygoma fractures. Over a Two-year period (January 2009 to January 2011), seven patients with fractures of the zygomatic complex and maxilla fracture treated under maxillary nerve block were reported. The objective of this study is to assess the efficacy of the maxillary nerve block in maxillary and zygomatic bone fractures reduction and fixation. Regional anesthesia present several advantages over general anesthesia, including smoother recovery, fewer side effects, residual analgesia into the postoperative period, earlier discharge from the recovery room and reduced costs. Fractures of the zygomatic arch and bone injuries are common in isolated anterior side of the face due to its prominence. They are easy to perform and may prolong postoperative analgesia. Facial nerve blocks may be used in ambulatory surgery as a single technique or combined with general anesthesia or intravenous sedation. This technique, the maxillary nerve block via the pterygopalitine fissure, provides the patient with a profound block of maxillary nerve and allows the dentist, the ability to do procedures anywhere in the maxillary quadrant that has been anesthetized. Despite the advantages of many of these newer techniques, conventional needle and syringe procedures remain the cornerstone of local anesthesia for most dental practitioners. The dental industry has introduced a number of new local anesthetic techniques to do surgery in maxilla and mandible. Of all medical specialists, there are indeed few who utilize local or regional analgesia as effectively, as do the dentists. Regional analgesia enjoys widespread and frequent use throughout the various disciplines of medicine.
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