Nervus alveolaris inferior blokajında klasik gow-gates ve akinosi tekniklerinin karşılaştırılmalı olarak değerlendirilmesi

Comparative evaluation of the conventional gow-gates and akinosi techniques in inferior alveolar nerve block

Özet

Sunulan çalışmada Nervus alveolaris inferior blokajı amacıyla uygulanan Klasik, Gow-Gates ve Akinosi man-dibüler anestezi teknikleri, alt birinci ve ikinci molar dişlerine çekim endikasyonu konulan 192 hastada kar¬şılaştırmalı olarak incelendi. Çift-kör ve rastgele (ran¬domize) olarak yürütülen çalışmada enjeksiyonun ver¬diği ağrı, pozitif aspirasyon, bloke olan sinirler ve diş çekiminin verdiği ağrı kriterleri değerlendirildi. En¬jeksiyonun verdiği ağrırım klasik yöntemde en fazla ol¬duğu, Akinosi tekniğinin bunu takip ettiği, Gow-Gates tekniğinde ise en az olduğu gözlendi. Pozitif aspiras¬yon değerleri klasik teknikte %17.18, Gow-Gates tekni¬ğinde %3.12 ve Akinosi tekniğinde %9.37 olarak bu¬lundu. Nervus alveolaris inferiorun on dakika içerisin¬deki blokaj oram, klasik teknikteki %87.5, Gow-Gates tekniğinde %95.3, Akinosi tekniğinde ise %90.6 olarak tespit edildi. Diş çekimi esnasında duyulan ağrı ince¬lendiğinde, Gow-Gates tekniğinin en derin anesteziyi sağladığı, Akinosi tekniğinde ise en fazla ağrı duyuldu¬ğu izlendi.

Abstract

This double-blind, randomised study compared the effecti¬veness of the Conventional, Gow-Gatesand Akinosi, madi-bular block injection techniques in 192 requiring anesthe¬sia for tooh extraction. Criteria for evaluation were as fol¬lows: pain experienced during injection (determined by using verbal and visual analogue scalas), the frequency of positive aspiration, nerves anesthetised with a single injec¬tion within 5 and 10 minutes, and pain exerienced during tooth extraction (determined by using verbal and visual analogue scalas). Remits showed the conventional block technique was Hie most painful method when tlie pain expe¬rienced during injection was considered. Conventional, Gow-Gates and Akinosi techniques, respectively, yielded 17.18%, 3.12%, and 9.37% positive aspirations. Onset of anesthesia was sligthly faster with conventional than with Hie Gow-Gates and Akinosi injection, but there were no sig¬nificant differences among the techniques at 10 minutes. Tlie overall success rate of inferior alveolar nerve anethesia with a single injection to be 87.5% in theconventional, 95.3 % int the Gow-Gates and 90.6% in the Akinosi gro¬ups. These values were not found to be significant statisti¬cally. It was concluded that the Gow-Gates technique was more effective in blocking not only the inferior alveolar ner¬ve but also oilier related nerves such as long buccal, auricu¬lotemporal and mylohyoid nerves which may be played a role in the innervation of the lower morals. Althoung, con¬ventional technique was faster and equally effective in bloc¬king of the inferior alveolar nerve, it yielded more positive aspirations than others.