Post operative pain relief through intermittent mandibular nerve block

Area of Science:

• Anesthesiology
• Oral and Maxillofacial Surgery

Background:

• Mandibular nerve blocks are crucial for procedures in the mandibular region, offering pain relief and avoiding opioid side effects.
• Maxillofacial trauma often necessitates surgical intervention, requiring effective anesthesia and analgesia.

Observation:

• A patient with right parasymphyseal mandibular fracture underwent open reduction and internal fixation under general anesthesia.
• A lateral extraoral approach was used to administer 0.25% bupivacaine via an 18-gauge IV cannula for intraoperative and postoperative analgesia.
• The patient received 4 ml boluses every 12 hours for 48 hours postoperatively.

Findings:

• Visual Analog Scale (VAS) scores remained below 4 throughout the observation period, indicating effective pain management.
• The primary side effect was temporary numbness of the ipsilateral lower jaw, which resolved upon discontinuation of the local anesthetic.
• The patient was discharged after four days with no long-term adverse effects.

Implications:

• Mandibular nerve blocks are a viable and effective analgesic strategy for maxillofacial trauma surgery.
• This technique offers a favorable safety profile, minimizing the need for systemic analgesics like opioids or NSAIDs.
• Further research can explore long-term outcomes and optimal dosing for various maxillofacial procedures.