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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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Related Experiment Video

Updated: Mar 31, 2026

Ethanol-Induced Cervical Sympathetic Ganglion Block Applications for Promoting Canine Inferior Alveolar Nerve Regeneration Using an Artificial Nerve
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Challenges in Developing an Effective Inferior Alveolar Nerve Block Guide.

Tomoyasu Noguchi, Kento Odaka, Ken-Ichi Fukuda

    Anesthesia Progress
    |March 29, 2026
    PubMed
    Summary
    This summary is machine-generated.

    A new 3D-printed guide for the inferior alveolar nerve block (IANB) shows promise for improving dental anesthesia safety and reliability. While requiring more time and resources, the IANB guide demonstrated good precision in initial testing.

    Keywords:
    3D printingCAD/CAM technologyDental anesthesiaInferior alveolar nerve blockVirtual planning

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    Area of Science:

    • Dentistry
    • Anesthesiology
    • Biomedical Engineering

    Background:

    • The inferior alveolar nerve block (IANB) is crucial in dental procedures.
    • IANB failure can occur due to operator and anatomical variations, leading to complications.

    Purpose of the Study:

    • To develop and evaluate a 3D-printed guide to enhance the safety and reliability of the IANB.
    • To assess the accuracy, production efficiency, and cost-effectiveness of the novel IANB guide.

    Main Methods:

    • Three types of IANB guides were designed using dentition and the lingula as reference points.
    • Digitalization of dental models and mandibles via intraoral scanning and CT scans.
    • 3D printing technology was employed to fabricate the IANB guides for evaluation.

    Main Results:

    • The average error in needle tip positioning was 0.63 mm, indicating high precision.
    • Average fabrication time was 201 minutes, with material costs averaging $21.60.
    • Biocompatible resin and support materials were used, with specific quantities detailed.

    Conclusions:

    • The 3D-printed IANB guide demonstrates potential for improving the safety and efficacy of dental anesthesia.
    • While precision is suitable, further accuracy improvements are needed for widespread clinical application.
    • The guide represents a promising advancement in dental regional anesthesia techniques.