Twin Mix Inferior Alveolar Nerve Anaesthesia for Transalveolar Extraction of Mandibular Third Molar Surgery: Review of Current Evidence

D. Bhargava, Dr. Siva Kumar Beena, Dr. Shubhanshi Kangloo, Dr. Monica Gupta
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Abstract

Utmost recurrent surgical process executed in oral & maxillofacial surgery is transalveolar extraction (TAE) of mandibular impacted 3rd molar which consequences to surgical trauma to surrounding soft & hard tissues during the process of tooth removal. Post-operative sequalae like pain, facial swelling & sometimes trismus follow TAE. Dexamethasone is commonly used steroid post-operatively and studies have revealed clinical aids in refining patients’ quality of life (QoL). To improve the QoL after TAE of third molars, use of twin-mix anaesthesia is proposed, where a combination of local anaesthetic solution and steroid is administered as a single injection, thus, negating the requirement of additional route of administration for dexamethasone. The advantages for this technique are, solitary method for dual drug delivery, reduced sensation of sting while injecting owing to altered pH of solution, short latency period, prolonged duration of anaesthesia & amended QoL post operatively. Twin Mix inferior alveolar nerve anaesthesia is found beneficial by reducing patient discomfort and enhancing patient compliance for surgeries of the mandible.
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双混合下牙槽神经麻醉用于下颌第三磨牙经牙槽拔牙手术:现有证据的回顾
在口腔颌面外科手术中,最常见的复发性手术是下颌阻生第三磨牙的经牙槽拔牙(TAE),这导致在拔牙过程中对周围软硬组织造成手术创伤。术后后遗症如疼痛、面部肿胀,有时伴有牙关紧闭。地塞米松是手术后常用的类固醇,研究表明临床有助于改善患者的生活质量(QoL)。为了提高第三磨牙TAE术后的生活质量,建议采用双混合麻醉,局部麻醉溶液和类固醇作为单次注射的组合,从而不需要额外的地塞米松给药途径。该技术的优点是:采用单药双重给药的方法,由于溶液pH改变,注射时刺痛感减轻,潜伏期短,麻醉时间延长,术后生活质量提高。双混合下牙槽神经麻醉可减少患者不适,提高患者对下颌骨手术的依从性。
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