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Regional anaesthetic techniques in oral and maxillofacial surgery 

Regional anaesthetic techniques in oral and maxillofacial surgery
Regional anaesthetic techniques in oral and maxillofacial surgery

John Gerard Meechan

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date: 27 October 2021

Many procedures in oral surgery can be performed under local anaesthesia with or without sedation. In addition, local anaesthesia can be used to supplement general anaesthesia. There are advantages of local anaesthesia during general anaesthesia, and these include haemostasis (from the vasoconstrictor in many local anaesthetic solutions), reduced surgical stimulation, and improved postoperative pain control.

Local anaesthetics that are used intraorally are often supplied in prefilled cartridges of varying volumes, ranging from 1.8 to 2.2 ml. The concentration of adrenaline (epinephrine) in some prefilled cartridges for dental use (1:80 000 [12.5 mg/ml]) is greater than that used in other sites. Some syringes that are used by dentists do not permit aspiration when prefilled cartridges are used and these cannot be recommended as the mouth and perioral structures are well vascularized so inadvertent intravascular injection can occur. Positive aspirates may occur in around 20% of intraoral regional blocks.

This chapter will describe infiltration, regional block, and specialized injections that are used to provide local anaesthesia of the mouth and perioral structures.

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