NERVUS ALVEOLARIS INFERIOR BLOKAJINDA KLASİK, GOW-GATES VE AKİNOSİ TEKNİKLERİNİN KARŞILAŞTIRILMALI OLARAK DEĞERLENDİRİLMESİ

Yıl 1996, Cilt: 30 Sayı: 4, 198 - 205, 08.08.2012

Zekai Yaman Şevket Özkal Cem Gürgan Bahadır Gürbüzer

Öz

Sunulan çalışmada Nervus alveolaris inferior blokajı amacıyla uygulanan Klasik, Gow-Gates ve Akinosi ınaııdibüler anestezi teknikleri, alt birinci ve ikinci molar dişlerine çekim endîkasyonu konulan 192 hastada karşılaştırmalı olarak incelendi. Çift-kör ve rastgele (randomize) olarak yürütülen çalışmada enjeksiyonun verdiği ağrı, pozitif aspirasyon, bloke olan sinirler ve diş çekiminin verdiği ağrı kriterleri değerlendirildi. Enjeksiyonun verdiği ağrının klasik yöntemde en fazla olduğu, Akinosi tekniğinin bunu takip ettiği, Gow-Gates tekniğinde ise en az olduğu gözlendi. Pozitif aspirasyon değerleri klasik teknikte %17.18, Gow-Gates tekniğinde %3.12 ve Akinosi tekniğinde %9.37 olarak bulundu. Nervus alveolaris inferİorun on dakika içerisindeki blokaj oranı, klasik teknikteki %87.5, Gow-Gates tekniğinde %95.3, Akinosi tekniğinde ise %90.6 olarak tespit edildi. Diş çekimi esnasında duyulan ağrı incelendiğinde, Gow-Gates tekniğinin en derin anesteziyi sağladığı, Akinosi tekniğinde ise en fazla ağrı duyulduğu izlendi. 

Anahtar Kelimeler

Nervus alevolarİs inferior, mandibüler anestezi, klasik teknik, Gow-Gates tekniği, Akinosi Tekniği.

COMPARATIVE EVALUATION OF THE CONVENTIONAL, GOW-GATES AND AKINOSI TECHNIQUES IN INFERIOR ALVEOLAR NERVE BLOCK

Öz

Tiiis double-blind, randomised study compared the effectiveness of the Conventional, Gow-Gatesand Akinosi, madibularblock injection techniques in 192 requiring anesthesia for took extraction. Criteria for evaluation were as follows: pain experienced during injection (determined by using verbal and visual analogue scalas), the frequency of positive aspiration, nerves anesthetised with a single injection within 5 and 10 minutes, and pain exerienced during tooth extraction (determined by using verbal and visual analogue scalas). Results showed the conventional block technique was die mostpainfid method when the pain experienced 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 die Gow-Gates and Akinosi injection, but there were no significant 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% intthe Gow-Gatesand 90.6% in the Akinosi groups. These values were not found to be significant statistically. It was concluded that the Gow-Gates technique was more effective in blocking not only die inferior alveolar nerve but also oilier related nerves such as long buccal, auriculotemporal and mylohyoid nerves which may be played a role in the innervation of the lower morals. Althoung, conventional technique was faster and equally effective in blocking of the inferior alveolar nerve, it yielded more positive aspirations than others. 

Anahtar Kelimeler

Inferior alveolar nerve, mandibular anesthesia, conventional block injection technique, Gow-Gates technique, Akinosi technique