A regional approach to financial crisis prevention: lessons by Jan Joost Teunissen (editor)

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By Jan Joost Teunissen (editor)

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Example text

Nevertheless a defect in a territory can be corrected by troncular distal block on the branches of the mandibular nerve (auriculotemporal, mental, alveolar inferior). Many indications for the mandibular block in surgery. Alls acts on the lower lip, the mandibular skin zone and temporal skin zone, the chin; mandibular bone surgery. And inferior dental surgery. In emergency, fracture of the mandible, wound of the tongue, superficial wounds in a mandibular territory. The other indications are analgesia: ƒ is postoperative, of bone surgery, tegumental surgery (cutaneous tumours) or lingual; ƒ is in the rebellious pains with other analgesics.

The territory of inferior alveolar nerve is an inferior tooth; sometimes the lingual nerve is reached [26]. The indications for the inferior alveolar block are a dental surgery or also for rescue a defective mandibular block. This block is very easy and frequently performed by odontologists. A possible lesion of the lingual nerve with dysesthesias of the lingual edge and loss of the taste [7, 26] are noted; a lesion of the facial nerve (resolutive paralysis) is also noted. More rarely [7]: a superior laryngeal block, vascular lesion, an injection will intra muscular (pterygoid) involving a blocking temporomandibular articulation.

However for broad acts covering several territories it is to better extend nervous blocking; thus for a lipostructure of the face interesting the maxillary territory and the mandibular territory in their totality. It is advised to make maxillary and mandibular blocks at their origin, if one chooses a regional anaesthesia. M AXILLOFACI AL SURGERY In this indication the alone regional anaesthesia is exceptionally used [7]. Nevertheless simple gestures as the mandibular osteotomy can be carried out under blocks [21].

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