EFFICACY OF EXTRA-ORAL VS INTRA-ORAL MANDIBULAR NERVE BLOCK IN ARCH BAR FIXATION FOR MANAGEMENT OF MANDIBULAR FRACTURES
DOI:
https://doi.org/10.48047/HM.10.2.2024.1502-1508Keywords:
Mandible fracture, extraoral, intraoralAbstract
OBJECTIVE: This study aimed to compare the effects of intraoral and extraoral management strategies for mandibular angle fractures and to offer cost estimates.
METHODS: 150 people in all were reported to have had maxillofacial fractures. 50 of them were split into two groups based on the need for arch bar fixation to treat mandibular fractures: Group II: Intraoral mandibular nerve blocks; Group I: Extra-oral. We analyzed the postoperative complications, depth of needle insertion, volume of drug administered, timing of anesthesia onset, intraoperative pain, and repetition of injections.
RESULTS: Of the 150 patients who had mandibular angle fractures, 26% received extraoral treatment, and 76% underwent open reduction internal fixation by an intraoral technique. P = 0.009 indicates that 36% of the intraoral group and 69.6% of the extraoral group experienced any complications. However, in propensity-weighted analysis, the likelihood of any complication was no longer statistically significant (odd ratio 0.28; 95% confidence interval, 0.08 to 1.02; P = 0.053), even though it was less common in intraoral cases. The intraoral method resulted in a considerable reduction in operating room time. The duration of anesthesia, amount of anesthesia given, needle depth, number of injection repetitions, and postoperative problems were all higher in Group I (Extra-oral nerve block) than in Group II. The intra-operative pain score did not significantly differ between the two groups.
CONCLUSION: For the purpose of arch bar fixation of mandibular fractures in an output door setting, the intra-oral approach using the Gow-Gates technique appeared to be more effective and simpler to use than the extra-oral approach. This is because the extra-oral approach is more technique-sensitive and may result in certain complications that need to be addressed in an operating room with medical assistance. When clinically suitable, we advise treating mandibular angle fractures by an intraoral technique. Yet, this can save the health care system a substantial amount of money while producing a success rate that is equivalent.
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