J Dent Anesth Pain Med.  2016 Jun;16(2):111-116. 10.17245/jdapm.2016.16.2.111.

Success rates of the first inferior alveolar nerve block administered by dental practitioners

• Kriangcherdsak Y
• Raucharernporn S
• Chaiyasamut T
• Wongsirichat N

• KMID: 2328853
• DOI: http://doi.org/10.17245/jdapm.2016.16.2.111

Abstract

BACKGROUND
Inferior alveolar nerve block (IANB) of the mandible is commonly used in the oral cavity as an anesthetic technique for dental procedures. This study evaluated the success rate of the first IANB administered by dental practitioners.
METHODS
Volunteer dental practitioners at Mahidol University who had never performed an INAB carried out 106 INAB procedures. The practitioners were divided into 12 groups with their advisors by randomized control trials. We recorded the success rate via pain visual analog scale (VAS) scores.
RESULTS
A large percentage of the dental practitioners (85.26%) used the standard method to locate the anatomical landmarks, injecting the local anesthetic at the correct position, with the barrel of the syringe parallel to the occlusal plane of the mandibular teeth. Further, 68.42% of the dental practitioners injected the local anesthetic on the right side by using the left index finger for retraction. The onset time was approximately 0-5 mins for nearly half of the dental practitioners (47.37% for subjective onset and 43.16% for objective onset), while the duration of the IANB was approximately 240-300 minutes (36.84%) after the initiation of numbness. Moreover, the VAS pain scores were 2.5 ± 1.85 and 2.1 ± 1.8 while injecting and delivering local anesthesia, respectively.
CONCLUSIONS
The only recorded factor that affected the success of the local anesthetic was the administering practitioner. This reinforces the notion that local anesthesia administration is a technique-sensitive procedure.

Keyword

First injection; Inferior alveolar nerve; Nerve block; Pain measurement; Pain score; VAS

MeSH Terms

Anesthesia, Local
Dental Occlusion
Fingers
Hypesthesia
Mandible
Mandibular Nerve*
Methods
Mouth
Nerve Block
Pain Measurement
Syringes
Tooth
Visual Analog Scale
Volunteers

Figure

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  Fig. 1 The standard IANB injection technique.

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  Fig. 2 The side of IANB injection.

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  Fig. 3 The quantity of local anesthetic remaining in the syringe after IANB.

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  Fig. 4 Subjective and objective onset of anesthesia in the patients after IANB.

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  Fig. 5 Duration of anesthesia in the patients after IANB.

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