Does Peripheral Nerve Stimulator-Guided Extraoral Mandibular Nerve Block Provide Effective Anaesthesia for Third Molar Surgery: A Prospective Interventional Study.

Abstract

Background/aim: Mandibular nerve block provides good quality and long-lasting analgesia. In situations necessitating extraoral nerve-blocking procedures, clinicians may find it technically challenging to administer this block due to its uncertain surface landmarks or distorted anatomy. Peripheral nerve stimulator is a device used to electrically stimulate the peripheral and terminal branches of the nerve.

Methods: This prospective interventional clinical study was carried out in the Department of Oral and Maxillofacial Surgery, SRM Kattankulathur Dental College And Hospital in patients requiring surgical extraction of mandibular third molar. Patients were divided into two groups: control group and test group based on computer-generated randomization. Control group patients underwent impaction procedure after conventional extraoral mandibular nerve block, while test group patients underwent impaction procedure after PNS-guided extraoral mandibular nerve block.

Results: Statistical analysis was done and the mean length of anaesthesia between the two groups was compared using a paired t test, and the mean pain levels up to six hours were compared using a Wilcoxon signed-rank test. Out of 42 patients, 25 were male and 17 were female. The mean age was 28.36 years. The age range was 19-52 years. In both control and test groups, no patients had failure of anaesthesia, and no one complained of pain during the procedure; hence, no supplemental injections were given. Visual analogue scale score remained (score ≤ 2) up to 6 h for patients in test group.

Conclusion: Thus, using a peripheral nerve stimulator guarantees the success of the block. For patients undergoing third molar surgery, it is a reliable, secure, and safer option for administering extraoral mandibular nerve block. In the future, the use of this technique could extend to pain control during major procedures such as cleft lip and palate, orthognathic, tumour removal, and facial injuries too.