Ultrasound-guided lateral pterygoid muscle injection for inferior alveolar nerve block in sagittal split ramus osteotomy: a three-case series.

IF 1 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-06-16 DOI:10.1186/s40981-025-00799-4

Keisuke Nakazawa, Ryota Tsukui, Yoshio Ohyama, Yoshinori Inaba, Junko Tamari, Takahiro Suzuki

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引用次数: 0

Abstract

Background: Sagittal split ramus osteotomy is often associated with significant postoperative pain. Intraoral inferior alveolar nerve blocks have variable success rates and higher risks of vascular complications, while ultrasound-guided approaches to the pterygomandibular space require precise needle placement in a narrow anatomical space. We present a novel perioperative application of ultrasound-guided lateral pterygoid muscle injection for regional anesthesia.

Case presentations: Three female patients underwent bilateral sagittal split ramus osteotomy under general anesthesia. After anesthesia induction, ultrasound-guided lateral pterygoid muscle injections were performed using 10 mL of 0.25% levobupivacaine. All patients demonstrated excellent postoperative pain control (numerical rating scale score ≤ 2) with minimal analgesic requirements and no complications.

Conclusion: This novel lateral pterygoid muscle injection technique for perioperative analgesia demonstrates promising clinical efficacy through a simplified ultrasound-guided approach, providing effective opioid-free postoperative pain management for sagittal split ramus osteotomy.

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超声引导翼侧肌注射治疗矢状分叉支截骨术中下牙槽神经阻滞3例。

背景：矢状分叉支截骨术常伴有明显的术后疼痛。口内下牙槽神经阻滞成功率不同，血管并发症风险较高，而超声引导下翼下颌间隙入路需要在狭窄的解剖空间内精确放置针。我们提出了一种新的围手术期应用超声引导翼侧肌注射区域麻醉。病例介绍：3例女性患者在全身麻醉下行双侧矢状分支截骨术。麻醉诱导后，超声引导下翼状外侧肌注射0.25%左布比卡因10 mL。所有患者均表现出良好的术后疼痛控制（数值评定量表评分≤2），镇痛需求最小，无并发症。结论：这种新型翼状外侧肌注射围手术期镇痛技术通过超声引导下的简化入路，具有良好的临床疗效，为矢状分叉支截骨术后无阿片类药物的疼痛管理提供了有效的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.