A Comparative Study of Efficacy for Extra-Oral vs. Intra-Oral Mandibular Nerve Block in Arch Bar Fixation for Management of Mandibular Fractures.

Purpose: The aim of the study was to evaluate and compare the efficacy of extra-oral mandibular nerve block (infra-zygomatic approach/lateral approach) vs. intra-oral (Gow-Gates) mandibular nerve block in arch bar fixation for management of mandibular fractures.

Methodology: A total of 200 patients reported with maxillofacial fractures. Out of them, 50 patients who required arch bar fixation for management of mandibular fractures were divided into two groups: Group I: Extra-oral and Group II: Intra-oral mandibular nerve blocks. The intra-operative pain, time of onset of anaesthesia, volume of drug administered, depth of needle insertion, repetition of injections and postoperative complications were analysed.

Results: In Group I (Extra-oral nerve block), the time of onset of anaesthesia, volume of anaesthesia administered, needle depth, number of repetition of injections and postoperative complications were more as compared to Group II. No significant difference was observed in intra-operative pain score between two groups.

Conclusion: Intra-oral approach with Gow-Gates technique seemed to be efficient and easy to operate as compared to extra-oral approach, for arch bar fixation of mandibular fractures in an output door setting, as extra-oral approach is more technique-sensitive and may lead to certain complications which require operation theatre setting with medical attention.