Comparative Analysis Between Classical Inferior Alveolar Nerve Block Technique (IANB) and Vazirani Akinosis Closed Mouth Approach for Mandibular Nerve Block
Author(s): Rahaf A Alqahtani, Nasser M Alshahrani, Ibrahim A Alammari, Majed D Alshehri, Mahmoud J Almalki, Osama Y Alfaifi, Abdulrahman H Al-Salem, Mohammed Saber Alalyani, Dhafer Ali Alasmari, Turki Mohammed Al-Shehri, Abdulelah A Alnami, Mohammad Zahir Kota, Mohammed S Alshahrani, Abdulrahman Saad Al Hadhir, Aedh Hussain Alqahtani, Mohmmad M Alqahtani, Noura Alqahtani, Fatemah Alajmi, Arwa Alshehri, Zishan Haider and M Zakirulla*
Abstract
This study is designed to evaluate the efficacy of the Vazirani Akinosis (V-A) mandibular block technique in achieving local anesthesia for the procedures in the mandibular arch. Here the subject design is used to compare onset of anesthesia, quality of anesthesia, branches of the mandibular nerve affected, and complications with both the Akinosis technique and classical inferior alveolar nerve block technique (IANB).
Materials and Methods. Female adult patients with healthy medical records were participants for this study. 50 female adult patients between age group 15-65 were randomly selected for each technique. Total number of patients were 100. A 27-gauge needle was used for both the nerve block technique. 2% scaidicane (Mepivacaine) used as the local anesthesia with vasoconstrictor. 1.8 ml of solution was given for both the nerve block technique. Pain during the insertion was measured using visual analog scale. Chi-square, Anova test was used for statistical analysis.
Results: V-A technique had 69% painless injection compared to IANB (43%). Onset of numbness in IANB technique was 1 to 3 min in 95% of cases compared to V-A (66%). Achieving complete anaesthesia, the technique had similar experience. Failure rate was slightly high in case of V-A (27%) compared to IANB (15%).
Conclusion: Except for slower onset of lip anesthesia, less pain during injection and fewer post injection complications in Vazirani-Akinosi technique all other parameters were of same efficacy as classical inferior alveolar nerve block technique. This has strong clinical applications as in cases with limited mouth opening, apprehensive patients. Hence the Vazirani-Akinosi technique is the indicated technique of choice.