TRUNCAL ANESTHESIA OF THE MAXILLARY NERVE FOR OUTPATIENT SURGICALLY ASSISTED RAPID MAXILLARY EXPANSION

We present our experience of transcutaneous truncal anaesthesia of the maxillary nerve in association with transmucosal anaesthesia of the s phenopalatine ganglion in surgically assisted rapid maxillary expansio n. Twelve patients with a skeletal transverse discrepancy of the maxil la were treated in our department from 1994 to 1995. Maxillary transcu taneous nerve block was done,vith a Quincke 8 cm spinal needle togethe r with transmucosal anaesthesia of the sphenopalatine ganglion. Mepiva caine without adrenaline and sodium bicarbonate 1/10 was used for trun cal anaesthesia and lidocaine-prilocaine cream for transmucosal anaest hesia. A Le Fort I osteotomy, lateral nasal wall osteotomy, pterygomax illary osteotomy, and a palatal osteotomy were done for all patients b efore the maxillary expansion. Total anaesthesia of the maxillary area facilitated the operations and appreciably reduced the amount of post operative pain. The ease of achieving effective anaesthesia before and after operation and the absence of side-effects make this form of ana esthetic particularly useful in surgically assisted rapid maxillary ex pansion.