Ultrasound-guided lateral pterygoid muscle injection for inferior alveolar nerve block in sagittal split ramus osteotomy: a three-case series
Year: 2025
Type: article
Study design: Case Report
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.
Source: JA Clinical Reports
Institutions: Nihon University, Shizuoka City Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,390
OpenAlex ID: W4411328070