I blocchi di Gow-Gates, di Akinosi-Vazirani e di Mariuzzi eseguiti da un neofita

Summary After patient’s informed consent, the novice’s ability to learn three different nerve block techniques and their efficacy were studied. The first stage of learning was the performance of Gow-Gates and Akinosi-Vazirani mandibular nerve blocks, and Mariuzzi inferior alveolar nerve block, on three groups of patients scheduled for oral surgery. Then, the blocks were performed again on 25 (Gow-Gates), 20 (Akinosi-Vazirani) and 20 (Mariuzzi) patients. In this second stage of study the necessity for further infiltrations, the pain due to the block, the intra and postoperative pain, the number of positive aspirations, the pulp test on ipsilateral first premolar and central incisive were studied. In all patients prilocaine 3% with felypressin, 1.8 ml, were used. The learning stage was over after 13 patients treated with the Gow-Gates block, 14 with Akinosi-Vazirani block and 10 with Mariuzzi block. The variations of the first premolar sensitivity, were evaluated with the pulp test only when, an anaesthesia delay of the central incisive was observed. During the second stage of study, anaesthesia after Gow-Gates block, resulted earlier on first premolar than on central incisive. The patients treated with the Gow-Gates technique did not need further blocks of buccinator nerve, whereas the other patients needed it, (Akinosi-Vazirani 9 infiltrations, p<0,01; Mariuzzi 7 infiltrations, p<0,01). From results it appears that pain was light during block execution and absent during surgery, postoperative analgesia was prolonged and there were three positive aspirations during Gow-Gates blocks execution. The anaesthesia delay regarding the central incisive, observed after Gow-Gates block, may be explained by several factors: accessory innervations, peripheral nerve fibres located in the core of mandibular nerve, local anaesthetic dilution in tissues, etc.