Research ArticleOpen AccessGoogle Scholar indexed
Evaluation of Bilateral Mental Nerve Block as an Alternative to General Anesthesia for Resection of Lower Lip Tumors
Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Anesthesia and Surgical Intensive Care Department, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Anesthesia and Surgical Intensive Care Department, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Anesthesia and Surgical Intensive Care Department, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Anesthesia and Surgical Intensive Care Department, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 1 Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 2 Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 3 Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 4 Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 5 Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 6 Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 7 Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 8 Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 9 Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 10 Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 11 Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 12 Department of Surgical Oncology, Mansoura Oncology Center (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 13 Anesthesia and Surgical Intensive Care Department, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 14 Anesthesia and Surgical Intensive Care Department, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 15 Anesthesia and Surgical Intensive Care Department, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- 16 Anesthesia and Surgical Intensive Care Department, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Copy link · social · email
Abstract
Objective: Nerve blockade is commonly used in oncosurgical procedures as an alternative to general anesthesia for older patients and those with significant medical problems. We report a single tertiary oncology center experience in performing various lip resections and reconstructive techniques using this technique. Patients and methods: sixty patients with lower lip tumors were enrolled into this study with exclusion of refusing, non-compliant and critically ill patients. A solution of 4 ml 2% Lidocaine and epinephrine was put in a 5 ml syringe. Half the solution (2 ml) was injected into each side with a 23 gauge needle and after 5 minutes the surgical resection was carried out after testing for anesthesia. Results: The mean age was 68 ± 6.2 years. The mean ASA score was 3 ± 0.75. There were 4 cases who expressed painful sensation and their operations were completed with fentanyl increments. Mean hospital stay was 1 ± 0.75 days. There were three cases of wound gaping who were treated with secondary closure in an outpatient basis. One patient expressed postoperative acute ischemic heart pain that was managed with anti-ischemic measurements. Conclusion: Bilateral mental nerve block is a safe and effective alternative to general anesthesia in lower lip tumors’ resection especially in older patients and those with poor tolerance for general anesthesia provided that there is no need for cervical nodal dissection.
KeywordsMental Nerve BlockLip TumorsLidocaine
- Park, H.G., Park, P.G., Kim, W.J., Park, Y.H., Kang, H., Baek, C.W., et al. (2014) Ultrasound-Assisted Mental Nerve Block and Pulsed Radiofrequency Treatment for Intractable Postherpetic Neuralgia: Three Case Studies. The Korean Journal of Pain, 27, 81-85. https://doi.org/10.3344/kjp.2014.27.1.81
- Klepstad, P., Kurita, G.P., Mercadante, S. and Sjogren, P. (2014) Evidence of Peripheral Nerve Blocks for Cancer-Related Pain: A Systematic Review. Minerva Anestesiologica, 81, 789-793.
- Tetzlaff, J.E. (2010) Cousins and Bridenbaugh’s Neural Blockade in Clinical Anesthesia and Pain Medicine. Mayo Clinic Proceedings, 85, e51. https://doi.org/10.4065/mcp.2010.0230
- Moller, J.F., Nikolajsen, L., Rodt, S.A., Ronning, H. and Carlsson, P.S. (2007) Thoracic Paravertebral Block for Breast Cancer Surgery: A Randomized Double-Blind Study. Anesthesia & Analgesia, 105, 1848-1851. https://doi.org/10.1213/01.ane.0000286135.21333.fd
- Simpson, J., Ariyarathenam, A., Dunn, J. and Ford, P. (2014) Breast Surgery Using Thoracic Paravertebral Blockade and Sedation Alone. Anesthesiology Research and Practice, 2014, Article ID: 127467. https://doi.org/10.1155/2014/127467
- Brozovic, G., Stefancic, L., Goranovic, T. and Vrdoljak, D.V. (2015) Regional Anaesthesia in Cancer Surgery: An Update. Periodicum Biologorum, 117, 219-223.
- Khater, A., Mazy, A., Gad, M., Taha Abd Eldayem, O. and Hegazy, M. (2017) Tumescent Mastectomy: The Current Indications and Operative Tips and Tricks. Breast Cancer: Targets and Therap, 9, 237-243.
- Tan, F.F.S.L., Schiere, S., Reidinga, A.C., Wit, F. and Veldman, P.H. (2015) Blockade of the Mental Nerve for Lower Lip Surgery as a Safe Alternative to General Anesthesia in Two Very Old Patients. Local and Regional Anesthesia, 8, 11-14. https://doi.org/10.2147/LRA.S63246
- Syverud, S.A., Jenkins, J.M., Schwab, R.A., Lynch, M.T., Knoop, K. and Trott, A. (1994) A Comparative Study of the Percutaneous versus Intraoral Technique for Mental Nerve Block. Academic Emergency Medicine, 1, 509-513. https://doi.org/10.1111/j.1553-2712.1994.tb02542.x
- Yesilyurt, H., Aydinlioglu, A., Kavakli, A., Ekinci, N., Eroglu, C., Hacialiogullari, M. and Diyarbakirli, S. (2008) Local Differences in the Position of the Mental Foramen. Folia Morphologica, 67, 32-35.
- Whitworth, J.M., Kanaa, M.D., Corbett, I.P. and Meechan, J.G. (2007) Influence of Injection Speed on the Effectiveness of Incisive/Mental Nerve Block: A Randomized, Controlled, Double-Blind Study in Adult Volunteers. Journal of Endodontics, 33, 1149-1154. https://doi.org/10.1016/j.joen.2007.07.016