Gow-Gates Research Articles

Evaluation of Patient Comfort and Impact of Different Anesthesia Techniques on the Temporomandibular Joint Arthrocentesis Applications by Comparing Gow-Gates Mandibular Block Anesthesia with Auriculotemporal Nerve Block.

Aim Temporomandibular disorders (TMDs) are clinical situations that are characterized by pain, sound, and irregular movements of the temporomandibular joints. The most common method in the treatment of TMDs is arthrocentesis. This study aims to compare the effect of conventional extraoral auriculotemporal nerve block (ANB) and Gow-Gates (GG) mandibular anesthesia techniques on patient comfort in an arthrocentesis procedure. Materials and Methods We performed this study on 40 patients who underwent TMJ arthrocentesis with ANB (n = 20) or GG (n = 20) mandibular anesthesia techniques at the Marmara University Faculty of Dentistry between 2016 and 2019. The predictor variable was the type of an anesthesia technique, and the outcome variables included were pain, maximum mouth opening (MMO), and protrusive movement (PM). They were compared at the preoperative period and 3rd and 6th month periods. Statistical analysis included means with standard deviations, a one-way ANOVA for continuous data, and the results were evaluated at the significance level of p < 0.05. Results No statistically significant difference was observed between the VAS values, MMO, and PM averages of preoperative, 3rd and 6th months of ANB and GG (p=0.142, p=0.209, and p=0.148). Conclusion Both anesthesia techniques have provided effective results in terms of pain and functional jaw movements in the postoperative period in arthrocentesis treatment.

Efficacy of vazirani akinosi and gow gates technique in inferior alveolar nerve block

Aim: The purpose of this study is to evaluate the onset of anesthesia, anesthetic success and incidence of positive aspiration during administration of local anesthetic solution using the Vazirani Akinosi and Gow Gates techniques. Methodology: The study involves 100 subjects, divided into two different groups of 50 subjects each receiving Gow Gates, Vazirani Akinosi nerve blocks. The onset of anesthesia, positive aspiration and anesthetic success was evaluated. Results: In Vazirani Akinosi technique group, patients showed highest anesthetic success of 95.71%; there was a significant difference seen between the Gow Gates and Vazirani Akinosi techniques (p = 0.0241). The mean value of the onset of anesthesia in Gow Gates technique showed the longest 343.71 ± 153.20 s and in Vazirani Akinosi technique it was 192.86 ± 61.20 s. Conclusion: The Vazirani Akinosi technique was found to be significantly better than GG techniques with respect to both onset and success of anesthesia.

A randomized control trial to study the effect of bilateral Gow-gates block on visibility of surgical field and hemodynamic response in patients with carcinoma tongue

Background and AimsRegional anesthesia in oncosurgery is a current research topic. The use of nerve blocks near the surgical site gives good analgesia, surgical field visibility and hemodynamic profile. Our aim was to evaluate the effect of the Gow gate mandibular nerve block in tongue surgeries. MethodsASA 1 & 2 patients posted for surgery for carcinoma of tongue were included in the study. After randomization Bilateral Gowgates block was given to Group G. Group M received IV Morphine only. The investigator B who was blinded to which group the patient belonged conducted the anesthesia and did the outcome assessment. The hemodynamic response to surgical manipulation was noted. The visibility of the surgical field was assessed by the surgeon using Surgical visibility scale. Postoperative pain was assessed by assessing dose requirement of opioids and paracetamol. The mean difference between the two groups were tested using student's t-test for normally distributed variables and Mann-Whitney U test for non-normal variables. ResultsHemodynamic stress response during surgical stimulation was significantly lower in group G. Surgical field visibility score was better in the group G (p0.002). The use of morphine intraoperatively in group G was less (p= 0.001) ConclusionBilateral Gow gates block improves visibility of surgical field and hemodynamic response in patients undergoing surgery for carcinoma tongue.

Efficacy of a conventional inferior alveolar nerve block compared to the Vazirani–Akinosi and Gow-Gates techniques for mandibular anesthesia

Background: The conventional inferior alveolar nerve block (IANB) cannot be employed in clinical scenarios with trismus. In addition, it is a blind procedure, so failure to follow the ideal anatomical landmarks and improper positioning of the needle may result in anesthesia failure. This study evaluated whether the Vazirani–Akinosi (VA) and Gow-Gates (GG) techniques for mandibular anesthesia have superior outcomes in the form of fewer positive aspirations and rapid onset of action, as well as better anesthetic attainment. Objective: The objective of this study was to evaluate the anesthetic efficacy and associated complications of a conventional IANB compared to the VA and GG techniques. Method: The study involved 300 patients divided randomly into three groups of 100 patients each. Group I received mandibular anesthesia through the GG technique, Group II received mandibular anesthesia through the VA technique, and Group III received mandibular anesthesia through a conventional IANB. The onset of action, incidence of positive aspiration, and success of the anesthetic technique were assessed in all patients. Result: The Group II patients showed superior anesthetic success (97%) that was significantly different from the results of Groups I and III (P = 0.0241). The mean value of the onset of anesthesia was longer in Group I than in the other two groups. A significant difference was seen between the GG and VA techniques (P = 0.0001*) and between the GG and conventional IANB techniques (P = 0.0001*). Conclusion: The VA technique is considerably superior to either the GG or the conventional IANB techniques in terms of the onset of action and anesthesia success. Positive aspirations are encountered relatively more frequently with the conventional IANB technique.

Comparison of three anesthetic techniques for the removal of posterior mandibular teeth with 2% lidocaine: a systematic review

The present systematic review aimed to evaluate whether the IANB (conventional inferior alveolar nerve block) technique is superior to the VA (Vazirani-Akinosi) or GG (Gow-Gates) techniques for anesthesia in the removal of posterior mandibular teeth. This systematic review was structured according to the PICO strategy, adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist, and was recorded on the international prospective register of systematic reviews (PROSPERO-CRD42020153130). Studies were included based on the eligibility criteria and data from the included studies were collected by one author, while another reviewed the compilation. Eight studies were included, all of which were randomized controlled trials. Three studies tested the techniques by exclusively performing lower third molar removal; the others covered other posterior lower teeth. All studies used the same local anesthetic and the same vasoconstrictor: lidocaine 2% with epinephrine/adrenaline. A total of 1056 patients were evaluated. Some differences were observed between the techniques. Because of the heterogeneity between studies, clinical trials with more specific methodologies, such as comparisons of GG and VA with IANB for mandibular tooth removal, and the same clinical homogeneity will be worthwhile. A systematic review of which anesthetic technique is most effective for mandibular teeth removal may positively impact the population's life. There are no systematic reviews which approach this theme in a well-structured perspective.

Comparison of Efficacy of Gow-Gates Mandibular Nerve Block and Inferior Alveolar Nerve Block for The Extraction of Mandibular Molars

Objective: The purpose of this study is to compare the efficacy of two local anaesthesia techniques i.e. inferior alveolar nerve block and Gow-Gates nerve block technique in terms of their success rate to anaesthetize tissues, time of onset of action, pain levels during administration and amount of drug used to achieve adequate anaesthesia.&#x0D; Methods: This randomised control trial was carried out in department of Oral &amp; Maxillofacial Surgery at Rawal Institute of Health Sciences, Islamabad from September 2017 to May 2018. A total of 138 patients were selected and randomly allocated to receive Gow-Gates (GG) nerve block or inferior al- veolar nerve block (IANB) for extraction of mandibular molars. Onset of anaesthesia and success rate was noted for individual nerves. Pain during administration of anaesthesia was compared between IANB group and GG group by verbal response scale. Status of blood aspiration during injection and volume of local anaesthesia solution used to achieve adequate anaesthesia for extraction of lower molar tooth was also noted at the end of procedure.&#x0D; Results: Comparison of success to achieve anaesthesia did not show significant difference between IANB and GG groups except the buccal soft tissue. Onset of action of anaesthesia of all nerves (IAN, lin- gual and buccal) was achieved much earlier in IANB. While results of pain and total amount of drug used were significantly better in favor of GG group as shown by p-value of 0.015 and 0.002 respectively.&#x0D; Conclusion: We conclude that GG nerve block is a good alternative technique to conventional IANB technique for extraction of mandibular molars.

Comparison of Efficacy of Halstead, Vazirani Akinosi and Gow Gates Techniques for Mandibular Anesthesia.

Traditionally, the "Halstead block" has been widely used to provide anesthesia in mandibular teeth. Two other techniques, the Gow Gates mandibular nerve block and the Akinosi Vazirani closed-mouth mandibular nerve block, are reliable alternatives to the conventional inferior alveolar nerve block. The purpose of this study is to evaluate the onset of anesthesia, anesthetic success and incidence of positive aspiration during administration of local anesthetic solution using the Halstead, Vazirani Akinosi and Gow Gates techniques. The study involves 210 subjects, divided into three different groups of 70 subjects each receiving Gow Gates, Vazirani Akinosi and conventional inferior alveolar nerve blocks. The onset of anesthesia, positive aspiration and anesthetic success was evaluated. In Vazirani Akinosi technique group, patients showed highest anesthetic success of 95.71%; there was a significant difference seen between the Gow Gates and Vazirani Akinosi techniques (p=0.0241*). The mean value of the onset of anesthesia in Gow Gates technique showed the longest 343.71±153.20s, in Halstead technique it was 177.43±59.94s, and in Vazirani Akinosi technique it was 192.86±61.20s. There was a significant difference seen between Gow Gates and Vazirani Akinosi techniques (p=0.0001*) and Gow Gates and inferior alveolar nerve block techniques (p=0.0001*). The Vazirani Akinosi technique was found to be significantly better than the other two techniques with respect to both onset and success of anesthesia. Positive aspirations were slightly higher in the conventional IANB technique compared to the other two, but did not reach statistical significance.

Evaluation of Three Block Anesthesia Methods for Pain Management During Mandibular Third Molar Extraction: A Meta-analysis

A patient’s pain during mandibular third molar extraction often creates problems for a dental surgeon and can also cause immense patient discomfort, such as decreased quality of life, serious complications, or even danger to the patients’ lives. Effective pain management is therefore of great importance. Conventional block anesthesia method often fails to control such pain completely during an operation. Therefore, two available alternatives, Gow-Gates (G-G) and Vazirani-Akinosi (V-A) methods, have been developed. However, the results of current studies regarding their effectiveness and safety are somewhat ambiguous. The use of G-G and V-A techniques is therefore restricted. This study did a comprehensive review of the relevant research and finally 7 RCTs were included. The results of this meta-analysis indicate that both G-G and V-A techniques have a lower risk of positive aspiration. G-G technique also evidenced a higher success rate than the conventional method. V-A was faster while the G-G technique in contrast had a slower onset time than the conventional technique. In terms of the measurement of analgesic success, however, the V-A method was statistically indistinguishable from conventional techniques. These findings will hopefully endow clinicians with the knowledge required to make appropriate choices for effective anesthesia during lower third molar extraction.

Comparative evaluation of effect of preoperative alprazolam and diclofenac potassium on the success of inferior alveolar, Vazirani-Akinosi, and Gow-Gates techniques for teeth with irreversible pulpitis: Randomized controlled trial.

Introduction:In teeth with irreversible pulpitis, successful local anesthesia is hard to achieve irrespective of the amount of local anesthesia and technique used. Such cases can be managed by concoction of pre-medications like anxiolytics, analgesics and effective local anesthesia. This double-blind, placebo-controlled study was planned to evaluate the effect of oral administration of alprazolam and diclofenac potassium on the success rate of inferior alveolar nerve block (IANB), Gow-Gates (GG) and Vazirani-Akinosi (VA) techniques for the root canal treatment of mandibular molars with irreversible pulpitis.Method:198 emergency patients with symptomatic irreversible pulpitis were randomly divided into three groups as – A, B and C receiving IANB, GG or V-A respectively using 2% lidocaine with 1: 100,000 epinephrine. These groups were sub-divided into sub-groups I and II as control and pre-medication groups. Patients who did not react to the stimulus made by an explorer between the canine and first premolar and showing subjective lip and tongue numbness were included in the study.Result:All sub-groups showed statistically significant reduction in VAS score. However sub-groups V and VI (that is GG with and without pre-medication respectively) showed best improvement in initial severe pain in mandibular molars with irreversible pulpitis. Moreover, all pre-medication sub-groups showed better pain control compared to respective control groups.Conclusion:It was concluded that use of pre-medications in the form of combination of anxiolytics and analgesics improves the success rate of local anesthesia in teeth with irreversible pulpitis. Use of anxiolytics eases the patient in endodontic emergencies. Also use of GG along with pre-medication is the best method for effective pain management of acute pain in irreversible pulpitis.