Ultrasound-Guided Nerve Block With Intravenous Moderate Sedation for Dental Surgery in Thalidomide Embryopathy With Facial Hyperalgesia.

BACKGROUND

Thalidomide embryopathy is a disorder associated with a wide range of congenital anomalies, including limb deformities, craniofacial abnormalities, and neurological impairments. Facial hyperalgesia and dental anxiety represent significant barriers to the safe and effective management of invasive dental procedures.

CASE PRESENTATION: We report a 62-year-old woman with thalidomide embryopathy, bilateral upper limb agenesis, and pronounced facial hyperalgesia, scheduled for guided bone regeneration (GBR) as part of implant-supported prosthetic treatment. Given her heightened pain sensitivity and severe dental phobia, local anesthesia alone was considered inadequate.

MANAGEMENT AND OUTCOME: Ultrasound-guided nerve block (USG-NB) targeting the maxillary nerve and intravenous sedation were employed. This strategy provided targeted regional anesthesia and effective anxiolysis, enabling safe and comfortable perioperative management. The procedure was completed uneventfully. The patient reported no pain during or after the procedure, and no postoperative adverse events were observed.

CONCLUSION

This case illustrates the utility of USG-NB in managing complex dental procedures in patients with congenital disorders or pain hypersensitivity, offering insights for anesthetic management in comparable clinical situations.