Adjunctive Role of GANI in Reducing Pain During Third Molar Removal

Abstract

Background: Mandibular third molar extraction is one of the most common oral surgical procedures, yet achieving complete anesthesia remains challenging due to anatomical variations and accessory innervation. Conventional inferior alveolar nerve block (IANB) has a reported failure rate of 15–20%, often resulting in intraoperative discomfort and the need for supplemental injections.

Objective: This study aimed to evaluate the adjunctive role of Greater Auricular Nerve Infiltration (GANI) in reducing intraoperative pain during third molar surgery.

Methods: A quasi-experimental study was conducted at Mayo Hospital, Lahore, between June 2023 and May 2024. A total of 104 patients were enrolled and randomly allocated into two groups: Group A received IANB supplemented with GANI, while Group B received IANB alone. Pain intensity was assessed intraoperatively using the Visual Analogue Scale (VAS).

Results: Group A showed a significant reduction in mean VAS scores (1.9 ± 0.8) compared to Group B (4.8 ± 1.1) (p < 0.001). Moreover, 71.2% of patients in Group A reported complete absence of pain versus only 13.5% in Group B. No significant difference was observed in operative time between the two groups.

Conclusion: Targeting accessory innervation through GANI substantially improves perioperative analgesia and enhances patient comfort without prolonging surgery. Incorporating GANI as a supportive anesthetic technique may represent a practical and effective advancement in oral surgical anesthesia protocols.