Nerve Block: Mental: Difference between revisions
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*Local anesthesic | *Local anesthesic | ||
*Chloraprep | *Chloraprep | ||
*Syringe with blunt fill needle and 27ga needle | *Syringe with blunt fill needle and 27ga (or 25ga) needle | ||
==Procedure== | ==Procedure== | ||
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*Insert the needle along the lower gum into the buccal fold between the premolar teeth without placing the needle directly into the foramen | *Insert the needle along the lower gum into the buccal fold between the premolar teeth without placing the needle directly into the foramen | ||
*Aspirate; if no blood, inject a few cc's of anesthetic slowly (avoid injecting directly into the foramen as to prevent damage to the neurovascular bundle) | *Aspirate; if no blood, inject a few cc's of anesthetic slowly (avoid injecting directly into the foramen as to prevent damage to the neurovascular bundle) | ||
*For lacerations over the midline, block the mental nerve on each side of the face to anesthetize crossover fibers | |||
*Block may also be performed extraorally by palpating and approaching the mandible slightly laterally to make contact just outside the mental foramen | |||
==Complications== | ==Complications== | ||
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*Pain | *Pain | ||
*Needle fracture | *Needle fracture | ||
* | *Neuropraxia | ||
==See Also== | ==See Also== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
*Amsterdam J and Kilgore K. Regional Anesthesia of the Head and Neck. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014 | |||
[[Category:Procedures]] | [[Category:Procedures]] | ||
[[Category:ENT]] | [[Category:ENT]] | ||
Latest revision as of 18:48, 17 April 2024
Background
- Mental nerve innervates the skin of the chin and mucous membranes of the lower lip (from lip anteriorly to alveolar process and to the mid body of the mandible) - by blocking this nerve you can have adequate anesthesia for complicated laceration closures
- NOTE: this block does NOT anesthetize the teeth or mandibular soft tissue (see Nerve Block: Inferior Alveolar)
Indications
- Trauma or need to perform painful procedure on area innervated by mental nerve
Contraindications
- Infection overlying injection site
- Previous allergic reaction to local anesthesic used
- Distortion of anatomic landmarks
Equipment Needed
- Local anesthesic
- Chloraprep
- Syringe with blunt fill needle and 27ga (or 25ga) needle
Procedure
- Obtain informed consent
- Place patient in semi-recumbent position
- Draw up 2-5cc of anesthetic into syringe
- Locate the mental foramen by retracting the cheek laterally and palpating between the 2 lower premolar teeth
- Insert the needle along the lower gum into the buccal fold between the premolar teeth without placing the needle directly into the foramen
- Aspirate; if no blood, inject a few cc's of anesthetic slowly (avoid injecting directly into the foramen as to prevent damage to the neurovascular bundle)
- For lacerations over the midline, block the mental nerve on each side of the face to anesthetize crossover fibers
- Block may also be performed extraorally by palpating and approaching the mandible slightly laterally to make contact just outside the mental foramen
Complications
- Bleeding
- Infection
- Pain
- Needle fracture
- Neuropraxia
See Also
References
- Amsterdam J and Kilgore K. Regional Anesthesia of the Head and Neck. In: Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier; 2014