Buccal nerve block: Difference between revisions
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==Overview== | ==Overview== | ||
[[File:Mandibular nerve 3.jpg|thumb|Dissection showing branches of the mandibular nerve.]] | |||
*Also known as long buccal nerve block | *Also known as long buccal nerve block | ||
*Provides buccal soft tissue anesthesia adjacent to mandibular molars<ref>Siddik AB, Sapra A. Anatomy, Head and Neck: Buccal Nerve. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560732/</ref> | *Provides buccal soft tissue anesthesia adjacent to mandibular molars<ref>Siddik AB, Sapra A. Anatomy, Head and Neck: Buccal Nerve. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560732/</ref> | ||
Revision as of 18:54, 1 May 2024
Overview
- Also known as long buccal nerve block
- Provides buccal soft tissue anesthesia adjacent to mandibular molars[1]
Indications
- Soft-tissue injury to buccal soft-tissue
- Gingival pain not relieved with inferior alveolar block ('See also' below)
Contraindications
- Allergy to anesthetic
- Infection overlying site
Equipment Needed
- Anesthetic (see below)
- 5mL or 10mL syringe
- Blunt fill or 18 gauge needle
- 25-27 gauge needle
- Gauze
- Long cotton tipped applicators
- Personal protective equipment (non-sterile gloves and eye protection)
- Bite block if necessary
- If bite block unavailable, may use 5-10 (or more) tongue depressors taped together as improvised bite block
- Appropriate, dedicated lighting such as an overhead lamp
Procedure
Preparation
- Place patient in supine if tolerated or seated with as much recumbency as tolerated
- Position yourself contralateral to target
- Consider use of topical anesthetic
- Method 1: Swish and spit viscous lidocaine in mouth for at least 30 seconds
- Method 2: Soak gauze or cotton tipped applicators with viscous or regular lidocaine and place them at target for 1-5 minutes
Injection
- Area of insertion: mucous membrane distal and buccal to distal molar
- Target Area: buccal nerve as it passes anterior ramus of the mandible
- Identify and/or palpate landmarks: mandibular molars, mucobuccal fold
- Orient needle so it is parallel to occlusal surfaces of the teeth with bevel towards the bone
- Advance needle until bone is felt
- Inject 1-2cc of anesthetic
Special Considerations
- Consider use of additional support for distraction, especially for pediatric or highly anxious patients (child-life specialists, parental coaching, iPad or cell-phone videos etc)
- Approach with needle from mandibular side to reduce patient's visibility of needle
- Avoid cold/refrigerated anesthetic to reduce pain or allow time for anesthetic to warm to room temperature
Complications
- Unintentional biting of soft-tissue by patient
- Hematoma/bleeding
- Pain
See Also
External Links
- NUEM Oral Block blog post: https://www.nuemblog.com/blog/oral-nerve-blocks
- Dr. Zibran OMFS Lecture: https://www.youtube.com/watch?v=ILzRM73VVH0
References
- ↑ Siddik AB, Sapra A. Anatomy, Head and Neck: Buccal Nerve. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560732/