Nerve Block: Mental: Difference between revisions
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##LET | ##LET | ||
#local anesthesia | #local anesthesia | ||
##lidocaine 1% (lasts 30-60 minutes or longer if given with | ##lidocaine 1% (lasts 30-60 minutes or longer if given with epinephrine, rapid onset) | ||
##Mepivacaine 3% (lasts 45-90 minutes, slower onset) | ##Mepivacaine 3% (lasts 45-90 minutes, slower onset) | ||
##Bupivacaine 0.5% (lasts 2-4 hours, slowest in onset) | ##Bupivacaine 0.5% (lasts 2-4 hours, slowest in onset) |
Revision as of 05:17, 3 August 2016
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
- topical anesthesia
- viscous lidocaine
- LET
- local anesthesia
- lidocaine 1% (lasts 30-60 minutes or longer if given with epinephrine, rapid onset)
- Mepivacaine 3% (lasts 45-90 minutes, slower onset)
- Bupivacaine 0.5% (lasts 2-4 hours, slowest in onset)
- 18 gauge needle to draw up anesthetic
- 25 or 27 gauge needle
- 6 cc syringe
- gauze pads
- good light source
Procedure
- Place patient in semi-recumbent position
- apply topical anesthesia
- 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)
Complications
- Bleeding
- Infection
- Pain
- Needle fracture
- Neurapraxia