Nerve block: Lingual: Difference between revisions
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==Overview== | ==Overview== | ||
[[File:Grant 1962 656b.png|thumb|Distribution of lingual nerve.]] | |||
[[File:Gray778.png|thumb|Lingual nerve anatomy branching off V<sub>3</sub> mandibular division of the trigeminal nerve.]] | |||
[[File:Gray782 updated.png|thumb|Intra oral anatomy of lingual nerve.]] | |||
[[File:Gray1202.png|thumb|Lingual anatomy.]] | |||
* The lingual nerve is a branch of the mandibular (V<sub>3</sub>) division of the trigeminal nerve | |||
* Provides sensation to the anterior two-thirds of the tongue, the floor of the mouth, and the lingual mucous membrane | |||
* Lingual nerve block is an effective means of anesthesia for tongue lacerations and avoids the anesthesia of the lip, chin, and teeth that [[Nerve Block: Inferior Alveolar|inferior alveolar nerve block]] causes<ref>Balasubramanian S et al. Efficacy of Exclusive Lingual Nerve Block versus Conventional Inferior Alveolar Nerve Block in Achieving Lingual Soft-tissue Anesthesia. Ann Maxillofac Surg. 2017; 7(2): 250-255. | |||
</ref> | |||
* No chance of accidental carotid artery puncture compared to IANB | |||
** Studies have shown lower rates of nerve injury and trismus compared to IANB as well as greater success rates<ref>Balasubramanian S et al. Efficacy of Exclusive Lingual Nerve Block versus Conventional Inferior Alveolar Nerve Block in Achieving Lingual Soft-tissue Anesthesia. Ann Maxillofac Surg. 2017; 7(2): 250-255. | |||
</ref> | |||
==Indications== | ==Indications== | ||
* [[Tongue laceration]] | |||
* Sublingual abscess drainage | |||
* Foreign body removal | |||
* Sialolith removal | |||
* Periodontal surgery | |||
* Glossodynia | |||
==Contraindications== | ==Contraindications== | ||
* Lingual soft tissue infection | |||
* Local anesthetic allergy | |||
==Equipment Needed== | ==Equipment Needed== | ||
* Gloves | |||
* Aseptic mouth rinse | |||
* 4x4 gauze | |||
* Suction | |||
* Syringe | |||
* 25-27 gauge needle | |||
* Topical anesthetic | |||
* Local anesthetic | |||
==Procedure<ref>Reichman EF. Dental Anesthesia and Analgesia. In: Reichman EF. Emergency Medicine Procedures. 2nd ed. McGraw-Hill; 2013.</ref>== | |||
==Procedure== | # Have the patient rinse their mouth with an aseptic mouth rinse. | ||
# Apply soaked gauze with topical anesthetic. | |||
# Place patient reclining or upright and have them open their mouth. | |||
# Identify site of injection: 1 cm medial to the second mandibular molar. | |||
# Have the patient move their tongue to the side or use a tongue blade. | |||
# From the contralateral side, approach with your needle and insert 1 cm posteriorly directed. | |||
# Aspirate to confirm location is not intravascular. | |||
# Inject 1.0 - 1.5 ml local anesthetic. | |||
==Complications== | ==Complications== | ||
* Hematoma | |||
* Infection | |||
* Failure to anesthetize | |||
==See Also== | ==See Also== | ||
*[[Tongue laceration]] | *[[Tongue laceration]] | ||
*[[Nerve Block: Inferior Alveolar]] | |||
*[[Nerve blocks (main)]] | |||
*[[LAST]] | |||
==References== | ==References== | ||
Latest revision as of 18:29, 27 January 2021
Overview
- The lingual nerve is a branch of the mandibular (V3) division of the trigeminal nerve
- Provides sensation to the anterior two-thirds of the tongue, the floor of the mouth, and the lingual mucous membrane
- Lingual nerve block is an effective means of anesthesia for tongue lacerations and avoids the anesthesia of the lip, chin, and teeth that inferior alveolar nerve block causes[1]
- No chance of accidental carotid artery puncture compared to IANB
- Studies have shown lower rates of nerve injury and trismus compared to IANB as well as greater success rates[2]
Indications
- Tongue laceration
- Sublingual abscess drainage
- Foreign body removal
- Sialolith removal
- Periodontal surgery
- Glossodynia
Contraindications
- Lingual soft tissue infection
- Local anesthetic allergy
Equipment Needed
- Gloves
- Aseptic mouth rinse
- 4x4 gauze
- Suction
- Syringe
- 25-27 gauge needle
- Topical anesthetic
- Local anesthetic
Procedure[3]
- Have the patient rinse their mouth with an aseptic mouth rinse.
- Apply soaked gauze with topical anesthetic.
- Place patient reclining or upright and have them open their mouth.
- Identify site of injection: 1 cm medial to the second mandibular molar.
- Have the patient move their tongue to the side or use a tongue blade.
- From the contralateral side, approach with your needle and insert 1 cm posteriorly directed.
- Aspirate to confirm location is not intravascular.
- Inject 1.0 - 1.5 ml local anesthetic.
Complications
- Hematoma
- Infection
- Failure to anesthetize
See Also
References
- ↑ Balasubramanian S et al. Efficacy of Exclusive Lingual Nerve Block versus Conventional Inferior Alveolar Nerve Block in Achieving Lingual Soft-tissue Anesthesia. Ann Maxillofac Surg. 2017; 7(2): 250-255.
- ↑ Balasubramanian S et al. Efficacy of Exclusive Lingual Nerve Block versus Conventional Inferior Alveolar Nerve Block in Achieving Lingual Soft-tissue Anesthesia. Ann Maxillofac Surg. 2017; 7(2): 250-255.
- ↑ Reichman EF. Dental Anesthesia and Analgesia. In: Reichman EF. Emergency Medicine Procedures. 2nd ed. McGraw-Hill; 2013.