Nerve Block: Supraorbital: Difference between revisions

(supraorbital nerve block)
 
 
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==Background==
[[File:Gray894.png|thumb|Anterior view of the right orbit. The supraorbital nerve can be seen exiting the orbit through the supraorbital notch with the supraorbital artery.]]
*Supraorbital nerve innervates the ipsilateral upper eyelid, forehead, and anterior 1/3 of scalp
*Nerve block provides regional anesthesia without distortion of soft tissue seen in local infiltration
==Indications==
==Indications==
Supraorbital block provides facial anesthesia to the upper eyelid, forehead, anterior 1/3 of scalp for procedures (closure of lacerations, debridement) without distorting the soft tissues as seen with local infiltration 
*Trauma or need to perform painful procedure on area innervated by supraorbital nerve
   
   
==Contraindications==
==Contraindications==
#allergy to the type of anesthesia you are going to administer
*Infection overlying injection site
#uncooperative patient
*Previous allergic reaction to local anesthetic
#overlying skin infection
*Uncooperative patient
#distortion of anatomical landmarks  
*Distortion of anatomical landmarks  


==Equipment Needed==
==Equipment Needed==
#local anesthesia
*local anesthesia
##lidocaine 1% (lasts 30-60 minutes or longer if given with epi, rapid onset of 4-6 minutes)  
**lidocaine 2% (lasts 30-60 minutes or longer if given with epinephrine, rapid onset of 4-6 minutes)  
##Bupivacaine 0.5% (lasts 2-4 hours, slowest in onset)
**Bupivacaine 0.5% (lasts 2-4 hours, slowest in onset)
#18 gauge needle to draw up anesthetic
*18 gauge needle to draw up anesthetic
#1.5 inch 25 or 27 gauge needle  
*1.5 inch 25 or 27 gauge needle  
#6cc syringe
*3-5cc syringe
#gauze pads
*gauze pads
#gloves
*gloves
#betadine/chlorhexidine  
*betadine/chlorhexidine  


==Procedure==
==Procedure==
#Obtain informed consent
#Place patient in supine position or seated
#Place patient in supine position or seated
#Obtain informed consent
#Draw up 2-5cc of anesthetic into syringe
#Draw up 2-5cc of anesthetic into syringe
#Palpate the supraorbital foramen over the medial aspect of the supraorbital ridge
#Palpate the supraorbital foramen over the medial aspect of the supraorbital ridge
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#Advance the needle towards foramen (5-10mm)
#Advance the needle towards foramen (5-10mm)
#Aspirate, and if no blood, inject 1-3 cc of anesthetic slowly
#Aspirate, and if no blood, inject 1-3 cc of anesthetic slowly
#Massage area for 10-15 seconds  
#Massage area for 10-15 seconds
#If block is unsuccessful, inject a line of anesthetic solution along the orbital rim laterally to medially to block all branches of the ophthalmic nerve


==Complications==
==Complications==
#bleeding
*Bleeding/hematoma
#infection
*Infection
#pain
*Pain
#needle fracture
*Swelling of face/eyelid
#swelling of face/eyelid
*Allergic reaction to anesthetic
#hematoma
*Damage to nerves/vessels
#allergic reaction to anesthetic
 
#damage to nerves/vessels
==See Also==
#failure to achieve anesthesia
*[[Nerve blocks (main)]]


==Source==
==References==
Donaldson
<references/>
Uptodate
*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 06:03, 6 January 2022

Background

Anterior view of the right orbit. The supraorbital nerve can be seen exiting the orbit through the supraorbital notch with the supraorbital artery.
  • Supraorbital nerve innervates the ipsilateral upper eyelid, forehead, and anterior 1/3 of scalp
  • Nerve block provides regional anesthesia without distortion of soft tissue seen in local infiltration

Indications

  • Trauma or need to perform painful procedure on area innervated by supraorbital nerve

Contraindications

  • Infection overlying injection site
  • Previous allergic reaction to local anesthetic
  • Uncooperative patient
  • Distortion of anatomical landmarks

Equipment Needed

  • local anesthesia
    • lidocaine 2% (lasts 30-60 minutes or longer if given with epinephrine, rapid onset of 4-6 minutes)
    • Bupivacaine 0.5% (lasts 2-4 hours, slowest in onset)
  • 18 gauge needle to draw up anesthetic
  • 1.5 inch 25 or 27 gauge needle
  • 3-5cc syringe
  • gauze pads
  • gloves
  • betadine/chlorhexidine

Procedure

  1. Obtain informed consent
  2. Place patient in supine position or seated
  3. Draw up 2-5cc of anesthetic into syringe
  4. Palpate the supraorbital foramen over the medial aspect of the supraorbital ridge
  5. Prep area
  6. Advance the needle towards foramen (5-10mm)
  7. Aspirate, and if no blood, inject 1-3 cc of anesthetic slowly
  8. Massage area for 10-15 seconds
  9. If block is unsuccessful, inject a line of anesthetic solution along the orbital rim laterally to medially to block all branches of the ophthalmic nerve

Complications

  • Bleeding/hematoma
  • Infection
  • Pain
  • Swelling of face/eyelid
  • Allergic reaction to anesthetic
  • Damage to nerves/vessels

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
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