Nerve Block: Mental: Difference between revisions

(Created page with " ==Indications== * The mental nerve innervates the skin of the chin and mucous membranes of the lower lip, by blocking this nerve you can have adequate anesthesia for compli...")
 
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==Indications==
==Indications==
 
#The mental nerve innervates the skin of the chin and mucous membranes of the lower lip, 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  
 
#Use block to repair laceration of lower lip or soft tissues of the chin that extend from lip anteriorly to alveolar process and to the mid body of the mandible
 
* The mental nerve innervates the skin of the chin and mucous membranes of the lower lip, 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  
* Use block to repair laceration of lower lip or soft tissues of the chin that extend from lip anteriorly to alveolar process and to the mid body of the mandible  


==Contraindications==
==Contraindications==

Revision as of 13:40, 12 March 2011


Indications

  1. The mental nerve innervates the skin of the chin and mucous membranes of the lower lip, by blocking this nerve you can have adequate anesthesia for complicated laceration closures
    1. NOTE this block does NOT anesthetize the teeth or mandibular soft tissue
  2. Use block to repair laceration of lower lip or soft tissues of the chin that extend from lip anteriorly to alveolar process and to the mid body of the mandible

Contraindications

  • allergic reaction to the type of anesthesia you are going to administer
  • non-cooperative patient
  • overlying skin infection


Equipment Needed

  • topical anesthesia
  • viscous lidocaine
  • LET
  • local anesthesia
  • lidocaine 1% (lasts 30-60 minutes or longer if given with epi, 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


Source

emedicine