Nerve Block: Supraorbital: Difference between revisions
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==Background== | ==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 | *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 | *Nerve block provides regional anesthesia without distortion of soft tissue seen in local infiltration | ||
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==Equipment Needed== | ==Equipment Needed== | ||
*local anesthesia | *local anesthesia | ||
**lidocaine | **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 | ||
* | *3-5cc syringe | ||
*gauze pads | *gauze pads | ||
*gloves | *gloves | ||
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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== | ||
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==References== | ==References== | ||
<references/> | <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 | |||
[[Category:Procedures]] | [[Category:Procedures]] | ||
[[Category:ENT]] | [[Category:ENT]] | ||
Latest revision as of 06:03, 6 January 2022
Background
- 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
- Obtain informed consent
- Place patient in supine position or seated
- Draw up 2-5cc of anesthetic into syringe
- Palpate the supraorbital foramen over the medial aspect of the supraorbital ridge
- Prep area
- Advance the needle towards foramen (5-10mm)
- Aspirate, and if no blood, inject 1-3 cc of anesthetic slowly
- 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
- 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