Nerve Block: Supraorbital
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
Contraindications
- allergy to the type of anesthesia you are going to administer
- uncooperative patient
- overlying skin infection
- distortion of anatomical landmarks
Equipment Needed
- local anesthesia
- lidocaine 1% (lasts 30-60 minutes or longer if given with epi, 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
- 6cc syringe
- gauze pads
- gloves
- betadine/chlorhexidine
Procedure
- Place patient in supine position or seated
- Obtain informed consent
- 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
Complications
- bleeding
- infection
- pain
- needle fracture
- swelling of face/eyelid
- hematoma
- allergic reaction to anesthetic
- damage to nerves/vessels
- failure to achieve anesthesia
Source
- Donaldson
- Uptodate