Neurological Complications of Local Anesthesia in Dentistry: A Review

Abstract

Local anesthesia is a technique that temporarily desensitizes a specific body area, typically for a surgical procedure, dental work, or pain management. It is described as a sensation loss in a specific area of the body due to depression of excitation in the nerve endings or due to the inhibition of the conduction process within the peripheral nerves. It allows for safer and more comfortable medical procedures, reducing the need for general anesthesia and facilitating faster recovery. Local anesthesia is generally safe, but like any medical intervention, it carries potential risks and side effects. The complications related to local anesthetics can be assessed in terms of neurological, vascular, local, systemic, and neurological. In this review article, we discussed the neurological complications of local anesthesia related to the ophthalmic nerve, maxillary nerve, mandibular nerve, branches of the trigeminal nerve, and facial nerve. These include diplopia, ptosis, paralysis of the eye, blindness, paresthesia, trismus, soft tissue lesions, edema, hematoma, facial blanching, infection, allergy, overdose, neuralgia, facial palsy, etc.

Comparison between Ultrasonographic-Guided Temporal and Coronoid Approaches for Trigeminal Nerve Block in Dogs: A Cadaveric Study

“…Firstly, results from a cadaveric study cannot be entirely extrapolated to a clinical setting for various reasons: complications such as haemorrhage cannot be evaluated, and the spread of contrast can differ in live animals due to variations in the viscosity of the injectate compared to the local anaesthetics employed, as well as other factors such as muscle tone, blood supply, lymphatic drainage, temperature, and time [29]. In human literature, complications or side effects of blocks in the pterygopalatine fossa are not frequently reported [17]; however, due to the proximity of the surrounding neurovascular structures, facial paralysis, difficulty chewing, diplopia, exophthalmos, eye oedema, persistent numbness of the face, and hematoma can occur [30]. Furthermore, in live animals, the spread of local anaesthetics into muscles and fasciae can provide analgesia by desensitising free nerve endings or nociceptors present in those structures [29].…”

Comparison between Ultrasonographic-Guided Temporal and Coronoid Approaches for Trigeminal Nerve Block in Dogs: A Cadaveric Study

“…Firstly, results from a cadaveric study cannot be entirely extrapolated to a clinical setting for various reasons: complications such as haemorrhage cannot be evaluated, and the spread of contrast can differ in live animals due to variations in the viscosity of the injectate compared to the local anaesthetics employed, as well as other factors such as muscle tone, blood supply, lymphatic drainage, temperature, and time [ 29 ]. In human literature, complications or side effects of blocks in the pterygopalatine fossa are not frequently reported [ 17 ]; however, due to the proximity of the surrounding neurovascular structures, facial paralysis, difficulty chewing, diplopia, exophthalmos, oedema, persistent numbness of the face, and haematoma can occur [ 30 ]. Furthermore, in live animals, the spread of local anaesthetics into muscles and fasciae can provide analgesia by desensitising free nerve endings or nociceptors present in those structures [ 29 ].…”