Regional anesthesia in faciomaxillary and oral surgery

Abstract

Faciomaxillary and oral surgical procedures are frequently done under local anesthesia. Only few techniques are used widely in these areas in spite of the numerous blocks available. Knowledge about these techniques could encourage use of these techniques for the benefit of patients and operators’ comfort. Leaving aside the commonly used intraoral anesthetic technique by faciomaxillary and dental surgeons, focus is given on regional blocks of extraoral route, like maxillary block, mandibular block, superficial cervical plexus block, forehead and scalp block, trigeminal nerve block, sphenopalatine nerve block, and they are discussed with their indications and technical details involved in administering them. Advantages of using the regional blocks over general anesthesia and multiple pricks include reduced dosage and number of needle pricks. Pediatric considerations like prolonged duration of anesthesia and wider area of action for regional blocks warrant that they should be used with caution.

A Cadaveric Study of Ultrasound-Guided Maxillary Nerve Block Via the Pterygopalatine Fossa

“…2 Oral and maxillofacial surgical procedures are frequently conducted under local anesthesia. 3 In order to manage pain, intraoperative intravenous opioids are used, which may result in excessive sedation, respiratory depression, and postoperative nausea and vomiting. These symptoms may cause serious complications and suffering, particularly in patients who undergo intermaxillary fixation during the postoperative period.…”

Bupivacaine Mandibular Nerve Block Affects Intraoperative Blood Pressure and Heart Rate in a Yucatan Miniature Swine Mandibular Condylectomy Model: A Pilot Study

“…Our second hypothesis of decreased postoperative pain was not supported by the results. Based on the combined results of this study and the common use of local blocks in human oral and maxillary surgery [6], a mandibular nerve block is justified to improve patient comfort during surgery and thereby reduce potential necessity for higher dosages of systemic analgesics.…”

“…Local nerve blocks are established for effective pain control in oral and maxillofacial surgical procedures [6]. Local action, prolonged analgesia, and limited side effects make them an appealing alternative to systemic analgesics, and use of local mandibular nerve blocks are reported to provide relief from bone and soft tissue pain in humans and animals undergoing dental procedures [6–9].…”

“…Local action, prolonged analgesia, and limited side effects make them an appealing alternative to systemic analgesics, and use of local mandibular nerve blocks are reported to provide relief from bone and soft tissue pain in humans and animals undergoing dental procedures [6–9]. Bupivacaine (0.5%) nerve blocks alone humans [10, 11].…”

Electromyography assessment in zygomaticomaxillary complex fractures

“…EMG has been widely used in the evaluation of patients with temporomandibular joint disorders [9,10]. After surgical procedures, EMG is able to monitor the time when the activity of the muscles of mastication is recovered, thus the professional can guide the patient regarding daily activities, type of food, and mastication [8].…”