Ultrasound guidance characteristics and efficiency of suprazygomatic maxillary nerve blocks in infants: a descriptive prospective study

Abstract

With a very low technical failure rate and a good clinical success rate, ultrasound appears to be a useful and simple tool to aid suprazygomatic maxillary nerve block in children.

Evidence for the Use of Ultrasound Imaging in Pediatric Regional Anesthesia

“…A case series of ultrasound-guided suprazygomatic maxillary nerve blocks for cleft palate repair in children concluded that ultrasound allows good visualization of local anesthetic spread (spread seen in 94% of cases). 24 Palmer et al 17 prospectively audited the use of ultrasound-guided TAP block and found no significant correlation between dermatomal block spread and dose, volume, or concentration, although this study was limited by a small sample size.…”

“…There were 23 and 13 articles reporting quality and outcomes of ultrasound imaging for the pediatric population in peripheral and neuraxial blockade, respectively ( Table 2). From the peripheral nerve block (PNB) set, there were 10 RCTs, 4-13 6 prospective observational studies, [14][15][16][17][18][19] 2 retrospective studies, 20,21 and 5 case series [22][23][24][25][26] (Fig. 2).…”

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

“…With regard to head and neck blocks, the use of ultrasound images has been implicated in various superficial to deep nerve blocks. [7][8][9] Although trigeminal nerve blockade via the pterygopalatine fossa (PPF) under ultrasound guidance has been described in several reports, [10][11][12][13] the key anatomical landmarks, including the maxilla and lateral pterygoid plate (LPP), on ultrasound imaging remain unclear.…”

Trigeminal Nerve Blocks

“…The effectiveness of bilateral maxillary nerve blocks using a suprazygomatic approach with nerve stimulation [ 19 ] and ultrasound [ 21 ] has been reported. Using electrical stimulation, Mesnil et al [ 19 ] showed that the disappearance of the temporal muscle twitch coincided with the needle's tip in the pterygopalatine fossa where local anesthetic was injected.…”

“…Using electrical stimulation, Mesnil et al [ 19 ] showed that the disappearance of the temporal muscle twitch coincided with the needle's tip in the pterygopalatine fossa where local anesthetic was injected. More recently, this group successfully published a randomized, double-blind study evaluating an ultrasound-guided suprazygomatic maxillary nerve block [ 21 ]. They used a linear array probe located in the infrazygomatic area to allow out-of-plane visualization of the needle tip and local anesthetic spread in the pterygopalatine fossa.…”