ORS03 - Lecture 2 - Block Anaesthesia Technique Flashcards
Describe Block Anaesthsia (4)
Suspension of conduction in peripheral nerve distant to the surgical site
Ideal in inflammatory conditions
Less anaesthetic needed
Relatively difficult techniques
Describe the Mental Block (3)
1) Nerves anaesthetised:
Mental nerve
Mandibular incisive nerve
2) Area anaesthetised:
Soft tissues anterior to the mental foramen (mental N)
Teeth 1 to 4 (incisive N)
Lingual mucosa is NOT anaesthetised.
3) Technique:
Retract with mirror
Insert the needle in the mucobuccal fold next to the mental foramen, between the roots of the premolars
Injection depth is 5-6 mms. Do not enter the mental foramen.
Deposit gently 0.5-1 ml over 20 seconds.
Describe Long Buccal Block
1) Nerves anaesthetised:
Buccal nerve
2) Area anaesthetised:
Buccal soft tissues distal to the second premolar
3) Technique:
Retract with mirror
Insert the long needle in the mucobuccal fold at the external oblique ridge buccal and distal to the last molar.
Injection depth is 1-2 mms. Deposit gently 0.5ml.
Describe the PSA/ tuborosity Block (3)
1) Nerves anaesthetised:
Posterior superior alveolar nerve
2) Area anaesthetised:
All three upper molar teeth
Corresponding buccal soft tissues
3) Technique:
Retract with mirror.
Insert the needle in the mucobuccal fold next to the (distobuccal root of the) second molar.
Point the needle upwards, inwards and backwards towards the maxillary tuberosity parallel with the back of the nose.
Injection depth is 8-10 mms
Deposit one cartirdge ove 30 seconds.
What complication occurs if you inject the PSA/Tuberosity block too deep? (1)
Haematoma from Pterygoid plexus
Describe the Infraorbital Nerve Block (3)
1) Nerves anaesthetised:
Anterior superior alveolar nerve
Infraorbital nerve (sometime middle SA)
2) Area anaesthetised:
Teeth 1 to 3, sometimes premolars
Corresponding buccal soft tissues, upper lip, side of the nose, lower eyelid
3) Technique:
Palpate the infraorbital notch, then slide finger down to the foramen. Place thumb slightly below the foramen and retract the upper lip with the remaining fingers.
Insert long needle in the mucobuccal fold at the first premolar. Direct it towards the foramen holding it parallel with the first premolar.
Advance the needle while injecting to a depth where you either contact bone or start feeling the pressure of the fliud under your thumb. Deposit the rest of the cartridge.
Describe Maxillary Nerve Block
1) Nerves anaesthetised:
All branches of maxillary nerve
2) Area anaesthetised:
All the teeth on the same side
Corresponding soft tissues, buccal & palatal
3) Technique:
Tuberosity approach
Long needle is used.
Identical with the tuberosity block, but the needle is oriented higher and more medial
Depth of insertion is about 30mms
full cartridge is injected.
High risk of haematoma
Greater palatine approach
Mucosa over the greater palatine foramen is anaesthetised with 0.2 mms,
Needle is inserted into the canal directed superiorly and posteriorly at a 45 degree angle.
The needle is advanced to 30 mms. (must not be forced!)
1-1.5 mls are deposited.
Canal is only patent in 70% of the cases.
