II. Indication
- Regional Anesthesia for forehead
III. Physiology: Landmarks (V1-ophthalmic branch nerves)
- Supraorbital Nerve
- Exits skull at supraorbital foramen, along the orbital ridge
- Upper orbit border, between upper lid and brow
- Centered over upper lid (~2.5 cm lateral to midline) and directly above the pupil on forward gaze
- Supratrochlear Nerve
- Exits skull 1 cm medial to supraorbital foramen
IV. Technique: Supraorbital and Supratrochlear Nerve Block
- Images
- Locate supraorbital foramen as above
- Insert needle
- Lateral to supraorbital foramen
- Direct needle medially, parallel to brow, toward nose
- Infiltrate mid-two thirds of lower edge of eyebrow
- Use 5-7 cc of 1% Lidocaine
- Inject just above bone level
- Redirect needle if Paresthesias or sharp pain
V. Complications
- Eyelid Swelling
- Hematoma
- Periorbital Ecchymosis
VI. References
- Moy in Pfenninger (1994) Procedures, p. 145-55
- Latham (2014) Am Fam Physician 89(12): 956-62 [PubMed]
- Salam (2004) Am Fam Physician 69(3):585-90 [PubMed]
