Procedure

Inferior Alveolar Block

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Inferior Alveolar Block, Inferior Alveolar Nerve Anesthesia

  • Indications
  1. Anesthesia of lower teeth (mandibular teeth) to the midline on the affected side
  2. Tongue sensation (anterior two thirds)
  3. Oral cavity floor
  • Physiology
  1. Inferior alveolar nerve and lingual nerves pass through the pterygomandibular space, the target of this injection
  • Preparations
  1. Typical: 0.5% Bupivacaine (Marcaine or Sensorcaine) with Epinephrine 2 ml
  • Images
  1. Inferior Alveolar Nerve Block
    1. InferiorAlveolarBlock.png
  • Technique
  1. Apply topical benzocaine gel to area of planned injection
  2. Examiner holds patient's angle of the jaw with one hand between thumb and index finger
    1. Place thumb inside mouth at coronoid notch
    2. Place index finger on the outside of the jaw at posterior aspect of the mandibular ramus
  3. Direct the syringe
    1. Barrel should be over the top of the opposite premolar
    2. Needle should be inserted posterior to the coronoid notch, toward the mandibular ramus
  4. Insert the syringe
    1. Needle should enter mucosa and strike the Mandible bone at 2-3 cm
      1. Do not continue if bone is not struck (withdraw and redirect)
    2. Withdraw the needle slightly away from the bone
    3. Aspirate to confirm no blood from inferior alveolar artery or vein
    4. Deposit the anesthetic