Podcast 599: Facial Blocks for the Win

Contributor: Don Stader, MD

Educational Pearls:

• Local anesthetics injected directly into wounds can cause distortion - especially important in facial lacerations
• Several blocks can be helpful to help numb branches of the trigeminal nerve (CN V) which innervates the face:
• • Supraorbital nerve block: blocks distribution of V1 (most of the forehead) through injection above the eyebrow
  • External nasal nerve block: blocks superficial innervation of nose through injection along the nasal dorsum  
  • Infraorbital nerve block: blocks innervation to lip and cheek by injection below the eye
  • Mental nerve block: blocks innervation to chin and lower lip by injection at the mandible
• Zygomatic nerve block: blocks innervation to temporal scalp and lateral aspect of forehead by injection at the temple
• Greater auricular nerve block: blocks innervation to on and around the lower ear by injection across the sternocleidomastoid 

References

http://highlandultrasound.com/facial-blocks

https://www.nysora.com/techniques/head-and-neck-blocks/nerve-blocks-face/

Moskovitz JB, Sabatino F. Regional nerve blocks of the face. Emerg Med Clin North Am. 2013 May;31(2):517-27. doi: 10.1016/j.emc.2013.01.003. Epub 2013 Feb 18. PMID: 23601486.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD