How is an intraoral infraorbital nerve block administered?

Updated: Jun 14, 2018
  • Author: Karen M Byrne, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
  • Print
Answer

Answer

The following are steps for the intraoral approach:

  • Obtain informed consent.

  • Apply cotton-tipped applicator soaked with topical anesthetic to the mucosa opposite the upper second bicuspid (premolar tooth) for 1 minute.

  • To palpate the infraorbital foramen, have the patient look straight ahead and imagine a line drawn vertically (sagittally) from the pupil down toward the inferior border of the infraorbital ridge.

  • Keep the palpating finger in place over the inferior border on the infraorbital rim for the remaining steps.

  • Retract the cheek and introduce the needle into the mucosa opposite the upper second bicuspid approximately 0.5 cm from the buccal surface (see images below).

    Intraoral approach for infraorbital nerve block. Intraoral approach for infraorbital nerve block.
    Infraorbital nerve block, intraoral approach. Infraorbital nerve block, intraoral approach.
  • Keep the needle parallel with the long axis of the second bicuspid until it is palpated near the foramen. (The approximate depth is 1.5-2.5 cm.) If the needle is extended too far superiorly and posteriorly, the orbit may be entered.

  • Once the needle is positioned properly, aspirate to ensure that the needle is not within a vessel.

  • Inject 2-3 mL of anesthetic solution adjacent to the foramen.

  • Take care not to inject into the foramen (which may result in swelling of the lower eyelid) by keeping the palpating finger firmly on the inferior orbital rim.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!