How is an extraoral infraorbital nerve block administered?

Updated: Jun 14, 2018
  • Author: Karen M Byrne, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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The following are steps for the extraoral approach:

  • During the extraoral technique, the needle is in very close proximity to the facial artery. Because of this proximity, avoid adding vasoconstrictors to the anesthetic agent.

  • Use the previously described landmarks to locate the infraorbital foramen.

  • Prepare the skin overlying the infraorbital foramen with povidone iodine (Betadine) and sterile gauze.

  • Using sterile technique, insert the needle through the skin, the subcutaneous tissue, and the quadratus labii superioris muscle (see image below).

    Technique for extraoral infraorbital nerve block. Technique for extraoral infraorbital nerve block.
  • Aspirate to ensure the needle is not within a vessel. The facial artery and vein are very close to the needle in this position.

  • Inject the anesthetic solution. The infiltrated tissue appears swollen.

  • Firmly massage this area for 10-15 seconds.

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