eMedicine Specialties > Clinical Procedures > Anesthetic and Analgesic Techniques

Nerve Block, Infraorbital

Author: Michelle Marie Davitt, MD, Assistant Professor of Clinical Medicine, Department of Emergency Medicine, Albert Einstein College of Medicine; Medical Director, Department of Emergency Medicine, Moses Division, Montefiore Medical Center
Coauthor(s): Karen M Byrne, MD, BS, Chief Resident, Jacobi/Montefiore Emergency Medicine Program, Albert Einstein College of Medicine, Bronx, New York
Contributor Information and Disclosures

Updated: May 16, 2008

Introduction

The infraorbital nerve block is often used to accomplish regional anesthesia of the face. The procedure offers several advantages over local tissue infiltration. A nerve block often achieves anesthesia with a smaller amount of medication than is required for local infiltration. In addition, unlike local tissue infiltration, nerve blocks can provide anesthesia without causing tissue distortion. Therefore, the infraorbital nerve block is a convenient alternative for situations such as facial lacerations in which tissue distortion would be unacceptable.

In general, regional anesthesia is ideal when the area of interest is innervated by a single superficial nerve. The infraorbital nerve supplies sensory innervation to the lower eyelid, the side of the nose, and the upper lip. Since the infraorbital nerve provides a considerably large area of sensory innervation, it is a prime candidate for a regional nerve block. A successful infraorbital nerve block provides anesthesia for the area between the lower eyelid and the upper lip.


Area of anesthesia for infraorbital nerve block.

Area of anesthesia for infraorbital nerve block.

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Area of anesthesia for infraorbital nerve block.

Area of anesthesia for infraorbital nerve block.


The trigeminal nerve (cranial nerve V), provides sensory innervation to the face.1 The second division, the maxillary nerve (V2), exits the skull from the foramen rotundum. After giving off numerous branches, the maxillary nerve eventually enters the face through the infraorbital canal, where it ends as the infraorbital nerve. The infraorbital nerve supplies sensory branches to the lower eyelid, the side of the nose, and the upper lip.

Infraorbital nerve.

Infraorbital nerve.

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Infraorbital nerve.

Infraorbital nerve.


Indications

  • Wound closure
  • Pain relief
  • Anesthesia for debridement
  • Contraindication to general anesthesia

Contraindications

  • Any allergy or sensitivity to the anesthetic agent
  • Evidence of infection at the injection site
  • Distortion of anatomical landmarks
  • Uncooperative patient

More on Nerve Block, Infraorbital

Overview: Nerve Block, Infraorbital
Treatment & Medication: Nerve Block, Infraorbital
Multimedia: Nerve Block, Infraorbital
References
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References

  1. Gray H, Lewis WH. The trigeminal nerve. Gray's Anatomy of the Human Body. Bartleby.com. Available at http://www.bartleby.com/107/200.html. Accessed May 16, 2008.

  2. Amsterdam JT, Kilgore KP. Regional anesthesia of the head and neck. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia, Pa: WB Saunders Company; 2004:552-66.

  3. Crystal CS, Blankenship RB. Local anesthetics and peripheral nerve blocks in the emergency department. Emerg Med Clin North Am. May 2005;23(2):477-502. [Medline].

  4. Trott AT. Wounds and Lacerations: Emergency Care and Closure. 2nd ed. St. Louis, Mo: Mosby; 1997.

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Further Reading

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Keywords

facial nerve block, infraorbital nerve, nerve block, facial block, regional anesthesia, facial nerve, regional anesthesia, facial anesthesia, facial laceration, trigeminal nerve, cranial nerve V, ester, amide, PABA, -aminobenzoic acid, intraoral anesthesia, extraoral anesthesia, infraorbital foramen, facial artery, inferior orbital rim

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Contributor Information and Disclosures

Author

Michelle Marie Davitt, MD, Assistant Professor of Clinical Medicine, Department of Emergency Medicine, Albert Einstein College of Medicine; Medical Director, Department of Emergency Medicine, Moses Division, Montefiore Medical Center
Michelle Marie Davitt, MD is a member of the following medical societies: Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Karen M Byrne, MD, BS, Chief Resident, Jacobi/Montefiore Emergency Medicine Program, Albert Einstein College of Medicine, Bronx, New York
Karen M Byrne, MD, BS is a member of the following medical societies: American College of Emergency Physicians and Emergency Medicine Residents Association
Disclosure: Nothing to disclose.

Medical Editor

Luis M Lovato, MD, Assistant Clinical Professor, David Geffen School of Medicine at UCLA; Director of Critical Care, Department of Emergency Medicine, Olive View/UCLA Medical Center
Luis M Lovato, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

 
 
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