II. 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

III. Physiology

  1. Inferior alveolar nerve and lingual nerves pass through the pterygomandibular space, the target of this injection

IV. Preparations

  1. Typical: 0.5% bupivacaine (Marcaine or Sensorcaine) with Epinephrine 2 ml

V. Images

  1. Inferior Alveolar Nerve Block
    1. InferiorAlveolarBlock.png

VI. 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

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Ontology: Local anesthetic inferior alveolar nerve block (C0394801)

Concepts Therapeutic or Preventive Procedure (T061)
SnomedCT 231230006
English LA inferior alveol nerv block, ID - Inferior dental block, IDB - Inferior dental block, Inferior alveolar nerve block, Inferior dental block, Inferior dental nerve block, Local anaesthetic inferior alveolar nerve block, Local anesthetic inferior alveolar nerve block, Local anesthetic inferior alveolar nerve block (procedure)
Spanish bloqueo de nervio alveolar inferior con anest├ęsico local, bloqueo con anestesia local de nervio alveolar inferior, bloqueo con anestesia local de nervio alveolar inferior (procedimiento), bloqueo de nervio alveolar inferior con anest├ęsico local (procedimiento)