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Forehead Regional BlockAka: Regional Anesthesia for the Forehead, Supraorbital Nerve Block, Supratrochlear Nerve Block

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  1. Indication
    1. Regional anesthesia for forehead
  2. Physiology: Landmarks
    1. Supraorbital Nerve
      1. Exits skull at supraorbital foramen
      2. Upper orbit border, between upper lid and brow
      3. Centered over upper lid (~2.5 cm lateral to midline)
    2. Supratrochlear Nerve
      1. Exits skull 1 cm medial to supraorbital foramen
  3. Technique: Supraorbital and Supratrochlear nerve block
    1. Images
      1. SurgeryBlockForehead.jpg
    2. Locate supraorbital foramen as above
    3. Insert needle
      1. Lateral to supraorbital foramen
      2. Direct needle medially, parallel to brow, toward nose
    4. Infiltrate mid-two thirds of lower edge of eyebrow
      1. Use 5-7 cc of 1% Lidocaine
      2. Inject just above bone level
      3. Redirect needle if Paresthesias or sharp pain
  4. References
    1. Moy in Pfenninger (1994) Procedures, p. 145-55
    2. Salam (2004) Am Fam Physician 69(3):585

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