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Related Experiment Videos

Anatomic considerations in relation to the maxillary nerve block.

B Singh1, S K Srivastava, R Dang

  • 1Department of Anesthesiology, Lady Hardinge Medical College & Associated Hospitals, New Delhi, India. bali@ndf.vsnl.net.in

Regional Anesthesia and Pain Medicine
|November 15, 2001
PubMed
Summary

For maxillary nerve blocks, advance the needle approximately 0.25 cm past the pterygoid plate. This ensures accurate needle placement for effective anesthesia and patient comfort.

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Area of Science:

  • Anatomy
  • Regional Anesthesia
  • Surgical Techniques

Background:

  • Accurate needle placement is crucial for effective maxillary nerve blocks.
  • The lateral pterygoid plate serves as a key landmark in the extraoral approach.
  • Determining the precise needle depth beyond this landmark is essential to avoid complications.

Purpose of the Study:

  • To establish the optimal needle advancement distance past the lateral pterygoid plate for maxillary nerve blocks.
  • To provide anatomical guidance for clinicians performing lateral extraoral maxillary nerve blocks.

Main Methods:

  • A patient study measured distances from the zygomatic arch to the lateral pterygoid plate and paresthesia points.
  • An osteologic study measured distances on skulls from the zygomatic arch to the lateral pterygoid plate and the maxillary nerve's estimated location.

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  • Measurements were taken on both right and left sides in 75 patients and 120 skulls.

    • Main Results:

    • In patients, paresthesia occurred 0.21 cm (right) and 0.22 cm (left) beyond the lateral pterygoid plate.
    • In skulls, the maxillary nerve landmark was 0.13 cm (right) and 0.14 cm (left) beyond the lateral pterygoid plate.
    • Both studies indicated a small, consistent distance beyond the pterygoid plate.

    Conclusions:

    • Needle advancement should not exceed approximately 0.25 cm past the pterygoid plate.
    • This guideline aids in achieving accurate maxillary nerve blocks via the lateral extraoral approach.
    • The findings support precise needle selection for improved procedural safety and efficacy.