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Fixing Faces Painlessly: Facial Anesthesia In Emergency Medicine (Trauma CME)

December 2009

Abstract

Painful facial and oral conditions are very common reasons for emergency department (ED) visits. Dental-related complaints alone account for approximately 0.4% to 10.0% of ED visits and involved an estimated 3 million patients between 1997 and 2000.1

All emergency medicine clinicians will be called upon at some point to treat dental problems as well as facial lacerations, facial foreign bodies, tongue lacerations, and severe facial abrasions. Although these emergencies can be challenging and frustrating to treat (see the second vignette), managing them can be immensely rewarding for the emergency clinician with a basic understanding of dental and facial neuroanatomy and knowledge of some simple techniques. After all, there is no more appreciative and satisfied patient than one who has been relieved of severe pain.

Having diagnostic and treatment plans in place will facilitate care of these patients. Regional facial anesthesia should be an integral part of these plans, as the skilled use of this technique makes the clinician’s job easier and the patient’s experience less traumatic.

This issue of Emergency Medicine Practice focuses on determining which patients will benefit from regional anesthesia and how to perform the most common facial anesthesia procedures.

Keywords:
facial anesthesia, dental blocks, trigeminal nerve, benzocaine, bupivacaine, lidocaine,
and intraoral anesthesia, peritonsillar abscess anesthesia, greater palatine nerve block, nasopalatine nerve block, infraorbital nerve block, inferior alveolar nerve block, mental/incisive nerve block, tongue anesthesia, forehead block, facial anesthesia complications, facial anesthesia in the emergency department.

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