What is an infraorbital nerve block?

Infraorbital nerve block deadens facial sensation, and may be performed from inside or outside the mouth.
Infraorbital nerve block deadens facial sensation, and may be performed from inside or outside the mouth.

Infraorbital nerve block is a type of anesthesia used for numbing parts of the face. There is an infraorbital nerve on each side of the face, which is responsible for sensation to the skin on the side of the face, of the lower eyelid, the side of the nose, and the upper lip.

This type of anesthetic nerve block is mainly used for wound repair of the face, nose, and lip.

Where is the infraorbital nerve located?

The sensory area of the infraorbital nerve is located on the face, under the eye, on the side of the nose, and down the nasolabial fold to the upper lip. The infraorbital nerve is a branch of the 5th cranial nerve (called the trigeminal nerve), which provides sensory input to the face. 

The trigeminal nerve divides into the maxillary nerve, and exits the skull and enters the face through the infraorbital canal (infraorbital foramen), becoming the infraorbital nerve. 

What is an infraorbital nerve block used for?

Infraorbital nerve block is used for:

  • Laceration and wound repair
  • Pain relief
  • Anesthesia to clean out chronic wounds or ulcers (debridement)
  • Patients who need facial surgery but cannot receive general anesthetic
  • May be used in some plastic surgery procedures on the face

How do doctors perform an infraorbital nerve block?

There are two approaches to performing infraorbital nerve block, through the mouth (intraoral) and outside the mouth (extraoral). 

For an infraorbital nerve block performed through the mouth (intraoral):

  • Topical anesthetic is applied to the inner part of the upper lip and gums 
  • The doctor feels for the infraorbital canal (foramen) in the middle of the cheek
  • An anesthetic is injected into the area around the infraorbital canal using a small needle from inside the upper lip
  • After a few minutes, the area of the infraorbital nerve becomes numb and the procedure can be performed

For an infraorbital nerve block performed from outside the mouth (extraoral):

  • The skin over the cheek is cleansed with antiseptic
  • The doctor feels for the infraorbital canal (foramen) in the middle of the cheek
  • An anesthetic is injected through the skin of the cheek into the area around the infraorbital canal using a small needle 
  • The doctor firmly massages the area for 10-15 seconds
  • After a few minutes, the area of the infraorbital nerve becomes numb and the procedure can be performed

For either the intraoral or extraoral approach, the local anesthetic’s (usually lidocaine) effect lasts between 30 minutes and two hours. 

What are risks and complications of an infraorbital nerve block?

Complications that may result from an infraorbital nerve block can include the following:

  • Bleeding
  • Bruising
  • Allergic reaction to anesthetic
  • Systemic reaction to too much anesthetic 
  • Infection
  • Unintentional injection into artery or vein
  • Insufficient anesthetic use
  • Nerve damage
  • Eyelid swelling

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Medically Reviewed on 4/21/2020
References
Medscape Medical Reference
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