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Emergency Medical Minute


Sep 28, 2020

Contributor: Don Stader, MD

Educational Pearls:

  • Local anesthetics injected directly into wounds can cause distortion - especially important in facial lacerations
  • Several blocks can be helpful to help numb branches of the trigeminal nerve (CN V) which innervates the face:
    • Supraorbital nerve block: blocks distribution of V1 (most of the forehead) through injection above the eyebrow
    • External nasal nerve block: blocks superficial innervation of nose through injection along the nasal dorsum  
    • Infraorbital nerve block: blocks innervation to lip and cheek by injection below the eye
    • Mental nerve block: blocks innervation to chin and lower lip by injection at the mandible
  • Zygomatic nerve block: blocks innervation to temporal scalp and lateral aspect of forehead by injection at the temple
  • Greater auricular nerve block: blocks innervation to on and around the lower ear by injection across the sternocleidomastoid 


Moskovitz JB, Sabatino F. Regional nerve blocks of the face. Emerg Med Clin North Am. 2013 May;31(2):517-27. doi: 10.1016/j.emc.2013.01.003. Epub 2013 Feb 18. PMID: 23601486.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD