title: Lacrimal fossa block: an audit of a minimally invasive regional anaesthetic technique for endoscopic dacryocystorhinostomy (DCR).
abstract: The lacrimal fossa block (LFB), a new development to provide regional anaesthesia for endoscopic dacryocystorhinostomy, is reported. Cadaveric study showed that the block needle, inserted as described, made direct contact with the periosteum of the frontal process of the maxilla within the lacrimal fossa. This technique enables both relevant divisions of the trigeminal nerve to be anaesthetized through a single entry site and, as this injection is confined to the anterior part of the orbit, ocular complications are minimized. An audit of 66 patients has shown that this technique, combined with standard intranasal local anaesthesia, provides good intraoperative analgesia, causes minimal diplopia and has a high level of patient acceptability.
authors.affiliation: Pain Management Unit, Ipswich Hospital, Ipswich, Suffolk, UK. mylesfromhere@doctors.org.uk
authors.forename: M G
authors.initials: MG
authors.lastname: Smith
authors.forename: A S
authors.initials: AS
authors.lastname: Kong
authors.forename: M W
authors.initials: MW
authors.lastname: Yung
authors.forename: S
authors.initials: S
authors.lastname: Hardman Lea
authors.forename: G
authors.initials: G
authors.lastname: Leary
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction / Q000592:standards* / Q000639:trends; D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000175:diagnosis; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009407:Nerve Block / Q000592:standards / Q000639:trends; D010147:Pain Measurement; D016896:Treatment Outcome; D006113:United Kingdom