Nerve stimulation for regional anesthesia of the face: use of the blink reflex to confirm the localization of the trigeminal nerve.
A blink reflex is a bilateral eyelid closure in response to nociceptive stimuli. We hypothesized that elicitation of a blink by a stimulating needle may enhance performing regional anesthesia of the face. Thirty outpatients undergoing cutaneous surgery of the face were studied. A 2.5-cm insulated beveled stimulating needle was inserted at the emergence of the infraorbital nerve. On elicitation of a bilateral blink with 0.5 mA of stimulating current, bupivacaine 0.5% 3-7 mL was injected. Operative conditions were excellent. Blink response can be used to localize superficial branches of the trigeminal nerve. Elicitation of a blink response during nerve stimulation results in successful trigeminal block.


CONCLUSIONS
Elicitation of a blink response during nerve stimulation results in successful trigeminal block.
Bernard
Jean-Marc
JM
Département d'Anesthésie-Réanimation, Polyclinique Jean-Villar, Bruges-Bordeaux, France.
Péréon
Yann
Y
D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction; D000779:Anesthetics, Local; D001767:Blinking / Q000502:physiology*; D002045:Bupivacaine; D005145:Face / Q000294:innervation* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010812:Physical Stimulation; D012878:Skin Neoplasms / Q000601:surgery; D014276:Trigeminal Nerve / Q000033:anatomy & histology*
D000779:Anesthetics, Local; D002045:Bupivacaine