Post operative pain relief through intermittent mandibular nerve block

Mandibular nerve block is often performed for diagnostic, therapeutic and anesthetic purposes for surgery involving mandibular region. Advantages of a nerve block include excellent pain relief and avoidance of the side effects associated with the use of opiods or Non-steroidal anti-inflammatory drug (NSAIDs). A patient with maxillo facial trauma was scheduled for open reduction and internal fixation of right parasymphyseal mandibular fracture. The mandibular nerve was approached using the lateral extraoral approach with an 18-gauge i.v. cannula under general anesthesia. He received 4 ml boluses of 0.25% plain bupivacaine for intraoperative analgesia and 12 hourly for 48 h post operatively. VAS scores remained less than 4 through out observation period. The only side effect was numbness of ipsilateral lower jaw line, which subsided after local anesthetic administration was discontinued. Patient was discharged after four days.