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Intracranial Air Embolism after Inferior Alveolar Nerve Block: A Case Report
INTRODUCTION: The number of nontraumatic dental pain emergency department (ED) visits continues to substantially rise in frequency every year. While there are several methods for treating dental pain, an inferior alveolar nerve block (IANB) is a non-narcotic alternative that provides instantaneous r...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676777/ https://www.ncbi.nlm.nih.gov/pubmed/33217299 http://dx.doi.org/10.5811/cpcem.2020.7.48417 |
Sumario: | INTRODUCTION: The number of nontraumatic dental pain emergency department (ED) visits continues to substantially rise in frequency every year. While there are several methods for treating dental pain, an inferior alveolar nerve block (IANB) is a non-narcotic alternative that provides instantaneous relief of severe pain. CASE REPORT: A 59-year-old male presented to the ED from a dentist’s office for evaluation of a right-sided headache with an associated episode of palpitations and near syncope that developed while receiving an inferior alveolar nerve block. Computed tomography of the patient’s head revealed multiple small foci of air in the right temporalis muscle and in the intracranial venous drainage system. Given the patient’s history of dental procedure, the intravascular introduction of air and local anesthetic was suspected. CONCLUSION: Inferior alveolar nerve block procedures can have complications, including hematoma formation, trismus, facial palsy, needle breakage, and in this case, intravascular injection and cerebral air embolism. To perform a successful IANB, it is critical for providers to be familiar with anatomical landmarks and to consistently perform aspiration to confirm that needle placement is not intravascular. |
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