From the FDA Drug Label
INDICATIONS & USAGE Lidocaine HCl Injections are indicated for production of local anesthesia by infiltration techniques such as percutaneous injection by peripheral nerve block techniques such as brachial plexus and intercostal, when the accepted procedures for these techniques as described in standard textbooks are observed. The FDA drug label does not answer the question.
From the Research
The masseteric nerve block would be the most helpful peripheral nerve block for a patient experiencing pain directly over the masseters anteriorly into the jaw. This procedure typically involves injecting a local anesthetic such as lidocaine 1-2% or bupivacaine 0.25-0.5% near the mandibular notch where the nerve passes, as described in the study by 1. The masseteric nerve block is an effective technique for obtaining anesthesia in the whole masseter muscle, providing temporary relief and can be both diagnostic and therapeutic, helping to confirm the pain source while providing relief.
Some key points to consider when performing a masseteric nerve block include:
- The use of ultrasound guidance to improve accuracy and safety
- The typical volume of local anesthetic used, which is 3-5 mL
- The procedure involves identifying the coronoid notch of the mandible and inserting the needle perpendicular to the skin until bone is contacted, then withdrawing slightly before injecting
- The block provides temporary relief, which can last from hours to days depending on the anesthetic used
It's also worth noting that other studies, such as 2, 3, 4, and 5, discuss the use of different nerve blocks and local anesthetics for pain management in the mandibular region, but the masseteric nerve block is specifically targeted at the masseter muscle, making it the most relevant choice for this particular patient's symptoms.
In terms of the specific local anesthetic to use, bupivacaine has been shown to provide longer-lasting pain relief compared to lidocaine, as seen in studies such as 4 and 5. However, the choice of local anesthetic will depend on the individual patient's needs and medical history.
Overall, the masseteric nerve block is a effective and targeted treatment option for patients experiencing pain in the masseter muscle, and can provide significant relief from symptoms.