From the Guidelines
A mouth periosteal block is not a recommended technique for managing peri-operative analgesia, particularly in the context of proximal femoral fractures, as high volume, low concentration pericapsular / periosteal injection of local anaesthetic agents has not been assessed and may not provide sufficient analgesia 1. When considering analgesic techniques, it is essential to prioritize methods that have been proven to be effective and reliable.
- Peripheral nerve blockade, such as the psoas compartment block, may be a more reliable method for achieving peri-operative analgesia, although it carries risks such as neuraxial blockade and deep haematoma formation in recently anticoagulated patients 1.
- Anterior approaches, including femoral nerve and fascia iliaca block, may also be effective in reducing postoperative analgesia requirements and are more amenable to ultrasound-guided placement and continuous catheter infusions postoperatively 1.
- Wound infiltration with local anaesthetic is insufficiently analgesic, highlighting the need for more effective techniques to manage pain in patients undergoing surgery for proximal femoral fractures 1. In the context of dental anesthesia, a mouth periosteal block may be used to numb the periosteum in the oral cavity, but its application in other areas, such as proximal femoral fractures, is not supported by the available evidence.
- The technique involves injecting local anesthetic into the mucoperiosteum at the target site, but its effectiveness and safety in managing peri-operative analgesia for proximal femoral fractures have not been established 1.
From the Research
Mouth Periosteal Block
- The mouth periosteal block is not directly mentioned in the provided studies, however, the studies discuss alternative local anesthetic techniques such as buccal infiltration and intraligamentary injection 2, 3, 4.
- The inferior dental block is the standard for dental local anesthesia, but it has significant shortcomings, including a high rate of inadequate anesthesia, ranging from 31% to 81% 2.
- Alternative local anesthetic techniques, such as infiltration dentistry, have been shown to be effective in providing anesthesia for dental procedures, with articaine being a more successful agent compared to lidocaine and mepivacaine 3, 4.
- The use of articaine has been associated with a higher success rate in providing anesthesia, but there is also a risk of nerve damage, although the evidence is not conclusive 5, 6.
- Buccal infiltration with articaine has been shown to be an effective supplementary local anesthetic technique after a failed inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis 3, 4.