J Korean Dent Soc Anesthesiol.  2009 Dec;9(2):108-115. 10.17245/jkdsa.2009.9.2.108.

The Persistent Paresthesia Care on Left Lingual & Buccal Shelf Regions after the Lingual & Long Buccal Nerve Block Anesthesia: A Case Report

• Kim HR
• Yoo JH
• Choi BH
• Mo DY
• Lee CU
• Kim JB

• KMID: 2345102
• DOI: http://doi.org/10.17245/jkdsa.2009.9.2.108

Abstract

Trauma to any nerve may lead to persistent paresthesia. Trauma to the nerve sheath can be produced by the needle. The patient frequently reports the sensation of an electric shock throughout the distribution of the nerve involved. It is difficult for the type of needle used in dental practice to actually sever a nerve trunk or even its fibers. Trauma to the nerve produced by contact with the needle is all that is needed to produce paresthesia. Hemorrhage into or around the neural sheath is another cause. Bleeding increases pressure on the nerve, leading to paresthesia. Injection of local anesthetic solutions contaminated by alcohol or sterilizing solution near a nerve produces irritation; the resulting edema increases pressure in the region of the nerve, leading to paresthesia. Persistent paresthesia can lead to injury to adjacent tissues. Biting or thermal or chemical insult can occur without a patient's awareness, until the process has progressed to a serious degree. Most paresthesias resolve in approximately 8 weeks without treatment. In most situations paresthesia is only minimal, with the patient retaining most sensory function to the affected area. In these cases there is only a very slight possibility of self injury. But, the patient complaints the discomfort symptoms of paresthesia, such as causalgia, neuralgiaform pain and anesthesia dolorosa. Most paresthesias involve the lingual nerve, with the inferior alveolar nerve a close second. This is the report of a case, that had the persistent paresthesia care on left lingual & buccal shelf regions after the lingual and long buccal nerve block anesthesia.

Keyword

Lingual nerve block anesthesia; Buccal nerve block anesthesia; Needle trauma to the nerve sheath; Electric shock; Persistent paresthesia care

MeSH Terms

Anesthesia*
Causalgia
Edema
Hemorrhage
Humans
Lingual Nerve
Mandibular Nerve
Needles
Nerve Block*
Paresthesia*
Sensation
Shock