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Brown: Atlas of Regional Anesthesia, 3rd ed., Copyright © 2006 Saunders, An Imprint of Elsevier
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Chapter 21 – Maxillary Block


Local anesthetic block of the maxillary nerve in its peripterygoid location is most commonly used to evaluate facial neuralgia, although in its cutaneous distribution it can be used to facilitate surgical procedures ( Fig. 21-1 ). Injection of neurolytic solution from the lateral approach to the maxillary nerve in its peripterygoid location should be undertaken with extreme caution owing to its location near the orbit.

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Figure 21-1  Maxillary nerve (V2): cutaneous innervation.

Patient Selection.

The maxillary block is principally used diagnostically during the workup of facial neuralgia. For patients with significant cardiopulmonary disease who require a surgical procedure in the distribution of the maxillary nerve, it can be utilized for surgical anesthesia.

Pharmacologic Choice.

The maxillary nerve can be blocked with a low volume of local anesthetic (less than 5 mL); thus, virtually any local anesthetic can be chosen.

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