Nerve stimulation for regional anesthesia of the face: use of the blink reflex to confirm the localization of the trigeminal nerve.

Abstract

A blink reflex is a bilateral eyelid closure in response to nociceptive stimuli. We hypothesized that elicitation of a blink by a stimulating needle may enhance performing regional anesthesia of the face. Thirty outpatients undergoing cutaneous surgery of the face were studied. A 2.5-cm insulated beveled stimulating needle was inserted at the emergence of the infraorbital nerve. On elicitation of a bilateral blink with 0.5 mA of stimulating current, bupivacaine 0.5% 3-7 mL was injected. Operative conditions were excellent. Blink response can be used to localize superficial branches of the trigeminal nerve. Elicitation of a blink response during nerve stimulation results in successful trigeminal block. Elicitation of a blink response during nerve stimulation results in successful trigeminal block.