Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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Edema and hematoma after local anesthesia via posterior superior alveolar nerve block: a case report

  • Marques, Aline Louise Nascimento (Department of Biosciences, Piracicaba Dental School, University of Campinas - UNICAMP - Piracicaba) ;
  • Figueroba, Sidney R. (Department of Biosciences, Piracicaba Dental School, University of Campinas - UNICAMP - Piracicaba) ;
  • Mafra, Marco Antonio Tridapalli (Department of Biosciences, Piracicaba Dental School, University of Campinas - UNICAMP - Piracicaba) ;
  • Groppo, Francisco Carlos (Department of Biosciences, Piracicaba Dental School, University of Campinas - UNICAMP - Piracicaba)
  • Received : 2022.04.05
  • Accepted : 2022.05.22
  • Published : 2022.06.01
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Abstract

Although rare, complications can occur with anesthetic procedures. The posterior superior alveolar nerve (PSAN) block anesthetic technique has a high success rate, but positive aspiration can cause bruising, transient diplopia, blurred vision, and temporary blindness in approximately 3% cases. When edema occurs, it is occasionally massive, especially in the infratemporal fossa, and the resulting hematoma is usually unsightly. A 20-year-old woman presented with massive edema followed by hematoma in the upper right jaw immediately after PSAN block administration, which subsequently spread to the oral mucosa. The patient did not report any complications during the anesthetic procedure. However, after the injection was administered, the patient experienced anesthetic sensations, which rapidly evolved to facial edema. There was mild pain, but without intraoral or extraoral bleeding. The patient was prescribed medicines and instructed to perform contrast therapy. Although hematomas and edema are rare, they are difficult to prevent. The choice of local anesthetic and appropriate application of the anesthetic technique can minimize their occurrence.

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