. Regional anesthesia : its technic and clinical application . Fig. 84.—Mental block b> the extra oral route Note the direction of the needle. BLOCKING OF CRANIAL NER\rES III introduced through a wheal raised midway between the gingival marginand the lower margin of the mandible, at a point 4 cm. lateral to themidline of the chin. It is directed frontward, inward, and downward,and advanced close to the bone and along its axis until its point is. Fig. 85.—Mental block: Arrow A shows the direction of the needle by the oral route;B, by the extra-oral route. about cm. from the midline (Figs
. Regional anesthesia : its technic and clinical application . Fig. 84.—Mental block b> the extra oral route Note the direction of the needle. BLOCKING OF CRANIAL NER\rES III introduced through a wheal raised midway between the gingival marginand the lower margin of the mandible, at a point 4 cm. lateral to themidline of the chin. It is directed frontward, inward, and downward,and advanced close to the bone and along its axis until its point is. Fig. 85.—Mental block: Arrow A shows the direction of the needle by the oral route;B, by the extra-oral route. about cm. from the midline (Figs. 84 and 85); I of the 2 percent, solution is then injected before attempting to locate the mentalforamen and pass the needle through it. Paresthesias are inducedvery frequently. As soon as the point of the needle is felt enteringthe foramen, 1 of the 2 per cent, solution is forced into the 112 REGIONAL ANESTHESIA canal. The incisor nerve is thus instantaneously blocked, and like-wise the mental nerve. The solution diffuses also backward in thedental canal, although not far enough to block the nerve supply of themolar teeth. The mental block is indicated for operations on the anterior portionof the lower jaw, including the chin, lower lip, mandible, bicuspids,cuspids, and incisors. Wlien operating on the midline bilateral blockis necessary. But in every case a subcutaneous infiltration along thelower border of the jaw is advisab
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