. Regional anesthesia : its technic and clinical application . ildren, and a little closer to its uppermargin in elderly patients. As already stated (page 86), a straightline drawn through the supra-orbital notch and infra-orbital foramenpasses through the mental foramen. That line marks also the secondbicuspid (Fig. 82). The mental foramen gives access to the mentalcanal which is directed frontward, downward, and inward, almost alongthe axis of the bone; so that, if it is desired to block the mental nervewithin the canal, thereby blocking the incisor nerve at the same time,it will be necessar
. Regional anesthesia : its technic and clinical application . ildren, and a little closer to its uppermargin in elderly patients. As already stated (page 86), a straightline drawn through the supra-orbital notch and infra-orbital foramenpasses through the mental foramen. That line marks also the secondbicuspid (Fig. 82). The mental foramen gives access to the mentalcanal which is directed frontward, downward, and inward, almost alongthe axis of the bone; so that, if it is desired to block the mental nervewithin the canal, thereby blocking the incisor nerve at the same time,it will be necessary to insert the needle a little lateral to the foramenand introduce it along the axis of the canal, that is, frontward, inward, BLOCKING OF CRANIAL NERVES 109 and a little downward. The mental nerve may be blocked eitherthrough the mouth or from outside. Oral Route.—^With the teeth closed, the lower lip and angle of themouth are retracted downward and backward with the forefinger of theleft hand. Needle No. 2, fitted on to the syringe, is introduced in the. Fig. 82.—The straight line AB drawn through the supra-orbital notch and infra-orbital foramen passes through the mental foramen. gingivobuccal reflection at the level of the space between the firstand second bicuspids and advanced vertically downward close to thebone, as far as midway between the alveolar border and the lower marginof the mandible; 2 of the 2 per cent, solution are then injected andthe region submitted to light massage (Figs. 83 and 85). Extra-oral Route.—Needle No. 2, connected with the sjnringe, is REGIONAL ANESTHESIA
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