Barbed needle and inexplicable paresthesias and trismus after dental regional anesthesia

• Published in: Oral surgery, oral medicine, oral pathology Vol. 77; no. 6; pp. 585 - 588
• Main Authors: Stacy, G.C., Hajjar, G.
• Format: Journal Article
• Language: English
• Published: Saint Louis, MO Elsevier Inc 01.06.1994; Mosby
• Subjects: Anesthesia, Conduction - adverse effects; Anesthesia, Dental - adverse effects; Animals; Biological and medical sciences; Dentistry; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Maxillofacial surgery. Dental surgery. Orthodontics; Medical sciences; Needles - adverse effects; Paresthesia - etiology; Pterygoid Muscles - injuries; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Swine; Trigeminal Nerve Injuries; Trismus - etiology; Sensitivity disorder; Nervous system diseases; Stomatology; Dental disease; Paresthesia; Dentistry; Inferior dental nerve; Masticatory muscle; Pig; Striated muscle disease; Vertebrata; Trismus; Mammalia; Animal; Needle; Local anesthesia; Complication; Subcutaneous administration; Artiodactyla; Neurological disorder; Ungulata
• ISSN: 0030-4220; 1878-2175
• DOI: 10.1016/0030-4220(94)90315-8

The tips of 100 needles that had been used clinically for the administration of mandibular block anesthesia (50 by students and 50 by staff) were examined individually under a dissecting microscope. Sixty percent of these needles were found to be barbed. With the use of an animal laboratory simulation, it has been shown that the tips of standard needles as used in general dental practice will barb if allowed to touch bone (medial aspect of the mandibular ramus) during the administration of a mandibular block for dentistry using the direct approach and that a relationship exists between the pattern of this barbing, the disposition of the bevel of the needle at the time of its insertion, and the likelihood of lingual or inferior dental nerve involvement on withdrawal of the barbed needle. Simple precautions are advanced for reducing the possibility of nerve or other tissue damage from this source.