Transient asystole after mandibular nerve block

Abstract

Blockade of the trigeminal nerve and its branches at various locations is a well-established procedure to treat intractable pain syndromes in the distribution of the nerve. Mandibular nerve block is a commonly performed procedure by anesthesiologists, pain physicians, as well as dental practitioners. As it is considered to be a safe procedure, it is usually performed in an outpatient setting with or without monitoring. The complications associated with mandibular nerve block include intravascular injection, hypoesthesia, dysesthesia, sensory loss in mandibular nerve distribution, facial swelling, weakness of the masseter muscle, and injury to the auditory tube leading to severe vertigo. Here, we present an uncommon complication during mandibular nerve block with lignocaine in a patient of trigeminal neuralgia who suffered transient asystole during the procedure. The case highlights the importance of monitoring and emphasizes the need for additional precautions to be taken during pain procedures particularly in high-risk populations such as geriatric patients.

Keywords

• Asystole
• complications
• chronic pain
• mandibular nerve block