V2 Block

[MrRongeurs]

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Any advice or videos on a succesful V2 block (Greater Palatine Approach)? I am doing a full mouth (28 teeth) next week and want to be efficient with my time and anesthetic.

I have read Malamed but really want to see it done. If nothing else I will make one of my classmates sit for me so I can try it out . . .

 

[DGDDS]

Youtube has (mostly) everything, just search around: http://www.youtube.com/watch?v=CYZ_OT-362A
That being said, maybe at least get a classmate to sit so you can feel around for landmarks. Use your mirror handle or a cotton topped applicator to feel around.
Good luck 🙂

 

[MrRongeurs]

I cannot for the life of me find a youtube video of the V2 block. I am not asking about the greater palatine block but actually seeing the orientation of the syringe and needle when navigating the greater palatine canal.

The only videos I can find are of the high tuberosity approach. http://www.youtube.com/watch?v=0irRxI8tWAI

 

[Vapor1122]

It's not often talked about. I've never seen it done, but since it's basically a modified GP block, I felt comfortable trying it after reading a few papers on it. I don't do it often, but the few times I have have worked really well. Just don't force that needle!

 

[MrRongeurs]

It's not often talked about. I've never seen it done, but since it's basically a modified GP block, I felt comfortable trying it after reading a few papers on it. I don't do it often, but the few times I have have worked really well. Just don't force that needle!

Thank you! I talked with an oral surgeon today who described the technique as really simple as long as you are in the canal and not off into the soft palate.

 

[DrTacoElf]

The one disadvantage you will find is that it will be bloodier when you start the avleoloplasty than if you did multiple infiltrations. Realistically you will probably end up doing both.

 

[Vapor1122]

For anyone else interested, here's a nice paper from Malamed about locating the canal, and some technique for the V2 block:

https://dl.dropbox.com/u/2081882/Intraoral_Maxillary_Nerve_Block.pdf

And another about a few more 'exotic' blocks, including the V2 block:

https://dl.dropbox.com/u/2081882/Local_Anesthetic_Blocks_of_the_Head_and_Neck.pdf

 

[joefosho315]

Any of you have any success in a V2 block by doing a high tuberosity approach?

 

[djeffreyt]

Any of you have any success in a V2 block by doing a high tuberosity approach?

I've tried the high tuberosity approach. It works about 60% of the time for me. It's not super reliable but then I've found the greater palatine foramen approach to be too painful for many patients for fairly routine work.