Anaesthesia by posterior superior alveolar nerve block

(1) The patient was seated with his head slightly tilted back and his mouth half open. The maxillary occlusal surface was 45° to the ground plane. The surgeon uses the mouth mirror to pull the mouth and cheek back and above to fully expose the upper molars.

(2) Generally, the vestibular groove at the distal buccal root of the upper second molars is used as the needle insertion point. For children whose maxillary second molars have not yet erupted, the vestibular groove at the distal buccal root of the first molars is used as the needle insertion point. For the patients without maxillary molars, the vestibular groove of the zygomatic alveolar crest was used as the injection point.

(3) The injection needle is 45° with the long axis of the maxillary tooth, and thrusting upward, backward and inward at the same time. When the needle is inserted, the tip of the needle slides along the curved surface of the maxillary tubercle, and the depth is about 2cm. No blood is drawn back, and 1.5-2ml anesthetic liquid can be injected.

Note: The needle tip should not be too deep, so as not to Pierce the wing venous plexus behind the maxillary nodule and cause hematoma.

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