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<h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Inferior alveolar nerve anaesthesia</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. 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class="vector-pinnable-header-label">Appearance</div> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-pin-button" data-event-name="pinnable-header.vector-appearance.pin">move to sidebar</button> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-unpin-button" data-event-name="pinnable-header.vector-appearance.unpin">hide</button> </div> </div> </div> </nav> </div> </div> <div id="bodyContent" class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><p><b>Inferior alveolar nerve block</b> (abbreviated to <b>IANB</b>, and also termed <b>inferior alveolar nerve anesthesia</b> or <b>inferior dental block</b>) is a <a href="/wiki/Nerve_block" title="Nerve block">nerve block</a> technique which induces anesthesia (numbness) in the areas of the mouth and face innervated by one of the <a href="/wiki/Inferior_alveolar_nerve" title="Inferior alveolar nerve">inferior alveolar nerves</a> which are paired on the left and right side. These areas are the skin and mucous membranes of the lower lip, the skin of the chin, the lower teeth and the labial gingiva of the anterior teeth, all unilaterally to the midline of the side on which the block is administered.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> However, depending on technique, the <a href="/wiki/Long_buccal_nerve" class="mw-redirect" title="Long buccal nerve">long buccal nerve</a> may not be <sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> anesthetized by an IANB and therefore an area of buccal gingiva adjacent to the lower posterior teeth will retain normal sensation unless that nerve is anesthetized separately, via a (long) <a href="/wiki/Buccal_nerve#Anesthesia" title="Buccal nerve">buccal nerve block</a>. The inferior alveolar nerve is a branch of the <a href="/wiki/Mandibular_nerve" title="Mandibular nerve">mandibular nerve</a>, the third division of the <a href="/wiki/Trigeminal_nerve" title="Trigeminal nerve">trigeminal nerve</a>. This procedure attempts to anaesthetise the inferior alveolar nerve prior to it entering the <a href="/wiki/Mandibular_foramen" title="Mandibular foramen">mandibular foramen</a> on the medial surface of the mandibular ramus.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (February 2022)">citation needed</span></a></i>]</sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Symptoms_of_anesthesia">Symptoms of anesthesia</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Inferior_alveolar_nerve_anaesthesia&action=edit&section=1" title="Edit section: Symptoms of anesthesia"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Administration of anesthesia near the mandibular foramen causes blockage of the inferior alveolar nerve and the nearby lingual nerve by diffusion (includes supplying the <a href="/wiki/Tongue" title="Tongue">tongue</a>). This causes patients to lose sensation in: </p> <ul><li>their mandibular teeth on one side (via inferior alveolar nerve block)</li> <li>their <a href="/wiki/Lower_lip" class="mw-redirect" title="Lower lip">lower lip</a> and chin on one side (via <a href="/wiki/Mental_nerve" title="Mental nerve">mental nerve</a> block)</li> <li>and parts of their tongue and lingual gingival tissue on one side except on the cheek side of the mandibular molars (via <a href="/wiki/Lingual_nerve" title="Lingual nerve">lingual nerve</a> block); a buccal block will anesthetize this later tissue area.</li></ul> <p>Another symptom is harmless numbness and tingling of the body of the tongue and floor of the mouth, which indicates that the lingual nerve, a branch of the mandibular nerve, is anesthetized. Another symptom that can occur is “lingual shock” as the needle passes by the lingual nerve during administration. The patient may make an involuntary movement, varying from a slight opening of the eyes to jumping in the chair. This symptom is only momentary, and anesthesia will quickly occur.<sup id="cite_ref-:0_3-0" class="reference"><a href="#cite_note-:0-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Injection_techniques">Injection techniques</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Inferior_alveolar_nerve_anaesthesia&action=edit&section=2" title="Edit section: Injection techniques"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There are a number of techniques that are commonly used to achieve inferior alveolar nerve anesthesia. The most commonly used techniques involve an attempted block of an entire portion of the inferior alveolar nerve: </p> <ul><li>Inferior alveolar nerve block or IANB - The nerve is approached from the opposite side of the mouth over the contralateral premolars. After piercing the mandibular tissue on the medial border of the mandibular ramus within the pterygomandibular space and then contacting medial surface of the alveolar bone as well as being lateral to the pterygomandibular fold and the sphenomandibular ligament, the injection is given.<sup id="cite_ref-:0_3-1" class="reference"><a href="#cite_note-:0-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></li> <li>Gow-Gates technique - Invented by <a href="/wiki/Australia" title="Australia">Australian</a> dentist George A.E. Gow-Gates in the mid-1970s, the needle is directed at the neck of the condyle just under the insertion of the lateral pterygoid muscle.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> This is used for more extensive anesthesia or when there is failure of the IANB</li> <li>Vazirani-Akinosi technique - Invented by Sunder J. Vazirani in 1960 and later reintroduced in 1977 by Oyekunle J. Akinosi, a closed-mouth injection technique, the syringe is "advanced parallel to the maxillary occlusal plane at the level of the <a href="/wiki/Maxilla" title="Maxilla">maxillary</a> <a href="/wiki/Mucogingival_junction" title="Mucogingival junction">mucogingival junction</a>."<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> This is used when the patient cannot open his mouth enough for the IANB.</li></ul> <div class="mw-heading mw-heading2"><h2 id="Complications">Complications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Inferior_alveolar_nerve_anaesthesia&action=edit&section=3" title="Edit section: Complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>The most common adverse effect of this injection is accidental self-inflicted trauma after the procedure, either by biting the lip or tongue or by thermal burn caused by inadvertent drinking of fluid that is too hot. This classically occurs in children or those with learning disability.<sup id="cite_ref-:1_6-0" class="reference"><a href="#cite_note-:1-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></li> <li>A blood vessel may be punctured accidentally and a hematoma or "blood blister" may occur that will heal over time.<sup id="cite_ref-:1_6-1" class="reference"><a href="#cite_note-:1-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></li> <li>If needle is positioned too posteriorly, anesthetic may be put into <a href="/wiki/Parotid_gland" title="Parotid gland">parotid gland</a>, that may cause transient facial paralysis of the facial nerve or cranial Nerve VII (7). Symptoms of this temporary loss of the use of the muscles of facial expression include the inability to close the eyelid and the drooping of the labial commissure on the affected side for a few hours.<sup id="cite_ref-:0_3-2" class="reference"><a href="#cite_note-:0-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></li> <li>Also if the needle is placed too medially the medial pterygoid muscle can be injected, resulting in <a href="/wiki/Trismus" title="Trismus">trismus</a>.</li> <li>The sphenomandibular ligament may act as a barrier to the agent if the injection is given too shallow and the lingual nerve is only anesthetized.<sup id="cite_ref-:0_3-3" class="reference"><a href="#cite_note-:0-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></li> <li>This injection can rarely cause <a href="/wiki/Needle_tract_infection" class="mw-redirect" title="Needle tract infection">needle tract infections</a> of the <a href="/wiki/Pterygomandibular_space" title="Pterygomandibular space">pterygomandibular space</a>.<sup id="cite_ref-Connor_1988_7-0" class="reference"><a href="#cite_note-Connor_1988-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Hupp_2008_8-0" class="reference"><a href="#cite_note-Hupp_2008-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> This is because the mouth contains many types of bacteria which are normally harmless by virtue of the physical barrier that the mucosa presents. However, if they are inoculated into the tissues during an injection, they can become <a href="/wiki/Pathogenic" class="mw-redirect" title="Pathogenic">pathogenic</a> (disease causing).</li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Inferior_alveolar_nerve_anaesthesia&action=edit&section=4" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text">Agur, Anne M.R., and Arthur F. Dalley. Grant's Atlas Of Anatomy. 12th ed. Maryland, USA: Lippincott Williams & Wilkins, 2009. Print.</span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFAker2001" class="citation journal cs1">Aker, F. D. (2001). "Blocking the buccal nerve using two methods of inferior alveolar block injection". <i>Clinical Anatomy</i>. <b>14</b> (2): 111–119. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F1098-2353%28200103%2914%3A2%3C111%3A%3AAID-CA1019%3E3.0.CO%3B2-3">10.1002/1098-2353(200103)14:2<111::AID-CA1019>3.0.CO;2-3</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0897-3806">0897-3806</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11241746">11241746</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:25873814">25873814</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clinical+Anatomy&rft.atitle=Blocking+the+buccal+nerve+using+two+methods+of+inferior+alveolar+block+injection&rft.volume=14&rft.issue=2&rft.pages=111-119&rft.date=2001&rft.issn=0897-3806&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A25873814%23id-name%3DS2CID&rft_id=info%3Apmid%2F11241746&rft_id=info%3Adoi%2F10.1002%2F1098-2353%28200103%2914%3A2%3C111%3A%3AAID-CA1019%3E3.0.CO%3B2-3&rft.aulast=Aker&rft.aufirst=F.+D.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInferior+alveolar+nerve+anaesthesia" class="Z3988"></span></span> </li> <li id="cite_note-:0-3"><span class="mw-cite-backlink">^ <a href="#cite_ref-:0_3-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:0_3-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:0_3-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-:0_3-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text">Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, page 216</span> </li> <li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20090830170757/http://www.doctorspiller.com/gow-gates_block.htm">"Gow-Gates technique, explained"</a>. Archived from <a rel="nofollow" class="external text" href="http://www.doctorspiller.com/gow-gates_block.htm">the original</a> on 2009-08-30<span class="reference-accessdate">. Retrieved <span class="nowrap">2009-06-12</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Gow-Gates+technique%2C+explained&rft_id=http%3A%2F%2Fwww.doctorspiller.com%2Fgow-gates_block.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInferior+alveolar+nerve+anaesthesia" class="Z3988"></span></span> </li> <li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMeechan_JG1999" class="citation journal cs1">Meechan JG (January 1999). "How to overcome failed local anaesthesia". <i>Br Dent J</i>. <b>186</b> (1): 15–20. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fsj.bdj.4800006">10.1038/sj.bdj.4800006</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10028738">10028738</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:6618968">6618968</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Br+Dent+J&rft.atitle=How+to+overcome+failed+local+anaesthesia&rft.volume=186&rft.issue=1&rft.pages=15-20&rft.date=1999-01&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A6618968%23id-name%3DS2CID&rft_id=info%3Apmid%2F10028738&rft_id=info%3Adoi%2F10.1038%2Fsj.bdj.4800006&rft.au=Meechan+JG&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInferior+alveolar+nerve+anaesthesia" class="Z3988"></span></span> </li> <li id="cite_note-:1-6"><span class="mw-cite-backlink">^ <a href="#cite_ref-:1_6-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:1_6-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text">Local Anesthesia for the Dental Hygienist, Logothetis, Elsevier, 2012</span> </li> <li id="cite_note-Connor_1988-7"><span class="mw-cite-backlink"><b><a href="#cite_ref-Connor_1988_7-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFConnorEdelson,_JG1988" class="citation journal cs1">Connor, JP; Edelson, JG (April 1988). <a rel="nofollow" class="external text" href="https://zenodo.org/record/1258246">"Needle tract infection. A case report"</a>. <i>Oral Surgery, Oral Medicine, and Oral Pathology</i>. <b>65</b> (4): 401–3. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2F0030-4220%2888%2990351-9">10.1016/0030-4220(88)90351-9</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/3163131">3163131</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Oral+Surgery%2C+Oral+Medicine%2C+and+Oral+Pathology&rft.atitle=Needle+tract+infection.+A+case+report.&rft.volume=65&rft.issue=4&rft.pages=401-3&rft.date=1988-04&rft_id=info%3Adoi%2F10.1016%2F0030-4220%2888%2990351-9&rft_id=info%3Apmid%2F3163131&rft.aulast=Connor&rft.aufirst=JP&rft.au=Edelson%2C+JG&rft_id=https%3A%2F%2Fzenodo.org%2Frecord%2F1258246&rfr_id=info%3Asid%2Fen.wikipedia.org%3AInferior+alveolar+nerve+anaesthesia" class="Z3988"></span></span> </li> <li id="cite_note-Hupp_2008-8"><span class="mw-cite-backlink"><b><a href="#cite_ref-Hupp_2008_8-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFHuppEllisTucker2008" class="citation book cs1">Hupp JR, Ellis E, Tucker MR (2008). <i>Contemporary oral and maxillofacial surgery</i> (5th ed.). 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href="/wiki/Template:Anesthesia" title="Template:Anesthesia"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Anesthesia" title="Template talk:Anesthesia"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Anesthesia" title="Special:EditPage/Template:Anesthesia"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Anesthesia_and_anesthesiology" style="font-size:114%;margin:0 4em"><a href="/wiki/Anesthesia" title="Anesthesia">Anesthesia</a> and <a href="/wiki/Anesthesiology" title="Anesthesiology">anesthesiology</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Types</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/General_anaesthesia" title="General anaesthesia">General</a> <ul><li><a href="/wiki/Sedation" title="Sedation">Sedation</a> <ul><li><a href="/wiki/Procedural_sedation_and_analgesia" title="Procedural sedation and analgesia">Procedural sedation and analgesia</a></li></ul></li> <li><a href="/wiki/Twilight_anesthesia" title="Twilight anesthesia">Twilight anesthesia</a></li></ul></li> <li><a href="/wiki/Local_anesthesia" title="Local anesthesia">Local</a> <ul><li><a href="/wiki/Continuous_wound_infiltration" title="Continuous wound infiltration">Continuous wound infiltration</a></li> <li><a href="/wiki/Topical_anesthetic" title="Topical anesthetic">Topical</a></li></ul></li> <li><a href="/wiki/Neuraxial_blockade" title="Neuraxial blockade">Neuraxial blockade</a> <ul><li><a href="/wiki/Combined_spinal_and_epidural_anaesthesia" title="Combined spinal and epidural anaesthesia">Combined spinal and epidural anaesthesia</a></li> <li><a href="/wiki/Epidural_administration" title="Epidural administration">Epidural anesthesia</a></li> <li><a href="/wiki/Spinal_anaesthesia" title="Spinal anaesthesia">Spinal anaesthesia</a></li></ul></li> <li><a href="/wiki/Nerve_block" title="Nerve block">Nerve block</a> <ul><li><a href="/wiki/Brachial_plexus_block" title="Brachial plexus block">Brachial plexus block</a></li> <li><a href="/wiki/Fascia_iliaca_block" title="Fascia iliaca block">Fascia iliaca block</a></li> <li><a href="/wiki/Femoral_nerve_block" title="Femoral nerve block">Femoral nerve block</a></li> <li><a class="mw-selflink selflink">Inferior alveolar nerve block</a></li> <li><a href="/wiki/Intercostal_nerve_block" title="Intercostal nerve block">Intercostal nerve block</a></li> <li><a href="/wiki/Interpleural_block" title="Interpleural block">Interpleural block</a></li> <li><a href="/wiki/Intravenous_regional_anesthesia" title="Intravenous regional anesthesia">Intravenous regional anesthesia</a></li> <li><a href="/wiki/Occipital_nerve_block" title="Occipital nerve block">Occipital nerve block</a></li> <li><a href="/wiki/Paracervical_block" title="Paracervical block">Paracervical block</a></li> <li><a href="/wiki/Pudendal_anesthesia" title="Pudendal anesthesia">Pudendal nerve block</a></li> <li><a href="/wiki/Retrobulbar_block" title="Retrobulbar block">Retrobulbar block</a></li> <li><a href="/wiki/Sciatic_nerve_block" title="Sciatic nerve block">Sciatic nerve block</a></li> <li><a href="/wiki/Transverse_abdominis_plane_block" title="Transverse abdominis plane block">Transverse abdominis plane block</a></li></ul></li> <li><a href="/wiki/Total_intravenous_anaesthesia" title="Total intravenous anaesthesia">Total intravenous anaesthesia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pharmacologic agents</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anticholinergic" title="Anticholinergic">Anticholinergics</a></li> <li><a href="/wiki/Antiemetic" title="Antiemetic">Antiemetics</a></li> <li><a href="/wiki/Butyrophenone" title="Butyrophenone">Butyrophenones</a></li> <li><a href="/wiki/List_of_benzodiazepines" title="List of benzodiazepines">Benzodiazepines</a></li> <li><a href="/wiki/Category:General_anesthetics" title="Category:General anesthetics">General anesthetics</a></li> <li><a href="/wiki/Inhalational_anesthetic" title="Inhalational anesthetic">Inhalational anesthetics</a></li> <li><a href="/wiki/List_of_local_anesthetics" title="List of local anesthetics">Local anesthetics</a></li> <li><a href="/wiki/Neuromuscular-blocking_drug" title="Neuromuscular-blocking drug">Neuromuscular-blocking drugs</a></li> <li><a href="/wiki/List_of_opioids" title="List of opioids">Opioids</a></li> <li><a href="/wiki/Category:Sedatives" title="Category:Sedatives">Sedatives</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Techniques</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Airway_management" title="Airway management">Airway management</a></li> <li><a href="/wiki/Anesthesia_provision_in_the_United_States" title="Anesthesia provision in the United States">Anesthesia provision in the US</a></li> <li><a href="/wiki/Bronchoscopy" title="Bronchoscopy">Bronchoscopy</a></li> <li><a href="/wiki/Dogliotti%27s_principle" title="Dogliotti's principle">Dogliotti's principle</a></li> <li><a href="/wiki/Intravenous_therapy" title="Intravenous therapy">Intravenous therapy</a></li> <li><a href="/wiki/Laryngoscopy" title="Laryngoscopy">Laryngoscopy</a></li> <li><a href="/wiki/Tracheal_intubation" title="Tracheal intubation">Tracheal intubation</a> <ul><li><a href="/wiki/Rapid_sequence_induction" title="Rapid sequence induction">Rapid sequence induction</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Scientific principles</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Blood%E2%80%93gas_partition_coefficient" title="Blood–gas partition coefficient">Blood–gas partition coefficient</a></li> <li><a href="/wiki/Concentration_effect" title="Concentration effect">Concentration effect</a></li> <li><a href="/wiki/Fink_effect" title="Fink effect">Fink effect</a></li> <li><a href="/wiki/Minimum_alveolar_concentration" title="Minimum alveolar concentration">Minimum alveolar concentration</a></li> <li><a href="/wiki/Second_gas_effect" title="Second gas effect">Second gas effect</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Measurements</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/ASA_physical_status_classification_system" title="ASA physical status classification system">ASA physical status classification system</a></li> <li><a href="/wiki/Baricity" title="Baricity">Baricity</a></li> <li><a href="/wiki/Bispectral_index" title="Bispectral index">Bispectral index</a></li> <li><a href="/wiki/Body_mass_index" title="Body mass index">Body mass index</a></li> <li><a href="/wiki/Capnography" title="Capnography">Capnography</a></li> <li><a href="/wiki/Entropy_monitoring" title="Entropy monitoring">Entropy monitoring</a></li> <li><a href="/wiki/Fick_principle" title="Fick principle">Fick principle</a></li> <li><a href="/wiki/Goldman_index" class="mw-redirect" title="Goldman index">Goldman index</a></li> <li><a href="/wiki/Guedel%27s_classification" title="Guedel's classification">Guedel's classification</a></li> <li><a href="/wiki/Intraoperative_neurophysiological_monitoring" title="Intraoperative neurophysiological monitoring">Intraoperative neurophysiological monitoring</a></li> <li><a href="/wiki/Mallampati_score" title="Mallampati score">Mallampati score</a></li> <li><a href="/wiki/Neuromuscular_monitoring" title="Neuromuscular monitoring">Neuromuscular monitoring</a></li> <li><a href="/wiki/Pain_scale" title="Pain scale">Pain scale</a></li> <li><a href="/wiki/Thyromental_distance" title="Thyromental distance">Thyromental distance</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Instruments_used_in_anesthesiology" title="Instruments used in anesthesiology">Instruments</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anaesthetic_machine" title="Anaesthetic machine">Anaesthetic machine</a></li> <li><a href="/wiki/Anesthetic_vaporizer" class="mw-redirect" title="Anesthetic vaporizer">Anesthetic vaporizer</a></li> <li><a href="/wiki/Arterial_catheter" class="mw-redirect" title="Arterial catheter">Arterial catheter</a></li> <li><a href="/wiki/Bronchial_blocker" title="Bronchial blocker">Bronchial blocker</a></li> <li><a href="/wiki/Double-lumen_endobronchial_tube" title="Double-lumen endobronchial tube">Double-lumen endobronchial tube</a></li> <li><a href="/wiki/Gas_cylinder" title="Gas cylinder">Gas cylinder</a></li> <li><a href="/wiki/Laryngeal_mask_airway" title="Laryngeal mask airway">Laryngeal mask airway</a></li> <li><a href="/wiki/Laryngeal_tube" title="Laryngeal tube">Laryngeal tube</a></li> <li><a href="/wiki/Magill_forceps" title="Magill forceps">Magill forceps</a></li> <li><a href="/wiki/Relative_analgesia_machine" title="Relative analgesia machine">Relative analgesia machine</a></li> <li><a href="/wiki/Tracheal_tube" title="Tracheal tube">Tracheal tube</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Complications</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Allergic_reactions_to_anesthesia" title="Allergic reactions to anesthesia">Allergic reactions</a></li> <li><a href="/wiki/Anesthesia_awareness" title="Anesthesia awareness">Anesthesia awareness</a></li> <li><a href="/wiki/Drug-induced_amnesia" title="Drug-induced amnesia">Drug-induced amnesia</a></li> <li><a href="/wiki/Effects_of_early-life_exposures_to_anesthesia_on_the_brain" title="Effects of early-life exposures to anesthesia on the brain">Effects of early-life exposures to anesthesia on the brain</a></li> <li><a href="/wiki/Emergence_delirium" title="Emergence delirium">Emergence delirium</a></li> <li><a href="/wiki/Local_anesthetic_toxicity" class="mw-redirect" title="Local anesthetic toxicity">Local anesthetic toxicity</a></li> <li><a href="/wiki/Malignant_hyperthermia" title="Malignant hyperthermia">Malignant hyperthermia</a></li> <li><a href="/wiki/Perioperative_mortality" title="Perioperative mortality">Perioperative mortality</a></li> <li><a href="/wiki/Postanesthetic_shivering" title="Postanesthetic shivering">Postanesthetic shivering</a></li> <li><a href="/wiki/Postoperative_nausea_and_vomiting" title="Postoperative nausea and vomiting">Postoperative nausea and vomiting</a></li> <li><a href="/wiki/Postoperative_residual_curarization" title="Postoperative residual curarization">Postoperative residual curarization</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Subspecialties</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cardiothoracic_anesthesiology" title="Cardiothoracic anesthesiology">Cardiothoracic</a></li> <li><a href="/wiki/Critical_emergency_medicine" title="Critical emergency medicine">Critical emergency medicine</a></li> <li><a href="/wiki/Geriatric_anesthesia" title="Geriatric anesthesia">Geriatric</a></li> <li><a href="/wiki/Intensive_care_medicine" title="Intensive care medicine">Intensive care medicine</a></li> <li><a href="/wiki/Obstetric_anesthesiology" title="Obstetric anesthesiology">Obstetric</a></li> <li><a href="/wiki/Oral_sedation_dentistry" title="Oral sedation dentistry">Oral sedation dentistry</a></li> <li><a href="/wiki/Pain_medicine" class="mw-redirect" title="Pain medicine">Pain medicine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Professions</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anesthesiologist" class="mw-redirect" title="Anesthesiologist">Anesthesiologist</a></li> <li><a href="/wiki/Anesthesiologist_assistant" class="mw-redirect" title="Anesthesiologist assistant">Anesthesiologist assistant</a></li> <li><a href="/wiki/Nurse_anesthetist" title="Nurse anesthetist">Nurse anesthetist</a></li> <li><a href="/wiki/Operating_department_practitioners" class="mw-redirect" title="Operating department practitioners">Operating department practitioners</a></li> <li><a href="/wiki/Certified_anesthesia_technician" class="mw-redirect" title="Certified anesthesia technician">Certified anesthesia technician</a></li> <li><a href="/wiki/Certified_anesthesia_technologist" class="mw-redirect" title="Certified anesthesia technologist">Certified anesthesia technologist</a></li> <li><a href="/wiki/Anaesthetic_technician" class="mw-redirect" title="Anaesthetic technician">Anaesthetic technician</a></li> <li><a href="/wiki/Physicians%27_assistant_(anaesthesia)" class="mw-redirect" title="Physicians' assistant (anaesthesia)">Physicians' assistant (anaesthesia)</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">History</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/ACE_mixture" title="ACE mixture">ACE mixture</a></li> <li><a href="/w/index.php?title=Helsinki_Declaration_for_Patient_Safety_in_Anaesthesiology&action=edit&redlink=1" class="new" title="Helsinki Declaration for Patient Safety in Anaesthesiology (page does not exist)">Helsinki Declaration for Patient Safety in Anaesthesiology</a></li> <li><a href="/wiki/History_of_general_anesthesia" title="History of general anesthesia">History of general anesthesia</a></li> <li><a href="/wiki/History_of_neuraxial_anesthesia" title="History of neuraxial anesthesia">History of neuraxial anesthesia</a></li> <li><a href="/wiki/History_of_tracheal_intubation" title="History of tracheal intubation">History of tracheal intubation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Organizations</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/American_Association_of_Nurse_Anesthetists" class="mw-redirect" title="American Association of Nurse Anesthetists">American Association of Nurse Anesthetists</a></li> <li><a href="/wiki/American_Society_of_Anesthesia_Technologists_%26_Technicians" title="American Society of Anesthesia Technologists & Technicians">American Society of Anesthesia Technologists & Technicians</a></li> <li><a href="/wiki/American_Society_of_Anesthesiologists" title="American Society of Anesthesiologists">American Society of Anesthesiologists</a></li> <li><a href="/w/index.php?title=Anaesthesia_Trauma_and_Critical_Care&action=edit&redlink=1" class="new" title="Anaesthesia Trauma and Critical Care (page does not exist)">Anaesthesia Trauma and Critical Care</a></li> <li><a href="/wiki/Association_of_Anaesthetists_of_Great_Britain_and_Ireland" title="Association of Anaesthetists of Great Britain and Ireland">Association of Anaesthetists of Great Britain and Ireland</a></li> <li><a href="/wiki/Royal_College_of_Anaesthetists" title="Royal College of Anaesthetists">Royal College of Anaesthetists</a></li> <li><a href="/wiki/Association_of_Veterinary_Anaesthetists" title="Association of Veterinary Anaesthetists">Association of Veterinary Anaesthetists</a></li> <li><a href="/wiki/Australian_and_New_Zealand_College_of_Anaesthetists" title="Australian and New Zealand College of Anaesthetists">Australian and New Zealand College of Anaesthetists</a></li> <li><a href="/wiki/Australian_Society_of_Anaesthetists" title="Australian Society of Anaesthetists">Australian Society of Anaesthetists</a></li> <li><a href="/wiki/International_Anesthesia_Research_Society" title="International Anesthesia Research Society">International Anesthesia Research Society</a></li> <li><a href="/wiki/European_Society_of_Anaesthesiology_and_Intensive_Care" title="European Society of Anaesthesiology and Intensive Care">European Society of Anaesthesiology and Intensive Care</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow hlist" colspan="2"><div> <ul><li><span class="noviewer" 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