This high-yield revision note on Local Anesthesia Complications: Hematoma, Trismus & Facial Palsy covers everything examiners typically test under Local Anesthesia — structured as quick-reference tables, clinical correlations, mnemonics and previous-year-style high-yield points. It's built for last-mile revision before NEET MDS, INI-CET MDS and INBDE, so you can scan it in minutes instead of re-reading a whole textbook chapter.
| Complication | Cause | Feature/Management |
|---|---|---|
| Hematoma | Vessel puncture (especially with the PSA block - pterygoid venous plexus) | Swelling and discoloration, resolves in 7-14 days; apply immediate direct pressure |
| Trismus | Muscle/vessel trauma, intramuscular hematoma, or low-grade infection from repeated injections | Limited mouth opening; managed with heat therapy, physiotherapy, NSAIDs |
| Transient facial (CN VII) palsy | Anesthetic solution deposited into the parotid gland when the needle is inserted too far POSTERIOR during an IAN block (missing the mandibular ramus/pterygomandibular space) | Temporary facial paralysis, resolves as the LA wears off; reassure the patient and protect the eye (cannot close eyelid) with a patch/tape |
| Needle breakage | Sudden patient movement, thin needle, repeated bending | Rare with modern needles; refer for surgical retrieval if the fragment lodges deep in tissue |
| Paresthesia | Direct nerve trauma from the needle, or neurotoxic effect of certain LAs (articaine and prilocaine more implicated) | Usually resolves within weeks; refer if prolonged |
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