If the anesthetic is deposited into the parotid gland during a block, which complication is most likely?

If the anesthetic is deposited into the parotid gland during a block, which complication is most likely?

• A. Facial nerve paralysis
• B. Trismus
• C. Hematoma
• D. Infection

Answer: (A)

Depositing anesthetic into the parotid gland can block the facial nerve, because the facial nerve and its branches run through the parotid gland after exiting the skull. If the anesthetic diffuses to these nerve fibers, it temporarily prevents the muscles of facial expression on the affected side, causing facial paralysis that lasts for the duration of the anesthetic. This is the most likely complication specifically tied to injecting into the parotid gland. Hematoma is possible with any injection if a vessel is nicked, but the parotid gland injection isn’t as directly associated with bleeding as with nerve blockade. Trismus would imply involvement of the muscles of mastication or their nerves, which isn’t the primary risk of injecting into the gland. Infection is a general risk of injections but not the most likely, location-specific complication in this scenario.

Depositing anesthetic into the parotid gland can block the facial nerve, because the facial nerve and its branches run through the parotid gland after exiting the skull. If the anesthetic diffuses to these nerve fibers, it temporarily prevents the muscles of facial expression on the affected side, causing facial paralysis that lasts for the duration of the anesthetic. This is the most likely complication specifically tied to injecting into the parotid gland.

Hematoma is possible with any injection if a vessel is nicked, but the parotid gland injection isn’t as directly associated with bleeding as with nerve blockade. Trismus would imply involvement of the muscles of mastication or their nerves, which isn’t the primary risk of injecting into the gland. Infection is a general risk of injections but not the most likely, location-specific complication in this scenario.