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Post-Injection Haematoma — NDEB AFK MCQ

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ModerateOral SurgeryPost-Injection HaematomaNDEB AFK

Following an inferior alveolar nerve block using 2% lidocaine with 1:100,000 epinephrine, a patient develops rapid swelling in the pterygomandibular space. What is the most likely cause?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Haematoma from arterial puncture

Rapid swelling in the pterygomandibular region immediately after an inferior alveolar nerve block most likely represents a haematoma from puncture of the inferior alveolar artery or pterygoid venous plexus. Management is to apply direct pressure, apply ice extraorally, and monitor. Aspiration before injection reduces this risk. Allergic reactions to amide local anaesthetics are exceedingly rare.

Reference: Malamed – Handbook of Local Anesthesia, 7th ed., 2020