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Gow gate & Mandibular block

I prefer to administer IA, but sometime it is hard to find a target site on some patients who have very thin pterygomandibular raphe. As soon as I insert the needle, I touch the bone no matter what, I swing the barrel to anterior. Can anyone share tips please? Also, sometimes my pt doesn’t get anesthetized in the lower anterior when giving Gow gate. Of course I have the patient open his/her mouth for 1 minute in sitting position. I don’t know why they are not profoundly numbed. I would appreciate your answers.

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1 Answer

When administering an IA, if bone is contacted too soon, the needle tip is usually located too far anteriorly on the ramus. When you swing the barrel anteriorly, come clear to the canine or lateral incisor (on contralateral side). You could also try injecting at a higher site. For the Gow-Gates the failure rate of anesthesia is low assuming your technique is correct. With that said, sometimes the patient has a greater diameter of the mandibular nerve, which requires a bit more anesthetic (1.2 ml). What may help you the most is watching some Youtube videos on administration technique and even pulling out and reviewing your anesthesia book from school.

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