REGIONAL ANESTHETIC BLOCKS IN FACIAL AND PERIOCULAR AESTHETIC PROCEDURES: AN UPDATED REVIEW OF ULTRASOUND-GUIDED TECHNIQUES, SONOANATOMY, AND CLINICAL APPLICATIONS

Authors

  • Laura Lozer Galvão Author
  • Amanda Tung Author
  • Andressa Cristina Reginato Lopes Teixeira Author
  • Laura Godoy Murbach Author

DOI:

https://doi.org/10.56238/arev7n10-178

Keywords:

Regional Anesthesia, Ultrasound-Guided Nerve Block, Facial Aesthetics, Periocular Surgery, Infraorbital Nerve Block, Sonoanatomy

Abstract

Introduction: the use of regional anesthetic blocks in facial and periocular aesthetic procedures has expanded significantly with the advancement of ultrasound-guided techniques and a deeper understanding of facial sonoanatomy. These approaches aim to enhance patient comfort, procedural safety, and postoperative recovery. Objective: to analyze recent evidence on the application of regional anesthetic blocks in facial and periocular aesthetic procedures, emphasizing ultrasound-guided techniques, analgesic efficacy, and practical clinical recommendations. Methods: an integrative literature review was conducted in PubMed, Virtual Health Library (BVS), EuropePMC, and open-access repositories (PMC and MDPI) covering studies published between 2020 and 2025. Ten studies that met the inclusion criteria were analyzed according to technique, target nerves, ultrasound use, outcomes, and safety considerations. Results: the reviewed studies demonstrated that ultrasound-guided facial and periocular nerve blocks provide precise anesthesia, reduce intra- and postoperative complications, and improve pain control and patient satisfaction. The infraorbital, supraorbital, supratrochlear, and auriculotemporal nerves were the most frequently targeted, particularly in rhinoplasty, blepharoplasty, and filler procedures. Conclusion: regional anesthetic blocks are effective and safe alternatives for facial and periocular aesthetic procedures. Ultrasound guidance significantly enhances accuracy and safety, consolidating these blocks as an essential component of modern multimodal anesthesia. Standardized techniques and professional training are essential to expand their clinical use and ensure consistent outcomes.

Downloads

Download data is not yet available.

References

Cao, Z., Wang, Y., & Zhang, L. (2021). Application of ultrasound guidance in the oral and maxillofacial region. Frontiers in Oral Health, 2, Article 742389. https://doi.org/10.3389/froh.2021.742389

Hong, J. H., Lee, H. W., & Kim, S. B. (2022). Ultrasound guided infraorbital nerve radiofrequency thermocoagulation in patients with trigeminal neuralgia. Keimyung Medical Journal, 41(1), 42–45. https://doi.org/10.46308/kmj.2021.00143

Kacar, E., Tetik, B., Duzgun, O., & Yilmaz, A. (2020). Effects of adding a combined infraorbital and infratrochlear nerve block during general anesthesia on emergence agitation in septorhinoplasty. Journal of Pain Research, 13, 2503–2510. https://doi.org/10.2147/JPR.S273195

Kim, D. H., Park, J. B., Kim, S. W., Stybayeva, G., & Hwang, S. H. (2023). Effect of infraorbital and/or infratrochlear nerve blocks on postoperative care in patients with septorhinoplasty: A meta-analysis. Medicina, 59(9), Article 1659. https://doi.org/10.3390/medicina59091659

Kopp, S. L., Vandermeulen, E., McBane, R. D., Perlas, A., Leffert, L., & Horlocker, T. (2025). Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine evidence-based guidelines (fifth edition). Regional Anesthesia & Pain Medicine. Advance online publication. https://doi.org/10.1136/rapm-2024-105766

Lin, T. Y., Chen, C. H., & Wang, L. C. (2025). Ultrasound-guided interventions for neuropathic pain: Review of techniques and evidence. Pain and Therapy, 14(1), 45–62. https://doi.org/10.1007/s40122-025-00942-1

Martin, D. A., Ashworth, H., & Nagdev, A. (2024). Ultrasound-guided nerve blocks. Emergency Medicine Clinics of North America, 42(4), 905–926. https://doi.org/10.1016/j.emc.2024.05.013

Prineas, S. (2023). Local and regional anesthesia for ophthalmic surgery. NYSORA Review. https://www.nysora.com/topics/head-and-neck/local-anesthesia-ophthalmic

Tao, B. K., Butt, F. R., Dhivagaran, T., Balas, M., Nijhawan, N., Nassrallah, G., Hussain, A., & Ing, E. B. (2025). Periocular aging across populations and esthetic considerations: A narrative review. Journal of Clinical Medicine, 14(2), 535. https://doi.org/10.3390/jcm14020535

Tettamanzi, M., Muratore, G., Ziani, F., Arrica, G., Trignano, C., Rubino, C., & Trignano, E. (2025). Integrated reconstructive management of periocular complications following bilateral blepharoplasty. Plastic and Reconstructive Surgery - Global Open, 13(8), Article e7071. https://doi.org/10.1097/GOX.0000000000007071

Wu, W. T., Chang, K. V., & Hsu, Y. C. (2022). Ultrasound imaging of facial vascular neural structures: Sonoanatomy relevant to aesthetic injections. Diagnostics, 12(3), Article 567. https://doi.org/10.3390/diagnostics12030567

Wu, W. T., Chang, K. V., & Hsu, Y. C. (2023). Facial sonoanatomy for safe aesthetic procedures: Vascular and neural landmarks. Aesthetic Surgery Journal, 43(2), 210–223. https://doi.org/10.1093/asj/sjac312

Xie, F., Qi, A.-H., Pan, F., Zhang, Y., Gan, N., Xu, X.-T., Wang, A.-Z., & Zhang, N.-N. (2025). The impact of combining regional nerve block with general anesthesia on cognitive function in patients undergoing elbow joint release surgery: A randomized controlled trial. International Journal of Surgery, 111(9), 6460–6464. https://doi.org/10.1097/JS9.0000000000002717

Yao, P. Y., & Sequeira, M. B. (2024). Infraorbital nerve block. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499881/

Downloads

Published

2025-10-16

Issue

Section

Articles

How to Cite

GALVÃO, Laura Lozer; TUNG, Amanda; TEIXEIRA, Andressa Cristina Reginato Lopes; MURBACH, Laura Godoy. REGIONAL ANESTHETIC BLOCKS IN FACIAL AND PERIOCULAR AESTHETIC PROCEDURES: AN UPDATED REVIEW OF ULTRASOUND-GUIDED TECHNIQUES, SONOANATOMY, AND CLINICAL APPLICATIONS. ARACÊ , [S. l.], v. 7, n. 10, p. e8982, 2025. DOI: 10.56238/arev7n10-178. Disponível em: https://periodicos.newsciencepubl.com/arace/article/view/8982. Acesso em: 5 dec. 2025.