There are 8 nerves available for blocking in facial surgery, and several or all 8 of them can be blocked according to the scope of surgery, the blocking point of each nerve and the extent of anesthesia. In order to reduce intraoperative bleeding and ensure the flatness of the stripping plane, the surgical area can be supplemented with subcutaneous infiltration injection of an appropriate amount of 0.2% lidocaine epinephrine (1:400,000) solution according to the surgical needs. 1.Chin nerve: Inject 1~2ml, hold the upper lip open, and this nerve can sometimes be touched in the chin area below the 2nd cuspid. Anesthesia range: below the lower lip, both sides to the chin-facial groove, and down to the lower edge of the jaw. 2. Infraorbital nerve: The point of penetration is located approximately in the vertical line of the medial edge of the iris, 4~7mm from the infraorbital rim. The left index finger is placed on the infraorbital rim, the patient is looking straight ahead, the operator holds a 5ml syringe in the right hand, and the needle is inserted between the medial nasofacial groove and the nasal sulcus, and the bone surface is pierced at 4~7mm from the infraorbital rim, mostly directly into the infraorbital foramen, or 1~2ml is injected around this point. anesthesia area: almost the entire lateral wall of the nose, all the nasal wings, the base of the nasal columella, the entire upper lip and the lateral 1~1.5mm of the oral fissure, the medial eyelid The lower buccal area, and the inferior orbital area will also be numb. 3. Dorsal nerve: The point of penetration is located at the junction of the nasal bone and nasal cartilage, 6~9mm from the midline of the nose. The left thumb and index finger should touch the nasal midline, palpate the lower end of the nasal bone, and inject 1~2ml of drug about 6~10mm outside the nasal bone midline. anesthesia area: back of nasal cartilage and skin of nasal tip. 4. Supraorbital nerve bundle (supraorbital – supra-sliding – infra-sliding nerve): the supraorbital nerve is penetrated from the supraorbital notch. The supra-sliding nerve travels with the blood vessel of the same name, and the infra-sliding nerve penetrates the orbital wall below the sliding carriage. The area of anesthesia: (1) the frontal skin from the mid-temporal line or the temporal fusion line to the midline; (2) about 50% of the skin of the upper lid medially; (3) the skin of the top of the frontal area between the midline and the upper temporal line, and backward up to the skin before the vertical line made by the posterior margin of the two auricles. 5.Zygomatic-temporal nerve: 1 branch of zygomatic nerve, penetrating through the orbital wall to the anterior part of the temporal fossa, its penetration position is about 1 cm below the level of the lateral canthus. 1~1.2 mm is stabbed downward from the zygomatic-frontal suture (palpable) behind the lateral orbital wall, reaching about 1 cm below the level of the lateral canthus and injecting 2 ml of medicine. anesthesia range: the upper border is connected with the frontal block of the supraorbital nerve, and the lower border enters the temporal scalp from the level of the lateral canthus backward to the hairline. 6. Zygomatic-facial nerve: Place the index finger of the left hand at the junction of the infraorbital and lateral walls, with the zygomatic-facial nerve located just lateral to the fingertip within an area of about 1.5 cm in diameter, and inject 1~2 ml of drug. . 7, the mandibular nerve of the trigeminal nerve: when blocking this nerve, the entry point is located 2.5cm in front of the ear screen, in the middle of the sigmoid notch. The long injection needle is connected to a 5 ml syringe, and the plastic sheet is threaded through the needle as a length marker, and stabbed vertically from the sigmoid incision to the pterygoid plate, with the plastic sheet retreating as the needle enters. Exit the needle close to the skin surface, tilt backward about 10°~15° in the direction of the first puncture to change the direction of needle entry, stop at the same depth of entry that touches the pterygoid plate and draw back, inject 3~4ml of drug without blood. 8. Otodial nerve: The blocking point is about 6.5cm below the external auditory canal on the midline of the sternocleidomastoid muscle. on the midline of the sternocleidomastoid muscle. The superficial fascial surface of the muscle is injected with 2~3 ml. Anesthetic area: most of the buccal area (downward to below the inferior edge of the mandible, backward to connect with the auricular major nerve block area and forward to connect with the orbital-labial numbness area), the upper part of the ear and the auriculotemporal hair area. After 3~5mim of nerve block, numbness is produced in the blocked area, and the anesthetic effect can be maintained for 3.5h. The pain during injection of local anesthetic is generally related to the temperature of local anesthetic, PH, drug composition, injection speed and number of injections, etc. In practice, the first few items can be controlled artificially, while there is some difficulty in how to reduce the number of injections. Familiarity with anatomy and gentle operation is a key factor in determining the effectiveness of the block. Note: 1.Ensure that there is no blood in the retraction before injection, and it is more important to have no blood in the retraction when blocking the 3rd branch of the trigeminal nerve, because the maxillary vessels travel closely to this nerve. 2.When performing a full block of multiple nerves, if you want to avoid local anesthetics exceeding the limit, you can block them successively in different parts to avoid injecting too much local anesthetics in a short period of time.