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Use a new needle and syringe with every injection

Peripheral trigeminal nerve blocks and deeper image-guided injections may cause temporary facial numbness, weakness of nearby muscles, bruising, bleeding, infection, temporary pain flare, nerve irritation, vascular puncture, intravascular injection, local-anesthetic toxicity, or injury to nearby structures

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In obesity, NNMT activity is unusually high in fat cells, which means a lot of nicotinamide gets thrown out before it can be turned into NAD+