scholarly journals Cadaveric Evaluation of Injectate Distribution for Two Maxillary Nerve Block Techniques in Cats

2021 ◽  
Vol 8 ◽  
Author(s):  
Lily V. Davis ◽  
Naomi K. Hoyer ◽  
Pedro Boscan ◽  
Sangeeta Rao ◽  
Jennifer E. Rawlinson
Keyword(s):  
Nerve Block ◽  
Oral Surgery ◽  
Infraorbital Nerve ◽  
General Anesthetic ◽  
Nerve Blocks ◽  
Infraorbital Foramen ◽  
Maxillary Nerve ◽  
Infraorbital Canal ◽  
Significant Difference ◽  
Maxillary Nerve Block

Regional nerve blocks have been shown to decrease general anesthetic drug requirements and improve pain management in patients undergoing surgery. Regional nerve blocks are used routinely in patients undergoing oral surgery, such as dental extractions. There is little published information regarding the efficacy of feline maxillary and infraorbital nerve blocks. The goal of the study was to compare injectate distributions of the infraorbital foramen and percutaneous maxillary nerve block techniques in feline cadavers using a combined dye and radiopaque contrast media solution to simulate an injection. There was no significant difference in length of stained nerve between the two different techniques. It was not necessary to advance the needle into the infraorbital canal to achieve effective staining of the maxillary nerve. There was no significant difference in injectate distribution between two different injectate volumes, 0.2 and 0.4 ml, indicating that the smaller volume injected at the infraorbital foramen resulted in adequate nerve staining.

Regional Nerve Blocks for Equine Dentistry

2017 ◽  
Vol 34 (2) ◽  
pp. 106-109 ◽  
Author(s):  
Molly K. Rice
Keyword(s):  
Injection Site ◽  
Oral Surgery ◽  
Inferior Alveolar Nerve ◽  
Mental Foramen ◽  
Infraorbital Nerve ◽  
Nerve Blocks ◽  
Infraorbital Foramen ◽  
Mandibular Foramen ◽  
Maxillary Nerve ◽  
Dental Procedures

Regional nerve blocks are necessary to facilitate equine oral surgery in the standing sedated patient. Step-by-step instruction on how to perform common regional nerve blocks are discussed, including infraorbital, maxillary, middle mental, and inferior alveolar nerve blocks. Regional nerve blocks are critical when performing dental procedures in the standing horse.1 The infraorbital and maxillary nerve blocks provide anesthesia of the infraorbital nerve, which is a branch of the maxillary nerve. Both nerve blocks provide adequate anesthesia for all maxillary dental procedures.1 When the infraorbital nerve block is utilized, care must be taken to advance the needle into the infraorbital foramen in order to appropriately anesthetize the caudal maxillary teeth. Mandibular dental procedures require anesthesia of the inferior alveolar nerve, which is a branch of the mandibular nerve. Local anesthesia at the level of the mental foramen will result in anesthesia of ipsilateral incisors and canines, while anesthesia at the level of the mandibular foramen will anesthetize the entire ipsilateral mandibular dental quadrant. All nerve blocks should have the injection site aseptically prepared prior to the procedure. The 4 most common dental nerve blocks are described step by step.

Accidental arterial catheterisation during a maxillary nerve block using a modified infraorbital approach in a dog

2020 ◽  
Vol 8 (2) ◽  
pp. e001097
Author(s):  
Paul Massimo Giannoni McCarthy ◽  
Arthur Yuk Kong Chau
Keyword(s):  
Case Report ◽  
Nerve Block ◽  
Local Anaesthetic ◽  
Adverse Reactions ◽  
Intravenous Catheter ◽  
Infraorbital Foramen ◽  
Maxillary Nerve ◽  
First Case ◽  
Maxillary Nerve Block ◽  
Oromaxillofacial Surgery

The maxillary nerve block (MNB) is a local anaesthetic technique used in dentistry and oromaxillofacial surgery, with recent popular use for minimising adverse reactions during rhinoscopy. A modified approach via the infraorbital foramen using an intravenous catheter has been recently described in the veterinary literature to minimise potential nerve block associated complications. This case report describes inadvertent arterial catheterisation using the aforementioned technique in a 5.4-kg, 9-year-old male neutered Maltese terrier cross that was presented for diagnostic workup of a chronic cough that had recently worsened. To the authors’ knowledge, this is the first case report of such a complication. It is recommended for veterinary practitioners to be aware of accidental arterial puncture and catheterisation whenever a modified infraorbital approach to the MNB is performed in order to facilitate rapid intervention and management.

scholarly journals Subzygomatic and infraorbital approaches for maxillary nerve blockade in cats’ cadaver

2018 ◽  
Vol 48 (4) ◽  
Author(s):  
José Ricardo Herrera Becerra ◽  
Tainor de Mesquita Tisotti ◽  
Maria Eduarda Baier ◽  
Ronaldo Viana Leite-Filho ◽  
Verônica Santos Mombach ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Nerve Block ◽  
Contralateral Side ◽  
Blue Dye ◽  
Methylene Blue Dye ◽  
Maxillary Nerve ◽  
Significant Difference ◽  
Blinded Study ◽  
Maxillary Nerve Block ◽  
Nerve Staining

ABSTRACT: This study compared the accuracy of dye placement on the maxillary nerve by using the percutaneous subzigomatic (SBZ) and infraorbitary (IO) approaches in cats’ cadavers. A second aim was to compare the accuracy of dye placement on the maxillary nerve between different untrained anesthetists. This was a prospective, randomized, blinded study, performed in 40 heads obtained from feline cadavers. Three veterinarians (A, B and C) with no previous experience with the IO approach performed the experiments. The SBZ approach was randomly performed on one side of the head and the IO approach was performed in the contralateral side of the same head. For each approach, 0.2ml of 1% methylene blue dye was injected. Scores for length of nerve staining were as follows: 0 (failure), no staining; 1 (moderate), <6mm of nerve stained; and 2 (ideal), ≥6mm of nerve stained. Median scores (interquartile range) for the SBZ and IO approaches were 2.0 (0.3-2.0) and 1.0 (0.0-2.0), respectively. Scores for length of nerve staining were higher with the SBZ approach than the IO approach (P=0.016). Considering the scores for both the SBZ and IO approaches, there was a significant difference among the three veterinarians (P=0.002). Results of this study do not support the IO approach to perform a maxillary nerve block in cats. A greater accuracy of methylene blue dye placement was observed with the SBZ approach. A variable accuracy may exist between different veterinarians when performing a maxillary nerve block employing the SBZ and IO techniques in cats.

scholarly journals Efficacy and Feasibility of Frontozygomatic Angle Approach for Extra Oral Maxillary Nerve Block in Oral Surgery: A Descriptive Clinical Trial

2013 ◽  
Vol 13 (3) ◽  
pp. 231-237 ◽  
Author(s):  
Kiran Radder ◽  
Ashwin Shah ◽  
Shereen Fatima ◽  
Chaitanya Kothari ◽  
Syed Zakaullah ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Nerve Block ◽  
Oral Surgery ◽  
Maxillary Nerve ◽  
Maxillary Nerve Block

scholarly journals A Retrospective Study of the Incidence and Management of Complications Associated With Regional Nerve Blocks in Equine Dental Patients

2019 ◽  
Vol 36 (1) ◽  
pp. 40-45 ◽  
Author(s):  
R. Brad Tanner ◽  
John A. E. Hubbell
Keyword(s):  
Regional Anesthesia ◽  
Oral Surgery ◽  
Hospital Setting ◽  
Infraorbital Nerve ◽  
Nerve Blocks ◽  
Maxillary Nerve ◽  
Dental Patients ◽  
Management Of Complications ◽  
Facial Anatomy

Regional anesthesia of the equine head is commonly performed to allow oral extraction of diseased teeth in the standing horse. The use of 4 blocks (infraorbital nerve, maxillary nerve, mental nerve, and mandibular nerve) is well documented for desensitization of dental quadrants for oral surgery for exodontia, but descriptions of associated complications are limited. A total of 270 regional nerve blocks were performed on 162 equine patients in a second opinion referral hospital setting. Criteria for inclusion in the study included a 24-hour stay in hospital, that the blocks be performed by one clinician and at minimum, a 2-week follow-up examination be performed. A total of 8 complications were identified in 7 patients representing a 2.96% incidence of complication. Complications included supraorbital hematoma (3), local hematoma (2), lingual self-trauma (2), and nerve block failure to desensitize (1). Treatment and management of complications are discussed. Complications associated with regional anesthesia may be reduced by reducing anesthetic volumes, precise needle placement, familiarity with the facial anatomy relevant to nerve blocks, adequate restraint, aseptic technique, postprocedural muzzling, and the use of a newly opened bottle of local anesthetic.

scholarly journals Compuflo®-Assisted Performance of a Maxillary Nerve Block in Horses: Evaluation of a Novel Technology as a Training Tool and Guide in Clinical Practice

2020 ◽  
Vol 4 (1) ◽  
pp. 1-7
Author(s):  
Klaus Hopster ◽  
Keyword(s):  
Clinical Practice ◽  
Nerve Block ◽  
Nerve Blocks ◽  
Training Tool ◽  
Maxillary Nerve ◽  
Novel Technology ◽  
Maxillary Nerve Block

The CompuFlo®-device provides value as training tool for veterinary professionals learning to execute maxillary nerve blocks. Further research is warranted to determine its true benefits in equine dentistry practice.

scholarly journals Comparison of three regional anaesthetic techniques for infraorbital or maxillary nerve block in cats: a cadaveric study

2021 ◽  
pp. 1098612X2110201
Author(s):  
Yael Shilo-Benjamini ◽  
Shachar Letz ◽  
Dana Peery ◽  
Wiessam Abu Ahmad ◽  
Yoav Bar-Am
Keyword(s):  
Anaesthetic Techniques ◽  
Mixed Effects ◽  
Nerve Blocks ◽  
Maxillary Nerve ◽  
Intraocular Injection ◽  
Infraorbital Canal ◽  
Before And After ◽  
Injection Techniques ◽  
Maxillary Nerve Block ◽  
Blinded Trial

Objectives The maxillary nerve courses very close to the globe, rendering cats – with their large eyes – at risk of globe penetration during infraorbital or maxillary nerve blocks. Therefore, the goals of the study were to compare the distribution and potential complications of three infraorbital or maxillary regional injection techniques. Methods Twenty-three bilateral maxillae of cat cadavers were used in a randomised blinded trial. Each maxilla was injected with a 0.2 ml 1:1 mixture of lidocaine 2% and a contrast medium by one of three injection techniques: infraorbital foramen (IOF; n = 14); infraorbital canal (IOC; n = 16); or maxillary foramen (MF; transpalpebral approach; n = 16) using a 25 G 1.6 cm needle. CT imaging of each cadaver head was performed before and after injections. A radiologist scored injectate distribution (none [0], mild [1], moderate [2], large [3]) in four locations: rostral, central and caudal IOC, and at the MF, for which the distribution side was also determined. Comparisons were performed with ordinal logistic mixed effects ( P <0.05). Results The median (range) total distribution score of the IOC and MF technique were significantly higher compared with the IOF technique (6.5 [4–12], 4 [2–8] and 0 [0–10], respectively). The total IOC score was also significantly higher compared with the MF technique. Injectate distribution at the MF was significantly more central following IOC injection compared with MF injection, which distributed centrolaterally. None of the techniques resulted in intraocular injection. Conclusions and relevance The IOC and MF techniques produced a satisfactory spread of the mixture that could result in effective maxillary anaesthesia in cats. Further studies are required to determine the effectiveness and safety of these techniques.

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