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Veres-Nyéki KO. Clinical techniques in veterinary dermatology Regional anaesthesia of the canine and feline nose. Vet Dermatol 2021; 33:258-262. [PMID: 34873755 DOI: 10.1111/vde.13050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/27/2021] [Accepted: 09/02/2021] [Indexed: 12/01/2022]
Abstract
Local anaesthesia techniques are now essential parts of the multimodal analgesic approach applied in the care of small animals. The sensory innervation of the nose is provided by the maxillary division of the trigeminal nerve, so nasal pain can be prevented or alleviated by blocking branches of this nerve. Maxillary or infraorbital nerve block can be used if invasive procedures are performed on the nose of the canine and feline patients. Clear anatomical landmarks facilitate the placements of these blocks, which impose relatively low risk to the patients. These blocks do not require any advanced equipment and all necessary material is widely available in small animal veterinary practices. The total dose of the local anaesthetic agents should be calculated precisely to avoid toxicity.
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Shilo-Benjamini Y, Letz S, Peery D, Abu Ahmad W, Bar-Am Y. Comparison of three regional anaesthetic techniques for infraorbital or maxillary nerve block in cats: a cadaveric study. J Feline Med Surg 2021; 24:322-327. [PMID: 34106793 PMCID: PMC8961245 DOI: 10.1177/1098612x211020163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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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Affiliation(s)
- Yael Shilo-Benjamini
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Shachar Letz
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Dana Peery
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Wiessam Abu Ahmad
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Yoav Bar-Am
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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Volk HA, Bayley KD, Fiani N, Billson FM. Ophthalmic complications following ocular penetration during routine dentistry in 13 cats. N Z Vet J 2018; 67:46-51. [DOI: 10.1080/00480169.2018.1521314] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- HA Volk
- Melbourne EyeVet, Melbourne, Australia
| | - KD Bayley
- Veterinary Ophthalmic Services, Wellington, New Zealand
| | - N Fiani
- Cornell University, College of Veterinary Medicine, Ithaca, NY, USA
| | - FM Billson
- Small Animal Specialist Hospital, Sydney, Australia
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Chau AYK. Tongue lacerations in a geriatric dog after bilateral inferior alveolar nerve blocks with bupivacaine. VETERINARY RECORD CASE REPORTS 2017. [DOI: 10.1136/vetreccr-2017-000433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cerasoli I, Cornillie P, Gasthuys F, Gielen I, Schauvliege S. A novel approach for regional anaesthesia of the auricular region in horses: an anatomic and imaging study. Vet Anaesth Analg 2017; 44:656-664. [DOI: 10.1016/j.vaa.2016.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 01/12/2016] [Accepted: 03/04/2016] [Indexed: 10/20/2022]
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Aguiar J, Chebroux A, Martinez-Taboada F, Leece EA. Analgesic effects of maxillary and inferior alveolar nerve blocks in cats undergoing dental extractions. J Feline Med Surg 2015; 17:110-6. [PMID: 24820999 PMCID: PMC10816425 DOI: 10.1177/1098612x14533551] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
The aim of this study was to evaluate the analgesic effects of maxillary and/or inferior alveolar nerve blocks with lidocaine and bupivacaine in cats undergoing dental extractions. Twenty-nine cats were enrolled. Using an adapted composite pain scale, cats were pain scored before the dental procedure and 30 mins, and 1, 2 and 4 h after isoflurane disconnection. Cats were sedated with buprenorphine (20 µg/kg), medetomidine (10 µg/kg) and acepromazine (20 µg/kg) intramuscularly. Anaesthesia was induced using alfaxalone (1-2 mg/kg) intravenously and maintained with isoflurane in oxygen. Each cat was randomly assigned to receive maxillary and/or inferior alveolar nerve blocks or no nerve blocks prior to dental extractions. Each nerve block was performed using lidocaine (0.25 mg/kg) and bupivacaine (0.25 mg/kg). Heart rate, systolic arterial blood pressure, respiratory rate, end tidal carbon dioxide and isoflurane vaporiser settings were recorded 5 mins before and after the dental extractions, and the difference calculated. Group mean differences (mean ± SD) for heart rate (-9.7 ± 10.6 vs 7.6 ± 9.5 beats/min [nerve block vs control group, respectively], P <0.0001), systolic arterial blood pressure (-10.33 ± 18.44 vs 5.21 ± 15.23 mmHg, P = 0.02) and vaporiser settings (-0.2 ± 0.2 vs 0.1 ± 0.4, P = 0.023) were significantly different between groups. The control group had higher postoperative pain scores (median [interquartile range]) at 2 h (3 [1.75-4.00] vs 1 [0-2], P = 0.008) and 4 h (4 [2-6] vs 2 [1-2], P = 0.006) after the dental extractions. Maxillary and inferior alveolar nerve blocks with lidocaine and bupivacaine administered prior to dental extractions resulted in a reduction in heart rate and blood pressure while allowing for a reduction in isoflurane. Cats receiving nerve blocks had lower postoperative pain scores than the group without nerve blocks.
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Affiliation(s)
- Joana Aguiar
- Stone Lion Veterinary Hospital, Wimbledon, London, UK
| | - Alexandre Chebroux
- University of Cambridge, Queen's Veterinary School Hospital, Cambridge, UK
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Holman SD, Campbell-Malone R, Ding P, Gierbolini-Norat EM, Lukasik SL, Waranch DR, German RZ. Swallowing kinematics and airway protection after palatal local anesthesia in infant pigs. Laryngoscope 2014; 124:436-45. [PMID: 23686446 PMCID: PMC4319539 DOI: 10.1002/lary.24204] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 04/02/2013] [Accepted: 04/13/2013] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Abnormal kinematics during swallowing can result in aspiration, which may become life threatening. We tested the role of palatal sensation in the motor control of pharyngeal swallow in infants. STUDY DESIGN In eight infant pigs, we reduced palatal sensation using local anesthesia (PLA) and measured the impact on swallowing kinematics and airway protection. METHODS The pigs drank milk containing barium while we simultaneously recorded videofluoroscopy and electromyography from fine wire bipolar electrodes in several hyolaryngeal muscles. We compared these results to control feedings and feedings following palatal saline injections. RESULTS After PLA, four pigs had extreme jaw movements and abnormal tongue movement uncharacteristic of sucking. For this reason, we evaluated differences between these group B pigs and the others that could suck normally after PLA (group A). In the four group A pigs, after PLA there was less hyoid elevation (P < .001) but normal jaw and tongue movements. In group B, in addition to greater jaw movement (P < .001) there was more anterior and superior tongue movement (P < .001) and a larger range of hyoid movement (P < .001). CONCLUSIONS The airway was protected in all of the pigs, indicating that these changes allowed successful adaptation to the reduction in palatal sensation. However, the oral and pharyngeal phases of the swallow were functionally linked, and trigeminal sensation influenced the motor control of the pharyngeal swallow. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
- Shaina Devi Holman
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 98 North Broadway, Baltimore, MD 21231, USA
- Department of Neural and Pain Sciences, University of Maryland, School of Dentistry, 650 West Baltimore Street, Baltimore, MD 21201, USA
| | - Regina Campbell-Malone
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 98 North Broadway, Baltimore, MD 21231, USA
| | - Peng Ding
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 98 North Broadway, Baltimore, MD 21231, USA
| | - Estela M. Gierbolini-Norat
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 98 North Broadway, Baltimore, MD 21231, USA
| | - Stacey L. Lukasik
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 98 North Broadway, Baltimore, MD 21231, USA
| | - Danielle R. Waranch
- Department of Neural and Pain Sciences, University of Maryland, School of Dentistry, 650 West Baltimore Street, Baltimore, MD 21201, USA
| | - Rebecca Z. German
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 98 North Broadway, Baltimore, MD 21231, USA
- Department of Neural and Pain Sciences, University of Maryland, School of Dentistry, 650 West Baltimore Street, Baltimore, MD 21201, USA
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Holman SD, Waranch DR, Campbell-Malone R, Ding P, Gierbolini-Norat EM, Lukasik SL, German RZ. Sucking and swallowing rates after palatal anesthesia: an electromyographic study in infant pigs. J Neurophysiol 2013; 110:387-96. [PMID: 23636723 PMCID: PMC3727070 DOI: 10.1152/jn.00064.2013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 04/29/2013] [Indexed: 12/20/2022] Open
Abstract
Infant mammalian feeding consists of rhythmic suck cycles and reflexive pharyngeal swallows. Although we know how oropharyngeal sensation influences the initiation and frequency of suck and swallow cycles, the role of palatal sensation is unknown. We implanted EMG electrodes into the mylohyoid muscle, a muscle active during suckling, and the thyrohyoid muscle, a muscle active during swallowing, in eight infant pigs. Pigs were then bottle-fed while lateral videofluoroscopy was simultaneously recorded from the electrodes. Two treatments were administered prior to feeding and compared with control feedings: 1) palatal anesthesia (0.5% bupivacaine hydrochloride), and 2) palatal saline. Using the timing of mylohyoid muscle and thyrohyoid muscle activity, we tested for differences between treatment and control feedings for swallowing frequency and suck cycle duration. Following palatal anesthesia, four pigs could not suck and exhibited excessive jaw movement. We categorized the four pigs that could suck after palatal anesthesia as group A, and those who could not as group B. Group A had no significant change in suck cycle duration and a higher swallowing frequency after palatal saline (P = 0.021). Group B had significantly longer suck cycles after palatal anesthesia (P < 0.001) and a slower swallowing frequency (P < 0.001). Swallowing frequency may be a way to predict group membership, since it was different in control feedings between groups (P < 0.001). The qualitative and bimodal group response to palatal anesthesia may reflect a developmental difference. This study demonstrates that palatal sensation is involved in the initiation and frequency of suck and swallow cycles in infant feeding.
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Affiliation(s)
- Shaina Devi Holman
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Cremer J, Sum SO, Braun C, Figueiredo J, Rodriguez‐Guarin C. Assessment of maxillary and infraorbital nerve blockade for rhinoscopy in sevoflurane anesthetized dogs. Vet Anaesth Analg 2013; 40:432-9. [DOI: 10.1111/vaa.12032] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Accepted: 12/23/2011] [Indexed: 11/30/2022]
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Development, reliability, and validation of an infant mammalian penetration-aspiration scale. Dysphagia 2012; 28:178-87. [PMID: 23129423 DOI: 10.1007/s00455-012-9427-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 09/27/2012] [Indexed: 01/04/2023]
Abstract
A penetration-aspiration scale exists for assessing airway protection in adult videofluoroscopy and fiberoptic endoscopic swallowing studies; however, no such scale exists for animal models. The aim of this study was threefold: (1) develop a penetration-aspiration scale (PAS) for infant mammals, (2) test the scale's intra- and interrater reliabilities, and (3) validate the use of the scale for distinguishing between abnormal and normal animals. After discussion and reviewing many videos, the result was a 7-point infant mammal PAS. Reliability was tested by having five judges score 90 swallows recorded with videofluoroscopy across two time points. In these videos, the frame rate was either 30 or 60 frames per second and the animals were either normal, had a unilateral superior laryngeal nerve (SLN) lesion, or had hard palate local anesthesia. The scale was validated by having one judge score videos of both normal and SLN lesioned pigs and testing the difference using a t test. Raters had a high intrarater reliability [average κ = 0.82, intraclass correlation coefficient (ICC) = 0.92] and high interrater reliability (average κ = 0.68, ICC = 0.66). There was a significant difference in reliability for videos captured at 30 and 60 frames per second for scores of 3 and 7 (P < 0.001). The scale was also validated for distinguishing between normal and abnormal pigs (P < 0.001). Given the increasing number of animal studies using videofluoroscopy to study dysphagia, this scale provides a valid and reliable measure of airway protection during swallowing in infant pigs that will give these animal models increased translational significance.
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Harding PG, Smith RL, Barakzai SZ. Comparison of two approaches to performing an inferior alveolar nerve block in the horse. Aust Vet J 2012; 90:146-50. [DOI: 10.1111/j.1751-0813.2012.00897.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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