Evaluation of Three Methods of Sensory Function Testing for the Assessment of Successful Maxillary Nerve Blockade in Horses.
Abstract: Maxillary nerve blocks (MNBs) commonly facilitate dental surgeries in standing horses. The goal of this prospective, blinded, cross-over design trial including 15 client-owned horses was to evaluate 3 methods of sensory function testing for confirming a successful MNB. Testing was performed bilaterally before sedation, 5 min after sedation, and 15 and 30 min after MNB with 0.5% bupivacaine and involved a needle prick dorsal to each naris, hemostat clamping of each nostril, and gingival algometry (measuring sensitivity to pain). Responses to stimulation were numerically scored and scores were summed up to a total score. Total score increases on the blocked side by ≥ 2 between baseline and 30 min Post MNB recordings signified a successful MNB. Sedation in the preceding 6 h, presence of sino-nasal disease, side of dental pathology, age, butorphanol administration, and detomidine dosing (µg/kg/min) throughout the tooth extraction procedure were recorded. In 73% of horses, MNB was successful. Sedation in the preceding 6 h (P = .732), age (P = .936), side of pathology (P = .516), and sino-nasal disease (P = .769) were not associated with total scores. Detomidine dosage and butorphanol use did not differ between horses in which the MNB was considered successful and for those in which it was not (P = .967 and P = .538, respectively). Scores obtained with gingival algometry were less closely associated with total scores (rho = .649) than those obtained with needle prick and nostril clamping (rho = .819 and .892, respectively). Therefore, needle prick and nostril clamping are considered the more reliable methods for use in clinical practice to determine the success of an MNB.
Publication Date: 2023-04-03 PubMed ID: 37013274PubMed Central: PMC11610202DOI: 10.1177/08987564231164769Google Scholar: Lookup
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Summary
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The research is about evaluating the effectiveness of three different sensory function testing methods in determining whether a maxillary nerve block (MNB), used in dental surgeries for horses, was successful or not.
Research Design and Procedure
- The study was designed as a prospective, blinded, cross-over trial involving 15 client-owned horses.
- The three methods evaluated in the study were needle prick, nostril clamping, and gingival algometry (a method to measure sensitivity to pain).
- These tests were performed before sedation, 5 minutes after sedation, and 15 and 30 minutes after the MNB using 0.5% bupivacaine.
- Different parameters such as sedation in the last 6 hours, the presence of sino-nasal disease, dental pathology’s side, the horse’s age, butorphanol administration, and detomidine dosing were recorded during the tooth extraction procedure.
Outcome assessment
- Responses to the sensory tests were gauged and numerically scored. Any increase in the total score by at least two points on the side that experienced the MNB signified the success of the block.
- The study found that for 73% of the horses, the MNB was successful.
- Parameters such as sedation in the last 6 hours, dental pathology’s side, age, and sino-nasal disease didn’t influence the total scores.
- There was no significant difference in detomidine dosage and butorphanol use between horses with successful and unsuccessful MNB.
Main Findings
- Among the three testing methods, needle prick and nostril clamping were found to be more reliable and strongly associated with the total scores as compared to gingival algometry.
- Hence, these two methods – needle prick and nostril clamping – are recommended for use in clinical practice to determine the success of an MNB in horses.
Cite This Article
APA
McAndrews A, Zarucco L, Hopster K, Stefanovski D, Foster D, Driessen B.
(2023).
Evaluation of Three Methods of Sensory Function Testing for the Assessment of Successful Maxillary Nerve Blockade in Horses.
J Vet Dent, 42(1), 48-54.
https://doi.org/10.1177/08987564231164769 Publication
Researcher Affiliations
- Garden State Equine Veterinary Dentistry, Princeton, NJ, USA.
- Department of Clinical Studies-NBC, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
- Dipartimento di Scienze Veterinarie, Universita Degli Studi di Torino, Grugliasco, TO, Italia.
- Department of Clinical Studies-NBC, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
- Department of Clinical Studies-NBC, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
- Department of Clinical Studies-NBC, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
- Department of Clinical Studies-NBC, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
MeSH Terms
- Animals
- Horses / physiology
- Nerve Block / veterinary
- Nerve Block / methods
- Cross-Over Studies
- Female
- Maxillary Nerve
- Prospective Studies
- Male
- Bupivacaine / administration & dosage
- Anesthetics, Local / administration & dosage
- Pain Measurement / veterinary
- Pain Measurement / methods
- Anesthesia, Dental / veterinary
- Anesthesia, Dental / methods
- Tooth Extraction / veterinary
- Imidazoles
Conflict of Interest Statement
Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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