FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Animals (Basel) / Retrograde Approach to Maxillary Nerve Block: An Alternative...
Animals : an open access journal from MDPI2022; 12(11); doi: 10.3390/ani12111369

Retrograde Approach to Maxillary Nerve Block: An Alternative in Orofacial Surgeries in Horses.

Abstract: The aim of this study was to retrospectively report outcomes resulting from the approach to the maxillary nerve block (MNB) through the infraorbital canal, in terms of needles selection, drawbacks or side effects during or after block execution, and analgesic efficacy leading to clinical and cardiovascular stability during surgery. Anesthetic records of 15 horses undergoing orofacial surgery in standing analgo-sedation (STA, n = 6) and in general anesthesia (GEN, n = 9) were retrieved and analyzed. Horses in group STA required surgery for dental extraction, nasal polyp resection and maxillary/frontal sinusitis. Horses in group GEN underwent surgery for fronto-maxillary, nasal and dental diseases. Size 19 and 20 G Tuohy needles were used in adult horses weighing 350-600 kg, while size 21 and 22 G were used in younger horses or ponies. None of the horses in both groups showed complications related to the block and physiological parameters were stable and within normal ranges during surgery; overall, an adequate anesthetic/sedation depth was achieved. Our results confirm the in vivo applicability of the MNB approached within the infraorbital canal, which had been described only on cadaveric specimens. The retrograde technique resulted in a valid and easy approach to the maxillary nerve that avoids damage to periorbital structures and side effects reported with traditional techniques.
Get Full Text
Publication Date: 2022-05-27 PubMed ID: 35681833PubMed Central: PMC9179549DOI: 10.3390/ani12111369Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article explores a retrograde approach to maxillary nerve block in horses for orofacial surgeries. The study aims to share the outcomes from this procedure, analyzing its execution, potential drawbacks, side effects, and pain-relief efficacy.

Objective of the Study

  • The study aimed to acquire knowledge on the effectiveness of a retrograde approach to the maxillary nerve block (MNB). The researchers used the infraorbital canal to reach the maxillary nerve, as opposed to the traditional methods.
  • The study examined the selections of needles, any potential issues or side effects during or post-block implementation, and the efficiency of pain management leading to stability during the operation.

Experiment and Findings

  • Anesthetic records of 15 horses experiencing orofacial surgeries under standing analgo-sedation (STA) and general anesthesia (GEN) were collected and analyzed. The STA group included horses requiring dental extraction, nasal polyp resection, and treatment for sinusitis. In contrast, the GEN group presented horses that underwent surgery for fronto-maxillary, nasal, and dental diseases.
  • The researchers used sized 19 and 20 G Tuohy needles on adult horses weighing between 350-600 kg, while 21 and 22 G sized needles were employed on younger horses or ponies.
  • The results were promising as none of the horses from both groups displayed complications linked to the nerve block. All physiological parameters recorded were stable and within normal ranges during surgery. Overall, an effective level of anesthesia/sedation was achieved.

Outcome and Conclusion

  • This research confirmed the in-vivo applicability of the maxillary nerve block when approached via the infraorbital canal, a method that was previously only described on preserved specimens.
  • The retrograde technique was found to be a valid, straightforward approach to the maxillary nerve. It also prevented damage to the periorbital structures and eliminated side-effects usually associated with conventional methods.

Cite This Article

APA
Vuerich M, Nannarone S. (2022). Retrograde Approach to Maxillary Nerve Block: An Alternative in Orofacial Surgeries in Horses. Animals (Basel), 12(11). https://doi.org/10.3390/ani12111369

Publication

Animals : an open access journal from MDPI
ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 12
Issue: 11

Researcher Affiliations

Vuerich, Matteo
  • Department of Veterinary Medicine, University of Perugia, 06126 Perugia, Italy.
Nannarone, Sara
  • Department of Veterinary Medicine, University of Perugia, 06126 Perugia, Italy.
  • Sport Horse Research Centre (C.R.C.S.), University of Perugia, 06126 Perugia, Italy.
  • Research Centre on Animal Pain (Ce.Ri.D.A.), University of Perugia, 06126 Perugia, Italy.

Conflict of Interest Statement

The authors declare no conflict of interest.

References

This article includes 24 references
  1. Ong CKS, Lirk P, Seymour RA, Jenkins BJ. The Efficacy of Preemptive Analgesia for Acute Postoperative Pain Management: A Meta-Analysis. Anesth. Analg. 2005;100:757–773.
    doi: 10.1213/01.ANE.0000144428.98767.0Epubmed: 15728066google scholar: lookup
  2. Roberts VLH, Perkins JD, Skärlina E, Gorvy D, Tremaine WH, Williams A, McKane S, White I, Knottenbelt D. Caudal Anaesthesia of the Infraorbital Nerve for Diagnosis of Idiopathic Headshaking and Caudal Compression of the Infraorbital Nerve for Its Treatment, in 58 Horses. Equine Vet. J. 2013;45:107–110.
    doi: 10.1111/j.2042-3306.2012.00553.xpubmed: 22413870google scholar: lookup
  3. Newton SA, Knottenbelt DC, Eldridge PR. Headshaking in Horses: Possible Aetiopathogenesis Suggested by the Results of Diagnostic Tests and Several Treatment Regimes Used in 20 Cases. Equine Vet. J. 2000;32:208–216.
    doi: 10.2746/042516400776563617pubmed: 10836475google scholar: lookup
  4. Fletcher BW. How to Perform Effective Equine Dental Nerve Blocks. Proceedings of the AAEP Annual Convention; Denver, CO, USA. 4–8 December 2004; pp. 233–239.
  5. Tremaine WH. Local Analgesic Techniques for the Equine Head. Equine Vet. Educ. 2007;19:495–503.
    doi: 10.2746/095777307X207114google scholar: lookup
  6. Bardell D, Iff I, Mosing M. A Cadaver Study Comparing Two Approaches to Perform a Maxillary Nerve Block in the Horse. Equine Vet. J. 2010;42:721–725.
    doi: 10.1111/j.2042-3306.2010.00080.xpubmed: 21039802google scholar: lookup
  7. Schumacher J, Perkins J. Surgery of the Paranasal Sinuses Performed with the Horse Standing. Clin. Tech. Equine Pract. 2005;4:188–194.
    doi: 10.1053/j.ctep.2005.04.012google scholar: lookup
  8. Wilmink S, Warren-Smith CMR, Roberts VLH. Validation of the Accuracy of Needle Placement as Used in Diagnostic Local Analgesia of the Maxillary Nerve for Investigation of Trigeminally Mediated Headshaking in Horses. Vet. Rec. 2015;176:148.
    doi: 10.1136/vr.102518pubmed: 25433055google scholar: lookup
  9. Staszyk C, Bienert A, Bäumer W, Feige K, Gasse H. Simulation of Local Anaesthetic Nerve Block of the Infraorbital Nerve within the Pterygopalatine Fossa: Anatomical Landmarks Defined by Computed Tomography. Res. Vet. Sci. 2008;85:399–406.
    doi: 10.1016/j.rvsc.2008.02.008pubmed: 18371997google scholar: lookup
  10. Hermans H, Veera S, Wolschrijn F, van Loon JPAM. Local Anaesthetic Techniques for the Equine Head, towards Guided Techniques and New Applications. Equine Vet. Educ. 2019;31:432–440.
    doi: 10.1111/eve.12757google scholar: lookup
  11. Dixon PM. Apical Infections of Cheek Teeth and Their Oral Extraction. Proceedings of the AAEP Focus Meeting of Equine Dentistry; Indianapolis, IN, USA. 1 August 2006.
  12. O’Neill HD, Garcia-Pereira FL, Mohankumar PS. Ultrasound-Guided Injection of the Maxillary Nerve in the Horse. Equine Vet. J. 2014;46:180–184.
    doi: 10.1111/evj.12106pubmed: 23679076google scholar: lookup
  13. El-Boghdadly K, Chin KJ. Local Anesthetic Systemic Toxicity: Continuing Professional Development. Can. J. Anaesth. 2016;63:330–349.
    doi: 10.1007/s12630-015-0564-zpubmed: 26830640google scholar: lookup
  14. Wilkins PA. Use of an Infraorbital Nerve Block in the Diagnosis of Headshaking. Proceedings of the AAEP Annual Convention; Phoenix, AZ, USA. 7–10 December 1997; pp. 156–157.
  15. Nannarone S, Bini G, Vuerich M, Menchetti L, Arcelli R, Angeli G. Retrograde Maxillary Nerve Perineural Injection: A Tomographic and Anatomical Evaluation of the Infraorbital Canal and Evaluation of Needle Type and Size in Equine Cadavers. Vet. J. 2016;217:33–39.
    doi: 10.1016/j.tvjl.2016.05.016pubmed: 27810208google scholar: lookup
  16. Nannarone S, Sommer L, Cercone M, Beccati F, Gialletti R. Romifidine or Detomidine Continuous Infusion for Standing Elective Surgery in 78 Horses. Proceedings of the AVA Spring Meeting; Bari, Italy. 13–15 April 2011; p. 133.
  17. Nannarone S, Spadavecchia C. Evaluation of the Clinical Efficacy of Two Partial Intravenous Anesthetic Protocols, Compared with Isoflurane Alone, to Maintain General Anesthesia in Horses. Am J Vet Res 2012;73:959–967.
    doi: 10.2460/ajvr.73.7.959pubmed: 22738046google scholar: lookup
  18. Archer M. Regional Anaesthesia of the Equine Head and Body. Proceedings of the ACVS Equine and Small Animal Symposium; Chicago, IL, USA. 3–5 November 2011; pp. 580–584.
  19. Meyer GA, Lin HC, Hanson RR, Hayes TL. Effects of Intravenous Lidocaine Overdose on Cardiac Electrical Activity and Blood Pressure in the Horse. Equine Vet. J. 2001;33:434–437.
    doi: 10.2746/042516401776254871pubmed: 11558736google scholar: lookup
  20. Budras K, Sack W, Röck S, Horowitz A, Berg R. Anatomy of the Horse. 6th ed. Schluetersche; Hannover, Germany: 2011. Head; pp. 32–51.
  21. Caruso M, Schumacher J, Henry R. Perineural Injection of the Ethmoidal Nerve of Horses. Vet Surg. 2016;45:494–498.
    doi: 10.1111/vsu.12469pubmed: 27041543google scholar: lookup
  22. Labelle AL, Clark-Price SC. Anesthesia for Ophthalmic Procedures in the Standing Horse. Vet. Clin. N. Am. Equine Pract. 2013;29:179–191.
    doi: 10.1016/j.cveq.2012.12.001pubmed: 23498052google scholar: lookup
  23. De Jong RH, Bonin JD. Mixtures of Local Anesthetics Are No More Toxic than the Parent Drugs. Anesthesiology 1981;54:177–181.
    doi: 10.1097/00000542-198103000-00001pubmed: 7469099google scholar: lookup
  24. Ribotsky BM, Berkowitz KD, Montague JR. Local Anesthetics. Is There an Advantage to Mixing Solutions?. J. Am. Podiatr. Med. Assoc. 1996;86:487–491.
    doi: 10.7547/87507315-86-10-487pubmed: 8918026google scholar: lookup
Subscribe to our newsletter
Join 99,357 horse owners like you who receive our email updates on horse health and nutrition.