Brett Beckman, DVM, FAVD, DAVDC, DAAPM
Board Certified Veterinary Dentist
Nerve blocks for oral surgical procedures in cats provide a complete sodium channel blockade, preventing ascending pain signals that are created during surgical manipulation to reach the cerebral cortex. Because of their high surface area to body ratio, cats are particularly susceptible to hypothermia. Nerve blocks not only provide perioperative analgesia but allow inhalant anesthetic concentrations to be minimized. Doing so maximizes cardiac output, blood pressure, and overall perfusion, resulting in warmer patients.
Bupivacaine is the anesthetic of choice for oral nerve blocks because of its long duration of action (6–10 hours). Its maximum extravascular dose is determined by patient weight; a safe target maximum dose is 2 mg/kg (Table), but this dose is not commonly reached.
Types of Nerve Blocks
Several types of nerve blocks can be used for oral surgery in cats:
-
Rostral maxillary (infraorbital) blocks affect the entire maxillary arcade on the ipsilateral side, adjacent bone, tooth, soft tissue, hard and soft palatal mucosa, and palatal bone.
-
Rostral mandibular (mental) blocks affect bone, teeth, and intraoral soft tissue from the mandibular canine to the mandibular symphysis.
-
Caudal mandibular (inferior alveolar) blocks affect bone, teeth, and intraoral soft tissue from the mandibular molar rostral to the midline.
Care should be taken not to inject a vessel. Extravascular placement can be ensured by aspirating the needle before injection.
Presurgical Considerations
In small cats, multiple quadrant blocks may approach or exceed the recommended maximum per patient volume of anesthetic agent. It is important to pay careful attention so as not to exceed the total volume. Cats are more susceptible to lidocaine and bupivacaine toxicity than are dogs.
If the volume of agent is less than 0.1 mL per site based on the calculated maximum dose, saline can be added to the agent to dilute it to a ratio of up to 1:1 without compromising the effectiveness of the block.
Some patients chew and/or macerate their tongue following regional oral nerve blocks. Sternal recumbency can prevent lateral deviation of the tongue between the carnassial teeth where damage can occur. As long as the patient is monitored carefully after surgery until it is sternally recumbent, such damage cannot occur.
Infusion Volume of 0.5% Bupivacaine per Site Based on Patient Weight
| Patient Weight (kg) | Volume Range (mL) |
|---|---|
| ≤2 | 0.1 |
| 2–6 | 0.1–0.25 |
| >6 | 0.25–0.3 |
What You Will Need
-
Tuberculin syringe
-
25-gauge, 5/8-inch needle
-
0.5% bupivacaine
-
Optional: feline skull to visualize anatomic landmarks
Step-by-Step n Rostral Maxillary (Infraorbital) Nerve Block
To assist with needle placement, visualize the infraorbital foramen that lies a few millimeters dorsal to the apices of the maxillary third premolar. Note that the infraorbital foramen is larger and more dorsal in cats than in dogs.
Author Insight Unlike in most dogs, in cats the neurovascular bundle is not readily palpable. As long as the needle is advanced against the bone starting rostral to the third premolar in a rostral-tocaudal direction, it should enter the canal with no resistance.
Lift the upper lip dorsally, and advance the needle against the bone in a rostral-to-caudal direction, starting rostral to the third premolar (B) and avoiding the thick lip tissue that contains the neurovascular bundle. Aspirate the needle before injection to confirm that no blood enters the needle hub.
Author Insight Because of the shortness of the feline infra orbital canal (A), performingthe rostral maxillary block desensitizes the entire maxillary arcade on the ipsilateral side, adjacent bone, tooth, soft tissue, hard and soft palatal mucosa, and palatal bone. By placing the needle just within the opening of the infraorbital canal, the agent can reach the infraorbital, pterygopalatine, and major and minor palatine nerves.
Author Insight The needle should pass into the canal without meeting bony resistance. Once the needle is placed, applying gentle lateral movement will yield resistance within the canal rather than free movement beneath adjacent alveolar mucosa.
Step-by-Step n Rostral Mandibular (Mental) Nerve Block
To assist with needle placement, visualize the middle mental foramen, which lies halfway between the mandibular canine tooth and third premolar. The middle mental foramen is one-third to one-fourth the distance from the ventral-to-dorsal mandibular body.
Retract the mandibular labial frenulum ventrally, and advance the needle about 15° ventral and caudal to just enter the foramen.
Author Insight Needle advancement into the canal for the rostral mandibular block may be limited by the size of the cat. The author routinely uses the caudal mandibular block (see below) in cats for this reason.
Step-by-Step n Caudal Mandibular (Inferior Alveolar) Nerve Block
To assist with needle placement for this extraoral block, visualize the lingual and ventral mandibular bone 4–6mm rostral to the angular process at the caudal mandible (A and B). An alternative landmark is the lateral canthus of the eye. Dropping an imaginary line directly ventral to the ventral mandible allows similar needle placement.
Direct the needle through the skin toward the lingual aspect of the mandibular body at an angle of 20°–40°. This allows tactile confirmation that the tip contacts the bone; the needle should be resting just ventral to where the inferior alveolar nerve enters the mandibular canal.
https://gamma.app/public/VOSTFR-Cette-maison-2023-Streaming-VF-FR-Film-Complet-1080p—d0o8nvaujscxloq
https://gamma.app/public/VOSTFR-Iris-et-les-hommes-2024-Streaming-VF-FR-Film-Complet-1080-yoxhjdufj5fhjg3
https://gamma.app/public/VOSTFR-Le-plongeur-2024-Streaming-VF-FR-Film-Complet-1080p—51mr2xhefiq722b
https://gamma.app/public/VOSTFR-Amours-a-la-finlandaise-2024-Streaming-VF-FR-Film-Complet-6b8ca6ai3fa0wta
https://gamma.app/public/VOSTFR-Un-silence-2024-Streaming-VF-FR-Film-Complet-1080p—ta2ikdcozzo5bgy
https://gamma.app/public/VOSTFR-La-Vie-revee-de-Miss-Fran-2024-Streaming-VF-FR-Film-Compl-o8uuyx84m6m0xuu
https://gamma.app/public/VOSTFR-Les-chambres-rouges-2024-Streaming-VF-FR-Film-Complet-108-1dw8qbicnw0eldu
https://gamma.app/public/VOSTFR-La-Tete-froide-2024-Streaming-VF-FR-Film-Complet-1080p—9owo9nokixy1rfa
https://gamma.app/public/VOSTFR-Priscilla-2024-Streaming-VF-FR-Film-Complet-1080p—9ca4dquqt45nynv
https://gamma.app/public/VOSTFR-Moi-capitaine-2024-Streaming-VF-FR-Film-Complet-1080p—scqoa4tu36bubpm
https://gamma.app/public/VOSTFR-Night-Swim-2024-Streaming-VF-FR-Film-Complet-1080p—k1zmlkodg7uvvpi
https://gamma.app/public/VOSTFR-La-Hess-2024-Streaming-VF-FR-Film-Complet-1080p—1257wswo3pngykg
https://gamma.app/public/VOSTFR-Bonnard-Pierre-et-Marthe-2024-Streaming-VF-FR-Film-Comple-32hotwrnc195nus
https://gamma.app/public/VOSTFR-Making-Of-2024-Streaming-VF-FR-Film-Complet-1080p—242jb1u70f3fbsy
https://gamma.app/public/VOSTFR-Mean-Girls-Lolita-Malgre-Moi-2024-Streaming-VF-FR-Film—asjs6kime5xpq7u
https://gamma.app/public/VOSTFR-Pauvres-creatures-2024-Streaming-VF-FR-Film-Complet-1080p-ohmjx2ymzf4lpwm
https://gamma.app/public/VOSTFR-Nicky-Larson-City-Hunter-Angel-Dust-2024-Streaming-VF-F-sazke3egz8g0861
https://gamma.app/public/VOSTFR-Lhomme-dargile-2024-Streaming-VF-FR-Film-Complet-1080p—0vn2bt0alj73igh
https://gamma.app/public/VOSTFR-The-Iron-Claw-2024-Streaming-VF-FR-Film-Complet-1080p—dqeyljuw6t92x3y
https://gamma.app/public/VOSTFR-Silent-Night-2023-Streaming-VF-FR-Film-Complet-1080p—wf9logjt5zezp7l
https://slashpage.com/renginang-kp9vb
https://slashpage.com/renginang-9rtp2
https://slashpage.com/renginang-r52iv
https://slashpage.com/renginang-z31ws
https://slashpage.com/renginang-yw4jw
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=383
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=384
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=385
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=386
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=387
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=388
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=389
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=390
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=391
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=392
https://gamma.app/public/VOSTFR-Les-SEGPA-au-ski-2023-Streaming-VF-FR-Film-Complet-1080p—o52jcyauj3vr4fz
https://gamma.app/public/VOSTFR-Linnocence-2023-Streaming-VF-FR-Film-Complet-1080p—urzyry6521b27g0
https://gamma.app/public/VOSTFR-Mon-ami-robot-2023-Streaming-VF-FR-Film-Complet-1080p-rs7ltqmr9v71bna
https://gamma.app/public/VOSTFR-Dream-Scenario-2023-Streaming-VF-FR-Film-Complet-1080p—n5dz5724vp9ipbm
https://gamma.app/public/VOSTFR-Kina-Yuk-renards-de-la-banquise-2023-Streaming-VF-FR-Film—99kmk4xpqydb334
https://gamma.app/public/VOSTFR-Vermines-2023-Streaming-VF-FR-Film-Complet-1080p—8ma3z1r8f71r2ay
https://gamma.app/public/VOSTFR-Une-affaire-dhonneur-2023-Streaming-VF-FR-Film-Complet-10-wc0zqb36rfj0e2e
https://gamma.app/public/VOSTFR-5-Hectares-2023-Streaming-VF-FR-Film-Complet-1080p—i2tratdttdrtp6i
https://gamma.app/public/VOSTFR-Aquaman-et-le-Royaume-perdu-2023-Streaming-VF-FR-Film-Com-mfw4ks39gus6p8s
https://gamma.app/public/VOSTFR-Ma-France-a-moi-2023-Streaming-VF-FR-Film-Complet-1080p—k7irzltgf8cj7pf
https://gamma.app/public/VOSTFR-La-fille-de-son-pere-2023-Streaming-VF-FR-Film-Complet-10-gtg4rx64vg81a40
https://gamma.app/public/VOSTFR-Chasse-gardee-2023-Streaming-VF-FR-Film-Complet-1080p—t0m9y9hoqbelhrk
https://gamma.app/public/VOSTFR-Jeff-Panacloc-A-la-poursuite-de-Jean-Marc-2023-Streaming—ghuhq20y67z8udw
https://gamma.app/public/VOSTFR-Une-equipe-de-reve-2023-Streaming-VF-FR-Film-Complet-1080-ygy74rztmagfdll
https://gamma.app/public/VOSTFR-Wonka-2023-Streaming-VF-FR-Film-Complet-1080p—8kpij0qticgk8g2
https://gamma.app/public/VOSTFR-Les-trois-mousquetaires-Milady-2023-Streaming-VF-FR-Film—mm61a04lyh6wybb
https://gamma.app/public/VOSTFR-Past-Lives-Nos-vies-davant-2023-Streaming-VF-FR-Film-Co-uofwd65vukn72z0
https://gamma.app/public/VOSTFR-Un-corps-sous-la-lave-2023-Streaming-VF-FR-Film-Complet-1-gnslacmcycbwo2x
https://gamma.app/public/VOSTFR-Le-Monde-dapres-3-2023-Streaming-VF-FR-Film-Complet-1080p-6g7b2zpd1d4sm8e
https://gamma.app/public/VOSTFR-La-Tresse-2023-Streaming-VF-FR-Film-Complet-1080p—rwu02j4hlzru9bv
https://slashpage.com/renginang-qf71c
https://slashpage.com/renginang-zxmum
https://slashpage.com/renginang-wj09g
https://slashpage.com/renginang-iswmg
https://slashpage.com/renginang-0p0az
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=373
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=374
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=375
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=376
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=377
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=378
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=379
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=380
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=381
https://xvvgsb6704.expandcart.com/index.php?route=product/product&product_id=382
https://sites.google.com/view/movers-riyadh/
https://sites.google.com/view/movers-riyadh/movers-mecca
https://sites.google.com/view/movers-riyadh/moversjeddah
https://sites.google.com/view/movers-riyadh/home
https://sites.google.com/view/movers-riyadh/dammam/mover-qatif
https://sites.google.com/view/movers-riyadh/movers-jedaah-elhamdniah
https://sites.google.com/view/movers-riyadh/movers-yanbu
https://sites.google.com/view/movers-riyadh/movers-najran
https://sites.google.com/view/movers-riyadh/movers-Jizan
https://sites.google.com/view/movers-riyadh/moversjeddah
https://sites.google.com/view/movers-riyadh/movers-abha
https://sites.google.com/view/movers-riyadh/movers-elahsa
https://sites.google.com/view/movers-riyadh/movers-elkhobar
https://sites.google.com/view/movers-riyadh/movers-elkharj
https://sites.google.com/view/movers-riyadh/movers-elmadina-elmnowara
https://sites.google.com/view/movers-riyadh/movers-eljubail
https://sites.google.com/view/movers-riyadh/movers-elqassim
https://sites.google.com/view/movers-riyadh/movers-hafrelbatin
https://sites.google.com/view/movers-riyadh/movers-elbaha
https://sites.google.com/view/movers-riyadh/movers-jeddah
https://sites.google.com/view/movers-riyadh/movers-dammam
https://sites.google.com/view/movers-riyadh/movers-taif
https://sites.google.com/view/movers-riyadh/movers-burydah
https://sites.google.com/view/movers-riyadh/movers-tabuk
https://sites.google.com/view/movers-riyadh/movers-hail
https://sites.google.com/view/movers-riyadh/movers-khamis-mushait
https://sites.google.com/view/movers-riyadh/movers-rabigh
https://sites.google.com/view/movers-riyadh/movers-dammam/transfer-furniture-from-dammam-to-jeddah
https://sites.google.com/view/movers-riyadh/dammam/movers-dahran
https://sites.google.com/view/movers-riyadh/dammam/mover-qatif
http://fullservicelavoro.com/ شركة ريلاكس لنقل العفش والاثاث
http://fullservicelavoro.com/2019/01/07/transfer-movers-taif-furniture/ شركة نقل عفش بالطائف
http://fullservicelavoro.com/2019/01/08/transfer-movers-riyadh-furniture/ شركة نقل عفش بالرياض
http://fullservicelavoro.com/2019/01/08/transfer-movers-jeddah-furniture/ شركة نقل عفش بجدة
http://fullservicelavoro.com/2019/01/01/transfer-and-movers-furniture-mecca/ شركة نقل عفش بمكة
http://fullservicelavoro.com/2019/01/07/transfer-movers-madina-furniture/ شركة نقل عفش بالمدينة المنورة
http://fullservicelavoro.com/2019/01/07/transfer-movers-khamis-mushait-furniture/ شركة نقل عفش بخميس مشيط
http://fullservicelavoro.com/2019/01/09/transfer-movers-abha-furniture/ شركة نقل اثاث بابها
http://fullservicelavoro.com/2019/01/07/transfer-movers-najran-furniture/ شركة نقل عفش بنجران
http://fullservicelavoro.com/2019/01/16/transfer-movers-hail-furniture/ ِشركة نقل عفش بحائل
http://fullservicelavoro.com/2019/01/16/transfer-movers-qassim-furniture/ شركة نقل عفش بالقصيم
http://fullservicelavoro.com/2019/02/02/transfer-movers-furniture-in-bahaa/ شركة نقل عفش بالباحة
http://fullservicelavoro.com/2019/01/13/transfer-movers-yanbu-furniture/ شركة نقل عفش بينبع
http://fullservicelavoro.com/2019/01/18/%d8%af%d9%8a%d9%86%d8%a7-%d9%86%d9%82%d9%84-%d8%b9%d9%81%d8%b4-%d8%a8%d8%a7%d8%a8%d9%87%d8%a7/ دينا نقل عفش بابها
http://fullservicelavoro.com/2019/01/13/%D9%86%D9%82%D9%84-%D8%A7%D9%84%D8%A7%D8%AB%D8%A7%D8%AB-%D8%A8%D8%A7%D9%84%D9%85%D8%AF%D9%8A%D9%86%D8%A9-%D8%A7%D9%84%D9%85%D9%86%D9%88%D8%B1%D8%A9-%D8%A7%D9%87%D9%85-%D8%B4%D8%B1%D9%83%D8%A7%D8%AA/ نقل الاثاث بالمدينة المنورة
http://fullservicelavoro.com/2019/01/12/%D8%A7%D8%B1%D8%AE%D8%B5-%D8%B4%D8%B1%D9%83%D8%A9-%D9%86%D9%82%D9%84-%D8%B9%D9%81%D8%B4-%D8%A8%D9%85%D9%83%D8%A9/ ارخص شركة نقل عفش بمكة
http://fullservicelavoro.com/2019/01/07/transfer-movers-elkharj-furniture/ شركة نقل عفش بالخرج
http://fullservicelavoro.com/2019/01/07/transfer-movers-baqaa-furniture/ شركة نقل عفش بالبقعاء
http://fullservicelavoro.com/2019/02/05/transfer-furniture-in-jazan/ شركة نقل عفش بجازان
شركة كيان لنقل العفش بالرياض والمدينة المنورة وجدة ومكة والطائف والدمام تقديم لكم دليل كامل لشركات نقل العفش بالمملكة العربية السعودية
https://mycanadafitness.com/ شركة كيان لنقل العفش
https://mycanadafitness.com/forum.html منتدي نقل العفش
https://mycanadafitness.com/movingfurnitureriyadh.html شركة نقل اثاث بالرياض
https://mycanadafitness.com/movingfurniturejaddah.html شركة نقل اثاث بجدة
https://mycanadafitness.com/movingfurnituremecca.html شركة نقل اثاث بمكة
https://mycanadafitness.com/movingfurnituretaif.html شركة نقل اثاث بالطائف
https://mycanadafitness.com/movingfurnituremadina.html شركة نقل اثاث بالمدينة المنورة
https://mycanadafitness.com/movingfurnituredammam.html شركة نقل اثاث بالدمام
https://mycanadafitness.com/movingfurniturekhobar.html شركة نقل اثاث بالخبر
https://mycanadafitness.com/movingfurnituredhahran.html شركة نقل اثاث بالظهران
https://mycanadafitness.com/movingfurniturejubail.html شركة نقل اثاث بالجبيل
https://mycanadafitness.com/movingfurnitureqatif.html شركة نقل اثاث بالقطيف
https://mycanadafitness.com/movingfurnitureahsa.html شركة نقل اثاث بالاحساء
https://mycanadafitness.com/movingfurniturekharj.html شركة نقل اثاث بالخرج
https://mycanadafitness.com/movingfurniturekhamismushit.html شركة نقل اثاث بخميس مشيط
https://mycanadafitness.com/movingfurnitureabha.html شركة نقل اثاث بابها
https://mycanadafitness.com/movingfurniturenajran.html شركة نقل اثاث بنجران
https://mycanadafitness.com/movingfurniturejazan.html شركة نقل اثاث بجازان
https://mycanadafitness.com/movingfurnitureasir.html شركة نقل اثاث بعسير
https://mycanadafitness.com/movingfurniturehail.html شركة نقل اثاث بحائل
https://mycanadafitness.com/movingfurnitureqassim.html شركة نقل عفش بالقصيم
https://mycanadafitness.com/movingfurnitureyanbu.html شركة نقل اثاث بينبع
https://mycanadafitness.com/movingfurnitureburaidah.html شركة نقل عفش ببريدة
https://mycanadafitness.com/movingfurniturehafralbatin.html شركة نقل عفش بحفر الباطن
https://mycanadafitness.com/movingfurniturerabigh.html شركة نقل عفش برابغ
https://mycanadafitness.com/movingfurnituretabuk.html شركة نقل عفش بتبوك
https://mycanadafitness.com/movingfurnitureasfan.html شركة نقل عفش بعسفان
https://mycanadafitness.com/movingfurnituresharora.html شركة نقل عفش بشرورة
https://mycanadafitness.com/companis-moving-riyadh.html شركات نقل العفش بالرياض
https://mycanadafitness.com/cars-moving-riyadh.html سيارات نقل العفش بالرياض
https://mycanadafitness.com/company-number-moving-riyadh.html ارقام شركات نقل العفش بالرياض
https://mycanadafitness.com/company-moving-jeddah.html شركات نقل العفش بجدة
https://mycanadafitness.com/price-moving-jeddah.html اسعار نقل العفش بجدة
https://mycanadafitness.com/company-moving-mecca.html شركات نقل العفش بمكة