Page 201 - BSAVA Guide to Pain Management in Small Animal Practice

Appendix

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Major local

anaesthetic blocks

With all blocks, the maximum dose of lidocaine • In ect between . and 1 ml depending
in cats is 4 mg kg and in dogs is 1 mg kg. or on the patient s si e and breed.
bupivacaine and ropivacaine the dose is ■ Blocking the inferior alveolar branch of the
approximately 1 mg kg in both dogs and cats. It mandibular nerve at its point of entry into
may be necessary to dilute the agent in sterile the mandibular canal at the mandibular
saline if several sites are being blocked. It is not foramen anaestheti es the entire hemi
recommended to mix two agents together. In all mandible and more reliably anaestheti es
cases, the skin should be aseptically prepared the teeth of the lower aw.
wherever possible, and always aspirate prior to • he foramen is located on the medial
in ection to avoid intravascular administration. side of the mandibular ramus, ust
or detailed instructions please refer to the rostral to the angular process and can
BSAVA Manual of Canine and Feline Anaesthesia easily be palpated in most dogs and
and Analgesia. cats from the inside of the mouth.
• he aim is to block the mandibular
nerve before it enters the foramen.
Dental blocks • In ect between . and 1 ml depending
Mental (A) and mandibular (B) on the patient s si e and breed.
nerve blocks Infraorbital (C) and maxillary (D)
■ Blocking the mental branch of the nerve blocks
mandibular nerve as it exits the largest ■ Local anaesthetic administration at the
mental foraminae anaestheti es the lower infraorbital foramen will provide anaesthesia
incisors and skin and tissues rostral to the rostral to the foramen. Local anaesthetic
foramen. administration where the maxillary nerve
• Insert the needle intraorally or courses perpendicular to the palatine bone,
percutaneously, parallel to the teeth, between the maxillary foramen and the
ust rostral to the mental foramen. foramen rotundum, will provide anaesthesia
• he mental foramen is caudal and to the entire upper aw, including the teeth,
ventral to the canine tooth. on the same side.

196 BSAVA Guide to Pain Management in Small Animal Practice. Edited by Ian Self. ©BSAVA 2019

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