• 1. Lent SE, Hawkins EC. Evaluation of rhinoscopy and rhinoscopy-assisted mucosal biopsy in diagnosis of nasal disease in dogs: 119 cases (1985–1989). J Am Vet Med Assoc 1992;201:14251429.

    • Search Google Scholar
    • Export Citation
  • 2. Noone KE. Rhinoscopy, pharyngoscopy, and laryngoscopy. Vet Clin North Am Small Anim Pract 2001;31:671689.

  • 3. Weil AB. Anesthesia for endoscopy in small animals. Vet Clin North Am Small Anim Pract 2009;39:839848.

  • 4. Gaynor JS, Dunlop CI, Wagner AE, et al. Complications and mortality associated with anesthesia in dogs and cats. J Am Anim Hosp Assoc 1999;35:1317.

    • Search Google Scholar
    • Export Citation
  • 5. Mazzaferro EWA. Hypotension during anesthesia in dogs and cats: recognition, causes, and treatment. Compend Contin Educ Pract Vet 2001;23:728734.

    • Search Google Scholar
    • Export Citation
  • 6. Skarda R, Tranquilli W. Local anesthetics. In: Tranquilli WJ, ed. Lumb and Jones' veterinary anesthesia and analgesia. 4th ed. Ames, Iowa: Blackwell Publishing, 2007; 395418.

    • Search Google Scholar
    • Export Citation
  • 7. Muir WW III, Wiese AJ, March PA. Effects of morphine, lidocaine, ketamine, and morphine-lidocaine-ketamine drug combination on minimum alveolar concentration in dogs anesthetized with isoflurane. Am J Vet Res 2003;64:11551160.

    • Search Google Scholar
    • Export Citation
  • 8. Valverde A, Doherty TJ, Hernandez J, et al. Effect of lidocaine on the minimum alveolar concentration of isoflurane in dogs. Vet Anaesth Analg 2004;31:264271.

    • Search Google Scholar
    • Export Citation
  • 9. Kehlet H, Dahl JB. The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg 1993;77:10481056.

    • Search Google Scholar
    • Export Citation
  • 10. Cremer J, Sum SO, Braun C, et al. Assessment of maxillary and infraorbital nerve blockade for rhinoscopy in sevoflurane anesthetized dogs. Vet Anaesth Analg 2013;40:432439.

    • Search Google Scholar
    • Export Citation
  • 11. Viscasillas J, Seymour CJ, Brodbelt DC. A cadaver study comparing two approaches for performing maxillary nerve block in dogs. Vet Anaesth Analg 2013;40:212219.

    • Search Google Scholar
    • Export Citation
  • 12. Esteves A, Ribeiro CF, Damaso CS, et al. Anatomical description of the trigeminal nerve [V] and its branching in mongrel dogs. Braz J Morphol Sci 2009;26:187192.

    • Search Google Scholar
    • Export Citation
  • 13. Evans HE, Kitchell RL. Cranial nerves and cutaneous innervation of the head. In: Evans HE, ed. Miller's anatomy of the dog. 3rd ed. Philadelphia: WB Saunders Co, 1993; 953987.

    • Search Google Scholar
    • Export Citation
  • 14. Dyce KM, Sack WO, Wensing CJ, et al. The nervous system. In: Dyce KM, Sack WO, Wensing CJG, eds. Textbook of veterinary anatomy. 3rd ed. Philadelphia: WB Saunders Co, 2002; 259322.

    • Search Google Scholar
    • Export Citation
  • 15. Budras KD, Reese S, McCarthy PH, et al. Head. In: Budras K-D, McCarthy PH, Fricke W, et al, eds. Anatomy of the dog. 5th ed. Hannover, Germany: Schlutersche Verlagsgesellschaft mbH & Co, 2007; 88107.

    • Search Google Scholar
    • Export Citation
  • 16. Duke T. Local and regional anesthetic and analgesic techniques in the dog and cat: part II, infiltration and nerve blocks. Can Vet J 2000;41:949952.

    • Search Google Scholar
    • Export Citation
  • 17. Faul F, Erdfelder E, Lang AG, et al. G*Power 3: a flexible statistical power analysis for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175191.

    • Search Google Scholar
    • Export Citation
  • 18. Jeng CL, Torrillo TM, Rosenblatt MA. Complications of peripheral nerve blocks. Br J Anaesth 2010;105(suppl 1):i97i107.

  • 19. Jeng CL, Rosenblatt MA. Intraneural injections and regional anesthesia: the known and the unknown. Minerva Anestesiol 2011;77:5458.

    • Search Google Scholar
    • Export Citation
  • 20. Butterworth JF. Clinical pharmacology of local anesthetics. In: Cousins MJ, Carr DB, Horlocker TT, et al, eds. Cousins & Bridenbaugh's neural blockade in clinical anesthesia and pain medicine. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2009; 96113.

    • Search Google Scholar
    • Export Citation
  • 21. Reid J, Nolan AM, Hughes JM, et al. Development of the short-form Glasgow Composite Pain Scale (CMPS-SF) and derivation of an analgesic intervention score. Anim Welf 2007;16:97104.

    • Search Google Scholar
    • Export Citation
  • 22. Hellyer PW, Uhrig SR, Robinson NG. Colorado State University Canine Acute Pain Scale. Available at: vasg.org/pdfs/CSU_Acute_Pain_Scale_Canine.pdf. Accessed Feb 1, 2015.

    • Search Google Scholar
    • Export Citation
  • 23. Claude AK, Miller WW, Beyer AM, et al. Quantification and comparison of baseline cortisol levels between aqueous and plasma from healthy anesthetized hound dogs utilizing mass spectrometry. Vet Ophthalmol 2014;17:5762.

    • Search Google Scholar
    • Export Citation
  • 24. Westfall PH, Tobias RD, Rom D, et al. Multiple comparisons among treatment means in the general linear model. In: Multiple comparisons and multiple tests using the SAS system. Cary, NC: SAS Institute Inc, 1999; 83106.

    • Search Google Scholar
    • Export Citation
  • 25. Westfall PH, Tobias RD, Rom D, et al. Multiple comparisons in heteroscedastic, mixed, and multivariate models using PROC MIXED. In: Multiple comparisons and multiple tests using the SAS system. Cary, NC: SAS Institute Inc, 1999; 203226.

    • Search Google Scholar
    • Export Citation
  • 26. Raymond SA, Steffensen SC, Gugino LD, et al. Critical exposure length for nerve block of myelinated fibers with lidocaine exceeds 3 nodes. Reg Anesth 1988;13:46.

    • Search Google Scholar
    • Export Citation
  • 27. Raymond SA, Steffensen SC, Gugino LD, et al. The role of length of nerve exposed to local anesthetics in impulse blocking action. Anesth Analg 1989;68:563570.

    • Search Google Scholar
    • Export Citation
  • 28. Campoy L, Martin-Flores M, Looney AL, et al. Distribution of a lidocaine-methylene blue solution staining in brachial plexus, lumbar plexus and sciatic nerve blocks in the dog. Vet Anaesth Analg 2008;35:348354.

    • Search Google Scholar
    • Export Citation
  • 29. Langton SD, Walker JJ. A transorbital approach to the maxillary nerve block in dogs: a cadaver study. Vet Anaesth Analg 2017;44:173177.

    • Search Google Scholar
    • Export Citation
  • 30. Chiono J, Raux O, Bringuier S, et al. Bilateral suprazygomatic maxillary nerve block for cleft palate repair in children: a prospective, randomized, double-blind study versus placebo. Anesthesiology 2014;120:13621369.

    • Search Google Scholar
    • Export Citation
  • 31. Mesnil M, Dadure C, Captier G, et al. A new approach for peri-operative analgesia of cleft palate repair in infants: the bilateral suprazygomatic maxillary nerve block. Paediatr Anaesth 2010;20:343349.

    • Search Google Scholar
    • Export Citation
  • 32. Prigge L, van Schoor AN, Bosman MC, et al. Clinical anatomy of the maxillary nerve block in pediatric patients. Paediatr Anaesth 2014;24:11201126.

    • Search Google Scholar
    • Export Citation
  • 33. Sola C, Raux O, Savath L, et al. Ultrasound guidance characteristics and efficiency of suprazygomatic maxillary nerve blocks in infants: a descriptive prospective study. Paediatr Anaesth 2012;22:841846.

    • Search Google Scholar
    • Export Citation
  • 34. Higashizawa T, Koga Y. Effect of infraorbital nerve block under general anesthesia on consumption of isoflurane and postoperative pain in endoscopic endonasal maxillary sinus surgery. J Anesth 2001;15:136138.

    • Search Google Scholar
    • Export Citation
  • 35. Mariano ER, Watson D, Loland VJ, et al. Bilateral infraorbital nerve blocks decrease postoperative pain but do not reduce time to discharge following outpatient nasal surgery. Can J Anaesth 2009;56:584589.

    • Search Google Scholar
    • Export Citation
  • 36. McAdam D, Muro K, Suresh S. The use of infraorbital nerve block for postoperative pain control after transsphenoidal hypophysectomy. Reg Anesth Pain Med 2005;30:572573.

    • Search Google Scholar
    • Export Citation
  • 37. Molliex S, Navez M, Baylot D, et al. Regional anaesthesia for outpatient nasal surgery. Br J Anaesth 1996;76:151153.

  • 38. Krikri A, Alexopoulos V, Zoumakis E, et al. Laparoscopic vs. open abdominal surgery in male pigs: marked differences in cortisol and catecholamine response depending on the size of surgical incision. Hormones 2013;12:283291.

    • Search Google Scholar
    • Export Citation
  • 39. Höglund OV, Hagman R, Stridsberg M. Chromogranin A and cortisol at intraoperative repeated noxious stimuli: surgical stress in a dog model. SAGE Open Med 2015;3:2050312115576432.

    • Search Google Scholar
    • Export Citation
  • 40. Richter SD, Schurmeyer TH, Schedlowski M, et al. Time kinetics of the endocrine response to acute psychological stress. J Clin Endocrinol Metab 1996;81:19561960.

    • Search Google Scholar
    • Export Citation
  • 41. Beerda B, Schilder MB, Janssen NS, et al. The use of saliva cortisol, urinary cortisol, and catecholamine measurements for a noninvasive assessment of stress responses in dogs. Horm Behav 1996;30:272279.

    • Search Google Scholar
    • Export Citation
  • 42. Wolf AR. Effects of regional analgesia on stress responses to pediatric surgery. Paediatr Anaesth 2012;22:1924.

  • 43. Adams HA, Saatweber P, Schmitz CS, et al. Postoperative pain management in orthopaedic patients: no differences in pain score, but improved stress control by epidural anaesthesia. Eur J Anaesthesiol 2002;19:658665.

    • Search Google Scholar
    • Export Citation
  • 44. Desborough JP. The stress response to trauma and surgery. Br J Anaesth 2000;85:109117.

  • 45. Väisänen M, Raekallio M, Kuusela E, et al. Evaluation of the perioperative stress response in dogs administered medetomidine or acepromazine as part of the preanesthetic medication. Am J Vet Res 2002;63:969975.

    • Search Google Scholar
    • Export Citation
  • 46. Jørgensen LS, Christiansen P, Raundahl U, et al. Autonomic response to an experimental psychological stressor in healthy subjects: measurement of sympathetic, parasympathetic, and pituitary-adrenal parameters: test-retest reliability. Scand J Clin Lab Invest 1990;50:823829.

    • Search Google Scholar
    • Export Citation
  • 47. Beerda B, Schilder MB, van Hooff JA, et al. Manifestations of chronic stress in dogs. Appl Anim Behav Sci 1991;52:307319.

  • 48. Beerda B, Schilder MB, Bernadina W, et al. Chronic stress in dogs subjected to social and spatial restriction. II. Hormonal and immunological responses. Physiol Behav 1999;66:243254.

    • Search Google Scholar
    • Export Citation
  • 49. Hahnenkamp K, Theilmeier G, Van Aken HK, et al. The effects of local anesthetics on perioperative coagulation, inflammation, and microcirculation. Anesth Analg 2002;94:14411447.

    • Search Google Scholar
    • Export Citation
  • 50. Wiksell H, Schassburger KU, Janicijevic M, et al. Prevention of tumour cell dissemination in diagnostic needle procedures. Br J Cancer 2010;103:17061709.

    • Search Google Scholar
    • Export Citation
  • 51. Rodgers MS, Collinson R, Desai S, et al. Risk of dissemination with biopsy of colorectal liver metastases. Dis Colon Rectum 2003;46:454458.

    • Search Google Scholar
    • Export Citation

Advertisement

Evaluation of a modified infraorbital approach for a maxillary nerve block for rhinoscopy with nasal biopsy of dogs

View More View Less
  • 1 Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762.
  • | 2 Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762.
  • | 3 Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762.
  • | 4 Department of Basic Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762.
  • | 5 Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762.
  • | 6 Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762.
  • | 7 Department of Basic Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762.
  • | 8 Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762.
  • | 9 Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762.
  • | 10 Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762.
  • | 11 Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS 39762.

Abstract

OBJECTIVE To determine whether a maxillary nerve block via a modified infraorbital approach, applied before rhinoscopy and nasal biopsy of dogs, would decrease procedural nociception, minimize cardiorespiratory anesthetic effects, and improve recovery quality.

ANIMALS 8 healthy adult hound-type dogs

PROCEDURES In a crossover study, dogs received 0.5% bupivacaine (0.1 mL/kg) or an equivalent volume of saline (0.9% NaCl) solution as a maxillary nerve block via a modified infraorbital approach. A 5-cm, 20-gauge over-the-needle catheter was placed retrograde within each infraorbital canal, and bupivacaine or saline solution was administered into each pterygopalatine region. Rhinoscopy and nasal biopsy were performed. Variables monitored included heart rate, systolic arterial blood pressure (SAP), mean arterial blood pressure (MAP), diastolic arterial blood pressure (DAP), plasma cortisol and norepinephrine concentrations, purposeful movement, and pain scores. After a 14-day washout period, the other treatment was administered on the contralateral side, and rhinoscopy and nasal biopsy were repeated.

RESULTS SAP, MAP, and DAP were significantly higher for the saline solution treatment than for the bupivacaine treatment, irrespective of the time point. Plasma cortisol concentrations after saline solution treatment were significantly higher 5 minutes after nasal biopsy than at biopsy. Heart rate, norepinephrine concentration, purposeful movement, and pain score were not significantly different between treatments.

CONCLUSIONS AND CLINICAL RELEVANCE Maxillary nerve block via a modified infraorbital approach prior to rhinoscopy and nasal biopsy reduced procedural nociception as determined on the basis of blood pressures and plasma cortisol concentrations during anesthesia. These findings warrant further evaluation in dogs with nasal disease.

Contributor Notes

Dr. Claude's present address is Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824.

Dr. Kuo's present address is Prince Animal Hospital, 1F, No. 32, Ln 26, Songjiang Rd, Zhongshan District, Taipei City 104, Taiwan.

Address correspondence to Dr. Archer (tarcher@cvm.msstate.edu).