title: Analgesic effects of maxillary and inferior alveolar nerve blocks in cats undergoing dental extractions.
abstract: The aim of this study was to evaluate the analgesic effects of maxillary and/or inferior alveolar nerve blocks with lidocaine and bupivacaine in cats undergoing dental extractions. Twenty-nine cats were enrolled. Using an adapted composite pain scale, cats were pain scored before the dental procedure and 30 mins, and 1, 2 and 4 h after isoflurane disconnection. Cats were sedated with buprenorphine (20 µg/kg), medetomidine (10 µg/kg) and acepromazine (20 µg/kg) intramuscularly. Anaesthesia was induced using alfaxalone (1-2 mg/kg) intravenously and maintained with isoflurane in oxygen. Each cat was randomly assigned to receive maxillary and/or inferior alveolar nerve blocks or no nerve blocks prior to dental extractions. Each nerve block was performed using lidocaine (0.25 mg/kg) and bupivacaine (0.25 mg/kg). Heart rate, systolic arterial blood pressure, respiratory rate, end tidal carbon dioxide and isoflurane vaporiser settings were recorded 5 mins before and after the dental extractions, and the difference calculated. Group mean differences (mean ± SD) for heart rate (-9.7 ± 10.6 vs 7.6 ± 9.5 beats/min [nerve block vs control group, respectively], P <0.0001), systolic arterial blood pressure (-10.33 ± 18.44 vs 5.21 ± 15.23 mmHg, P = 0.02) and vaporiser settings (-0.2 ± 0.2 vs 0.1 ± 0.4, P = 0.023) were significantly different between groups. The control group had higher postoperative pain scores (median [interquartile range]) at 2 h (3 [1.75-4.00] vs 1 [0-2], P = 0.008) and 4 h (4 [2-6] vs 2 [1-2], P = 0.006) after the dental extractions. Maxillary and inferior alveolar nerve blocks with lidocaine and bupivacaine administered prior to dental extractions resulted in a reduction in heart rate and blood pressure while allowing for a reduction in isoflurane. Cats receiving nerve blocks had lower postoperative pain scores than the group without nerve blocks.
authors.affiliation: Stone Lion Veterinary Hospital, Wimbledon, London, UK joanaaguiar@outlook.com.
authors.forename: Joana
authors.initials: J
authors.lastname: Aguiar
authors.affiliation: University of Cambridge, Queen's Veterinary School Hospital, Cambridge, UK.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Chebroux
authors.affiliation: North Downs Specialist Referrals, The Brewerstreet Dairy Business Park, Bletchingley, UK.
authors.forename: Fernando
authors.initials: F
authors.lastname: Martinez-Taboada
authors.affiliation: Dick White Referrals, Six Mile Bottom, UK.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Leece
mesh_terms: D000766:Anesthesia, Dental / Q000379:methods / Q000662:veterinary*; D000818:Animals; D002045:Bupivacaine / Q000494:pharmacology; D002047:Buprenorphine / Q000008:administration & dosage; D002371:Cat Diseases / Q000188:drug therapy*; D002415:Cats; D007530:Isoflurane / Q000008:administration & dosage; D008012:Lidocaine / Q000494:pharmacology; D020926:Medetomidine / Q000008:administration & dosage; D009407:Nerve Block / Q000379:methods / Q000662:veterinary*; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control / Q000662:veterinary*; D011229:Preanesthetic Medication / Q000379:methods / Q000662:veterinary; D011277:Pregnanediones / Q000008:administration & dosage; D014081:Tooth Extraction / Q000009:adverse effects / Q000379:methods / Q000662:veterinary*
chemical_list: D011277:Pregnanediones; D002047:Buprenorphine; D008012:Lidocaine; C006477:alphaxalone; D007530:Isoflurane; D020926:Medetomidine; D002045:Bupivacaine