This article provides an overview of the neuroanatomy of the head with a detailed explanation and visual images to enable accurate placement of loco-regional nerve blocks to achieve pre-emptive blockade of the nociceptive input which occurs when performing oral surgery. Variations in anatomy and between species are addressed to assist in accurate placement.
AguiarJChebrouxAMartinez-TaboadaF, et al.Analgesic effects of maxillary and inferior alveolar nerve blocks in cats undergoing dental extractions. J Feline Med Surg. 2015;17(2):110-116.
2.
SnyderCJSnyderLB. Effect of mepivacaine in an infraorbital nerve block on minimum alveolar concentration of isoflurane in clinically normal anesthetized dogs undergoing a modified form of dental dolorimetry. J Am Vet Med Assoc. 2013;242(2):199-204.
3.
SteinfeldtTNimphiusWWernerT, et al.Nerve injury by needle nerve perforation in regional anaesthesia: does size matter?Br J Anaesth. 2010;104(2):245-253.
4.
CampoyLReadMPeraltaS. Canine and feline local anesthetic and analgesic techniques. In: GrimmKALamontLATranquilliWJGreeneSARobertsonSA, eds. Veterinary anesthesia and analgesia: Lumb and Jones. 5,2015:827-856.
5.
BecerraJRHTisottiTDBaierME, et al.Subzygomatic and infraorbital approaches for maxillary nerve blockade in cats’ cadaver. Cienc Rural. 2018;48(4):1-6.
6.
ViscasillasJSeymourCJBrodbeltDC. A cadaver study comparing two approaches for performing maxillary nerve block in dogs. Vet Anaesth Analg. 2013;40(2):212-219.
7.
GrossMEPopeERJarboeJM, et al.Regional anesthesia of the infraorbital and inferior alveolar nerves during noninvasive tooth pulp stimulation in halothane-anesthetized cats. Am J Vet Res. 2000;61(10):1245-1247.
8.
LoughranCMRaisisALHaitjemaG, et al.Unilateral retrobulbar hematoma following maxillary nerve block in a dog. J Vet Emerg Crit Care. 2016;26(6):815-818.
9.
PerryRMooreDScurrellE. Global penetration in a cat following maxillary nerve block for dental surgery. J Feline Med Surg. 2015;17(1):66-72.
10.
AlessioTLKriegerEM. Transient unilateral vision loss in a dog following inadvertent intravitreal injection of bupivicaine during a dental procedure. J Am Vet Med Assoc. 2015;246(9):990-993.
11.
LangtonSDWalkerJJA. A transorbital approach to the maxillary nerve block in dogs: a cadaver study. Vet Anaesth Analg. 2017;44(1):173-177.
PumphreySAReaderRCRosensteinDS, et al.Iatrogenic ocular trauma associated with infraorbital block performed for rhinoscopy in a cat: case report and preliminary imaging findings. J Feline Med Surg. 2021;7(1):20551169211011456.
14.
PascoePJ. The effects of lidocaine or a lidocaine-bupivacaine mixture administered into the infraorbital canal in dogs. Am J Vet Res. 2016;77(7):682-687.
15.
ChohanASPascoePJ. Comparison of the efficacy and duration of desensitization of oral structures following injection of a lidocaine-bupivacaine mixture via lateral percutaneous and modified infraorbital approaches in dogs. Am J Vet Res. 2021;82(1):22-27.
16.
GenglerB. Proceedings. Pain Management for Dentistry American College of Internal Medicine Forum, AVDS Dental Forum, Baltimore2005.
17.
FizzanoKClaudeAArcherT, et al.Evaluation of a modified palatine nerve block in canine rhinoscopy with biopsy. Vet Anaesth Analg. 2017;44(1):195.e2.
18.
PascoePJChohanAS. Comparison of the efficacy and duration of desensitization of oral structures following injection of various volumes of a lidocaine-bupivacaine mixture via an infraorbital approach in dogs. Am J Vet Res. 2020;81(6):463-470.
19.
DavisLVHoyerNKBoscanP, et al.Cadaveric evaluation of injectate distribution for two maxillary nerve block techniques in cats. Front Vet Sci. 2021;8:619244.
20.
Shilo-BenjaminiYLetzSPeeryD, et al.Comparison of three regional anaesthetic techniques for infraorbital or maxillary nerve block in cats: a cadaveric study. J Feline Med Surg. 2022;24(4):322-327.
21.
LantzGC. Regional anesthesia for dentistry and oral surgery. J Vet Dent. 2003;20(3):181-186.
22.
ChauAYK. Tongue lacerations in a geriatric dog after bilateral inferior alveolar nerve blocks with bupivacaine. Vet Rec Case Reports. 2017;5(3):e000433.
23.
Goudie-DeAngelisESnyderCJ. A pilot study comparing the accuracy of two approaches to the inferior alveolar nerve block in canine cadavers. J Appl Anim Res. 2016;14(1):49-58.
24.
HoJTFvan RietTCTAfrianY, et al.Adverse effects following dental local anesthesia: a literature review. J Dent Anesth Pain Med. 2021;21(6):507-525.
GrossMEPopeERO'BrienD, et al.Regional anesthesia of the infraorbital and inferior alveolar nerves during noninvasive tooth pulp stimulation in halothane-anesthetized dogs. J Am Vet Med Assoc. 1997;211(11):1403-1405.
27.
FechneyAClarkeDE. Evaluation of injectate distribution of the middle mental nerve block within the mandibular canal in cadaveric dogs. J Vet Dent. 2025;42(1).
28.
KrugWLoseyJ. Area of desensitization following mental nerve blocks in dogs. J Vet Dent. 2011;28(3):146-150.
