{"id":127829,"date":"2025-05-12T17:33:18","date_gmt":"2025-05-12T17:33:18","guid":{"rendered":"https:\/\/todaysveterinarynurse.com\/?p=127829"},"modified":"2026-03-11T18:56:26","modified_gmt":"2026-03-11T18:56:26","slug":"performing-oral-regional-nerve-blocks-for-veterinary-patients","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/dentistry\/performing-oral-regional-nerve-blocks-for-veterinary-patients\/","title":{"rendered":"Performing Oral Regional Nerve Blocks for Veterinary Patients"},"content":{"rendered":"<div class=\"su-spacer\" style=\"height:20px\"><\/div><div class=\"su-note\"  style=\"border-color:#d8d8d8;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><div class=\"su-note-inner su-u-clearfix su-u-trim\" style=\"background-color:#f2f2f2;border-color:#ffffff;color:#333333;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><b>Abstract<\/b><\/p>\n<p class=\"p1\">All oral surgical procedures should include a regional block. The materials are readily available in practice, and the local anesthetic will help provide more balanced anesthesia. Local anesthetics can be administered intraorally or extraorally and are categorized by region as infraorbital, caudal maxillary, middle mental, and caudal mandibular\/inferior alveolar. Complications vary according to the drug used, patient species, and injection technique.<\/p>\n<p><b>Take-Home Points <\/b><\/p>\n<ul>\n<li class=\"p1\">Regional blocks provide excellent intraoperative and postoperative analgesia for dental procedures.<\/li>\n<li class=\"p1\">Materials for regional nerve blocks are cost-effective and readily available within the clinic.<\/li>\n<li class=\"p1\">Whether extraoral or intraoral, the area to which a regional block will be administered should first be disinfected.<\/li>\n<li class=\"p1\">The maximum calculated dose of the desired local agent should not be exceeded.<\/li>\n<li class=\"p1\">To avoid trauma to local structures, the needle entering a foramen within the oral cavity should not exceed 3\u20135 mm.<\/li>\n<li class=\"p1\">Aspiration is needed to avoid injecting a local agent into a vessel.<\/li>\n<\/ul>\n<\/div><\/div>\n<p class=\"p1\"><span class=\"s1\">R<\/span><span class=\"s1\">egional nerve blocks (also called locoregional, oral, local, or dental nerve blocks) provide excellent intraoperative and postoperative analgesia for patients undergoing dental procedures. They add to the safety and balance of the anesthetic event by minimizing the amount of inhalant anesthetic required.<sup>1<\/sup> Research supports using regional blocks to reduce the minimal alveolar concentration of inhalant needed without causing significant hemodynamic adverse effects.<sup>1<\/sup> Performing a regional block safely and successfully requires a strong understanding of small animal oral anatomy and landmarks.<sup>2<\/sup><\/span><\/p>\n<p><iframe src=\"https:\/\/w.soundcloud.com\/player\/?url=https%3A\/\/api.soundcloud.com\/tracks\/soundcloud%253Atracks%253A2256374162&amp;color=%23ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false&amp;show_teaser=true\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\"><\/iframe><\/p>\n<div style=\"font-size: 10px; color: #cccccc; line-break: anywhere; word-break: normal; overflow: hidden; white-space: nowrap; text-overflow: ellipsis; font-family: Interstate,Lucida Grande,Lucida Sans Unicode,Lucida Sans,Garuda,Verdana,Tahoma,sans-serif; font-weight: 100;\"><a style=\"color: #cccccc; text-decoration: none;\" title=\"VetFolio\" href=\"https:\/\/soundcloud.com\/vetfolio\" target=\"_blank\" rel=\"noopener\">VetFolio<\/a> \u00b7 <a style=\"color: #cccccc; text-decoration: none;\" title=\"Oral Regional Nerve Blocks: Application and Drug Combinations\" href=\"https:\/\/soundcloud.com\/vetfolio\/oral-regional-nerve-blocks-application-and-drug-combinations\" target=\"_blank\" rel=\"noopener\">Oral Regional Nerve Blocks: Application and Drug Combinations<\/a><\/div>\n<h2 class=\"p3\">Step 1: Assemble the Necessary Materials<\/h2>\n<ul>\n<li class=\"p4\"><span class=\"s1\">Gloves (sterile or nonsterile depending on the block)<\/span><\/li>\n<li class=\"p4\"><span class=\"s1\">Local antiseptic <\/span><\/li>\n<li class=\"p4\"><span class=\"s1\">Sterile syringes<\/span><\/li>\n<li class=\"p4\"><span class=\"s1\">Sterile needles <\/span><\/li>\n<li class=\"p5\"><span class=\"s1\">Local anesthetic agent <\/span><\/li>\n<\/ul>\n<p class=\"p2\"><span class=\"s1\">The materials needed to administer a regional anesthetic can be found within a general clinic. The amount of anesthetic agent to be delivered depends on the dose, the patient\u2019s weight, and the number of regions to be blocked. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Small-gauge short (12 to 36 mm) needles are recommended for superficial nerve blocks because they are less likely to cause nerve injury.<sup>3<\/sup> When an anesthetic agent is administered into multiple areas, needles should be changed to maintain their sterility and sharpness (<\/span><span class=\"s2\"><b>TABLE 1<\/b><\/span><span class=\"s1\">).<\/span><\/p>\n<p><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table1.png\"><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter size-full wp-image-127847\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table1.png\" alt=\"\" width=\"2020\" height=\"413\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table1.png 2020w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table1-300x61.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table1-1024x209.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table1-768x157.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table1-1536x314.png 1536w\" sizes=\"(max-width: 2020px) 100vw, 2020px\" \/><\/a><\/p>\n<h2 class=\"p3\">Step 2: Choose an Anesthetic and Calculate the Dose<\/h2>\n<p class=\"p2\"><span class=\"s1\">When choosing a local anesthetic, consider the duration of the surgical procedure and the effects of the local anesthetic (<\/span><span class=\"s2\"><b>TABLE 2<\/b><\/span><span class=\"s1\">).<\/span><\/p>\n<div id=\"attachment_128534\" style=\"width: 2024px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table2_R1-1.png\"><img decoding=\"async\" aria-describedby=\"caption-attachment-128534\" class=\"size-full wp-image-128534\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table2_R1-1.png\" alt=\"\" width=\"2014\" height=\"466\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table2_R1-1.png 2014w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table2_R1-1-300x69.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table2_R1-1-1024x237.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table2_R1-1-768x178.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Table2_R1-1-1536x355.png 1536w\" sizes=\"(max-width: 2014px) 100vw, 2014px\" \/><\/a><p id=\"caption-attachment-128534\" class=\"wp-caption-text\"><span style=\"color: #ffffff;\">.<\/span><\/p><\/div>\n<p>&nbsp;<\/p>\n<p class=\"p2\"><span class=\"s1\"><b>Lidocaine<\/b> is a short-acting agent commonly used for regional blocks. Use caution when administering this medication. Cats are significantly more sensitive to lidocaine than dogs; a potential adverse effect of lidocaine administration to cats is central nervous system excitation, resulting in convulsions.<sup>5<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\"><b>Bupivacaine<\/b> is a long-acting agent used for regional blocks. Cats are also sensitive to high doses of bupivacaine; known complications are neurotoxicity and cardiotoxic complications, such as tremors, seizures, coma, respiratory depression, profound cardiac depression, ventricular fibrillation, asystole, or death.<sup>5<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\"><b>Buprenorphine<\/b> is an adjunctive medication that can be added to bupivacaine or lidocaine to extend the action of a regional block. The recommended dose to be added to a regional nerve block is 15 <\/span><span class=\"s3\">\u00b5<\/span><span class=\"s1\">g per patient; a study proved that when bupivacaine was combined with an opioid, it increased the duration of action of the local anesthetic.<sup>6<\/sup><\/span><\/p>\n<p class=\"p2\"><span class=\"s1\"><b>Dexmedetomidine<\/b> is another adjunctive analgesic that can enhance the efficacy and duration of a local anesthetic. The recommended dose is 1 <\/span><span class=\"s3\">\u00b5<\/span><span class=\"s1\">g\/kg; keep in mind that using an <\/span><span class=\"s3\">\u03b1<\/span><span class=\"s1\"><sub>2<\/sub> agonist will cause associated dose-related systemic adverse effects (e.g., hypertension, bradycardia).<sup>6,7<\/sup><\/span><\/p>\n<p class=\"p7\"><span class=\"s1\">The following formula can be used to calculate the appropriate dose:<\/span><\/p>\n<ol>\n<li class=\"p8\"><span class=\"s1\">Patient weight (kg) \u00d7 dose of anesthetic agent = mg to be given <\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">The mg to be given \/ anesthetic concentration = total mL to be given<\/span><\/li>\n<li class=\"p9\"><span class=\"s1\">Total mL \/ 4 = amount of anesthetic agent to be applied per quadrant of the mouth<\/span><\/li>\n<\/ol>\n<p class=\"p7\"><span class=\"s1\"><b>Example:<\/b><\/span><\/p>\n<ol>\n<li class=\"p8\"><span class=\"s1\">10-kg (dog) \u00d7 1 mg\/kg 0.5% bupivacaine = 10\u00a0mg<\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">10 mg \/ 5 mg\/mL (concentration) = 2 mL<\/span><\/li>\n<li class=\"p9\"><span class=\"s1\">2 mL \/ 4 (quadrants) = 0.5 mL per quadrant<\/span><\/li>\n<\/ol>\n<h2 class=\"p3\">Step 3: Administer the Local Anesthetic<\/h2>\n<p class=\"p2\"><span class=\"s1\">A regional block is accomplished by administering a local anesthetic adjacent to or surrounding a peripheral nerve or nerve branch to temporarily inhibit nociception.<sup>8<\/sup> <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">The 4 types of regional nerve blocks of the oral cavity are the infraorbital, caudal maxillary, middle mental, and caudal mandibular\/inferior alveolar.<sup>8<\/sup> <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Before a local anesthetic agent is injected, the injection site must be prepared with an antiseptic such as alcohol (extraoral approach) or chlorhexidine (intraoral approach).<\/span><\/p>\n<h3 class=\"p10\">Type 1: Infraorbital Block<\/h3>\n<p class=\"p2\"><span class=\"s1\">Infraorbital (rostral maxillary) blocks affect bone, teeth, and intraoral soft tissue from the maxillary third premolar rostral to the midline.<sup>8<\/sup> The infraorbital foramen can be located by palpating the buccal mucosa dorsal to the maxillary third premolar (<\/span><span class=\"s2\"><b>FIGURES 1 AND 2<\/b><\/span><span class=\"s1\">).<sup>8<\/sup><\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69e89f9037ebe\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig1A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 1A. Infraorbital block demonstrated on a canine skull.\"><img decoding=\"async\" width=\"1008\" height=\"684\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig1A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig1A.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig1A-300x204.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig1A-768x521.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 1A. Infraorbital block demonstrated on a canine skull.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig1B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 1B. Infraorbital block performed on a canine patient.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"672\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig1B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig1B.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig1B-300x200.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig1B-768x512.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 1B. Infraorbital block performed on a canine patient.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig2A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 2A. Infraorbital block demonstrated on a feline skull.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"678\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig2A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig2A.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig2A-300x202.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig2A-768x517.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 2A. Infraorbital block demonstrated on a feline skull.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig2B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 2B. Infraorbital block performed on a feline patient.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"644\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig2B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig2B.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig2B-300x192.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig2B-768x491.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 2B. Infraorbital block performed on a feline patient.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69e89f9037ebe_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69e89f9037ebe\"))}, 0);}var su_image_carousel_69e89f9037ebe_script=document.getElementById(\"su_image_carousel_69e89f9037ebe_script\");if(su_image_carousel_69e89f9037ebe_script){su_image_carousel_69e89f9037ebe_script.parentNode.removeChild(su_image_carousel_69e89f9037ebe_script);}<\/script>\n<p class=\"p11\"><b>Intraoral approach<\/b><\/p>\n<ol>\n<li class=\"p8\"><span class=\"s1\">Locate the infraorbital foramen by retracting the lip dorsally and palpating the buccal mucosa over the third premolar. <\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">After locating the infraorbital foramen, place the needle next to the maxillary bone, advancing it in a caudal direction to just inside the canal. The needle should pass into the canal effortlessly. If it does not, the tip of the needle has encountered alveolar bone and needs to be redirected; retract the needle slightly and redirect it to pass into the canal smoothly.<\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">Before administering the agent into the foramen, aspirate the syringe to be sure the needle is not in a blood vessel.<\/span><\/li>\n<\/ol>\n<h3 class=\"p10\">Type 2: Caudal Maxillary Blocks<\/h3>\n<p class=\"p2\"><span class=\"s1\">Caudal maxillary (caudal infraorbital) blocks affect bone, teeth, and intraoral soft tissue from the last molar rostral to the midline, including the ipsilateral soft and hard palatal mucosa and bone (<\/span><span class=\"s2\"><b>FIGURES 3 AND 4<\/b><\/span><span class=\"s1\">).<sup>8<\/sup> The opening to the caudal maxillary foramen is dorsal to the last maxillary molars (teeth 110 and 210).<sup>8<\/sup> <\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69e89f9038590\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig3A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 3A. Caudal maxillary block demonstrated on a canine skull.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"673\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig3A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig3A.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig3A-300x200.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig3A-768x513.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 3A. Caudal maxillary block demonstrated on a canine skull.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig3B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 3B. Caudal maxillary block performed on a canine patient.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"673\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig3B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig3B.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig3B-300x200.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig3B-768x513.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 3B. Caudal maxillary block performed on a canine patient.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig4A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 4A. Caudal maxillary block demonstrated on a feline skull.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"734\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig4A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig4A.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig4A-300x218.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig4A-768x559.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 4A. Caudal maxillary block demonstrated on a feline skull.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig4B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 4B. Caudal maxillary block performed on a feline patient.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"672\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig4B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig4B.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig4B-300x200.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig4B-768x512.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 4B. Caudal maxillary block performed on a feline patient.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69e89f9038590_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69e89f9038590\"))}, 0);}var su_image_carousel_69e89f9038590_script=document.getElementById(\"su_image_carousel_69e89f9038590_script\");if(su_image_carousel_69e89f9038590_script){su_image_carousel_69e89f9038590_script.parentNode.removeChild(su_image_carousel_69e89f9038590_script);}<\/script>\n<p class=\"p11\"><b>Intraoral approach<\/b><\/p>\n<ol>\n<li class=\"p8\"><span class=\"s1\">Use your finger to palpate the maxillary tuberosity just after the last molar. <\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">Advance the needle dorsally, perpendicular to the last molar, entering the mucosa directly behind the maxillary second molar. To avoid injuring the eye, do not advance the needle more than 3 to 5 mm.<\/span><\/li>\n<li class=\"p12\"><span class=\"s1\">Before administering the agent, aspirate the syringe to be sure the needle is not in a blood vessel.<\/span><\/li>\n<\/ol>\n<h3 class=\"p10\">Type 3: Middle Mental Blocks<\/h3>\n<p class=\"p2\"><span class=\"s1\">Middle mental (rostral mandibular) blocks affect bone, teeth, and intraoral soft tissue from the mandibular second to third premolar rostral to the midline.<sup>8<\/sup> The middle mental foramen is ventral to the mesial root of the second premolar (<\/span><span class=\"s2\"><b>FIGURES\u00a05 AND 6<\/b><\/span><span class=\"s1\">).<sup>8<\/sup><\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69e89f9038ca5\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig5A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 5A. Middle mental block demonstrated on a canine skull.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"689\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig5A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig5A.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig5A-300x205.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig5A-768x525.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 5A. Middle mental block demonstrated on a canine skull.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig5B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 5B. Middle mental block performed on a canine patient.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"674\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig5B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig5B.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig5B-300x201.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig5B-768x514.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 5B. Middle mental block performed on a canine patient.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig6A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 6A. Middle mental block demonstrated on a feline skull.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"699\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig6A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig6A.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig6A-300x208.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig6A-768x533.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 6A. Middle mental block demonstrated on a feline skull.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig6B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 6B. Middle mental block performed on a feline patient.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"612\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig6B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig6B.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig6B-300x182.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig6B-768x466.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 6B. Middle mental block performed on a feline patient.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69e89f9038ca5_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69e89f9038ca5\"))}, 0);}var su_image_carousel_69e89f9038ca5_script=document.getElementById(\"su_image_carousel_69e89f9038ca5_script\");if(su_image_carousel_69e89f9038ca5_script){su_image_carousel_69e89f9038ca5_script.parentNode.removeChild(su_image_carousel_69e89f9038ca5_script);}<\/script>\n<p class=\"p11\"><b>Intraoral approach<\/b><\/p>\n<ol>\n<li class=\"p8\"><span class=\"s1\">Retract the mandibular buccal frenulum ventrally and hold. <\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">With your other hand, insert the needle in a caudal-ventral position (about 45 degrees) until the tip of the needle contacts the alveolar bone. If the opening to the middle mental foramen is large, the tip of the needle will fall into the entrance of the foramen. In the dog, the entrance to the middle mental foramen is about one-third of the distance from the border of the mandible; in the cat, it is about halfway between the mandibular canine and the third premolar. <\/span><\/li>\n<li class=\"p12\"><span class=\"s1\">Before administering the agent, aspirate the syringe to be sure the needle is not in a blood vessel.<\/span><\/li>\n<\/ol>\n<h3 class=\"p10\">Type 4: Caudal Mandibular Blocks<\/h3>\n<p class=\"p2\"><span class=\"s1\">Caudal mandibular (inferior alveolar) blocks affect bone, teeth, and intraoral soft tissue from the mandibular third molar rostral to the midline.<sup>8<\/sup> In the dog, the entrance to the inferior alveolar foramen is dorsal to the third molar and angular process. In the cat, the inferior alveolar foramen can be located by palpating the dorsal aspect of the angular process dorsal to the last molar of the mandible (<\/span><span class=\"s2\"><b>FIGURES 7 AND 8<\/b><\/span><span class=\"s1\">).<sup>8<\/sup> <\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69e89f903936f\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig7A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 7A. Caudal mandibular block demonstrated on a canine skull.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"759\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig7A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig7A.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig7A-300x226.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig7A-768x578.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 7A. Caudal mandibular block demonstrated on a canine skull.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig7B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 7B. Caudal mandibular block performed on a canine patient.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"689\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig7B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig7B.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig7B-300x205.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig7B-768x525.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 7B. Caudal mandibular block performed on a canine patient.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig8A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 8A. Caudal mandibular block demonstrated on a feline skull.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"944\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig8A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig8A.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig8A-300x281.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig8A-768x719.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 8A. Caudal mandibular block demonstrated on a feline skull.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig8B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"FIGURE 8B. Caudal mandibular block performed on a feline patient.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"674\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig8B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig8B.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig8B-300x201.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/05\/Davis_DentalBlocks_TVNSummer25_Fig8B-768x514.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>FIGURE 8B. Caudal mandibular block performed on a feline patient.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69e89f903936f_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69e89f903936f\"))}, 0);}var su_image_carousel_69e89f903936f_script=document.getElementById(\"su_image_carousel_69e89f903936f_script\");if(su_image_carousel_69e89f903936f_script){su_image_carousel_69e89f903936f_script.parentNode.removeChild(su_image_carousel_69e89f903936f_script);}<\/script>\n<p class=\"p11\"><b>Extraoral approach<\/b><\/p>\n<ol>\n<li class=\"p8\"><span class=\"s1\">Use your finger to palpate the indentation on the ventral aspect of the caudal mandible, just rostral to the angular process. <\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">Insert the needle into the skin on the lingual aspect of the caudal portion of the indentation. <\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">Maintain the needle parallel to the lingual aspect of the mandible while advancing the needle along the bone until it reaches one-third of the way, keeping the needle pointed toward the mandible. <\/span><\/li>\n<li class=\"p12\"><span class=\"s1\">Before administering the agent, aspirate the syringe when the needle is near the opening of the mandibular foramen to be sure the needle is not in a blood vessel.<\/span><\/li>\n<\/ol>\n<h2 class=\"p3\">Complications\/Adverse Effects<\/h2>\n<p class=\"p2\"><span class=\"s1\">Some of the complications that can arise from a regional block are accidental intravenous administration of local anesthetic, neurologic signs, hemorrhage\/hematoma, ocular injury, allergic reaction, nerve injury, and cardiovascular effects (atrial fibrillation).<sup>9<\/sup> <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">To avoid a hemorrhage\/hematoma after administration of a regional block, apply digital pressure over the injection site for approximately 1\u00a0minute (or longer, until bleeding stops). <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">In cats and brachycephalic patients, the orbit of the eye encompasses the space within the zygomatic arch in front of the infraorbital foramen and the caudal maxillary foramen. To avoid puncturing the orbit of the eye when administering a regional block to these patients, take care to not advance the needle too far as the distance from the infraorbital foramen and caudal maxillary foramen is small. Signs of ocular trauma resulting from a regional block are proptosis, sudden blindness\/vision loss, and severe uveitis.<\/span><\/p>\n<h2 class=\"p3\">Summary<\/h2>\n<p class=\"p2\"><span class=\"s1\">Regional nerve blocks are safe when performed correctly and the agent is administered at the proper dose. Local anesthetics are a recommended part of an anesthetic protocol, but users should be familiar with the drugs used, the anatomy of the oral cavity, and the potential adverse effects. <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Local anesthetics are categorized by region as infraorbital, caudal maxillary, middle mental, and caudal mandibular\/inferior alveolar.<\/p>\n","protected":false},"author":236,"featured_media":127846,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":0,"footnotes":""},"categories":[812],"tags":[145],"class_list":["post-127829","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-summer-2025","tag-peer-reviewed","column-skills-check","clinical_topics-dentistry"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Performing Oral Regional Nerve Blocks for Veterinary Patients | Today&#039;s Veterinary Nurse<\/title>\n<meta name=\"description\" content=\"Local anesthetics are categorized by region as infraorbital, caudal maxillary, middle mental, and caudal mandibular\/inferior alveolar.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Performing Oral Regional Nerve Blocks for Veterinary Patients\" \/>\n<meta property=\"og:description\" content=\"Local anesthetics are categorized by region as infraorbital, caudal maxillary, middle mental, and caudal mandibular\/inferior alveolar.\" \/>\n<meta property=\"og:url\" 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