McAndrews Amelie, Zarucco Laura, Hopster Klaus, Stefanovski Darko, Foster David, Driessen Bernd
Garden State Equine Veterinary Dentistry, Princeton, NJ, USA.
Department of Clinical Studies-NBC, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA.
J Vet Dent. 2025 Jan;42(1):48-54. doi: 10.1177/08987564231164769. Epub 2023 Apr 3.
Maxillary nerve blocks (MNBs) commonly facilitate dental surgeries in standing horses. The goal of this prospective, blinded, cross-over design trial including 15 client-owned horses was to evaluate 3 methods of sensory function testing for confirming a successful MNB. Testing was performed bilaterally before sedation, 5 min after sedation, and 15 and 30 min after MNB with 0.5% bupivacaine and involved a needle prick dorsal to each naris, hemostat clamping of each nostril, and gingival algometry (measuring sensitivity to pain). Responses to stimulation were numerically scored and scores were summed up to a total score. Total score increases on the blocked side by ≥ 2 between baseline and 30 min Post MNB recordings signified a successful MNB. Sedation in the preceding 6 h, presence of sino-nasal disease, side of dental pathology, age, butorphanol administration, and detomidine dosing (µg/kg/min) throughout the tooth extraction procedure were recorded. In 73% of horses, MNB was successful. Sedation in the preceding 6 h ( = .732), age ( = .936), side of pathology ( = .516), and sino-nasal disease ( = .769) were not associated with total scores. Detomidine dosage and butorphanol use did not differ between horses in which the MNB was considered successful and for those in which it was not ( = .967 and = .538, respectively). Scores obtained with gingival algometry were less closely associated with total scores (rho = .649) than those obtained with needle prick and nostril clamping (rho = .819 and .892, respectively). Therefore, needle prick and nostril clamping are considered the more reliable methods for use in clinical practice to determine the success of an MNB.
上颌神经阻滞(MNBs)通常有助于站立马匹的牙科手术。这项前瞻性、双盲、交叉设计试验纳入了15匹客户拥有的马匹,其目的是评估3种感觉功能测试方法,以确认MNB成功。在镇静前、镇静后5分钟、使用0.5%布比卡因进行MNB后15分钟和30分钟进行双侧测试,测试包括针刺每个鼻孔背侧、用止血钳夹闭每个鼻孔以及牙龈测痛法(测量疼痛敏感性)。对刺激的反应进行数字评分,并将分数相加得到总分。MNB记录后30分钟时,阻滞侧总分较基线增加≥2分表示MNB成功。记录前6小时的镇静情况、鼻窦疾病的存在、牙科病理的一侧、年龄、丁丙诺啡的使用以及拔牙过程中右美托咪定的给药剂量(μg/kg/分钟)。在73%的马匹中,MNB成功。前6小时的镇静情况(P = 0.732)、年龄(P = 0.936)、病理一侧(P = 0.516)和鼻窦疾病(P = 0.769)与总分无关。右美托咪定剂量和丁丙诺啡的使用在MNB被认为成功的马匹和未成功的马匹之间没有差异(分别为P = 0.967和P = 0.538)。与针刺和鼻孔夹闭相比,牙龈测痛法获得的分数与总分的相关性较低(rho = 0.649),针刺和鼻孔夹闭获得的分数与总分的相关性分别为rho = 0.819和0.892。因此,针刺和鼻孔夹闭被认为是临床实践中确定MNB成功更可靠的方法。