Cornell Ruffian Equine Specialists, 111 Plainfield Avenue, Elmont, New York 11003, USA (Woodman); Canadian Food Inspection Agency, 102-30585B Progressive Way, Abbotsford, British Columbia V2T 6W3 (MacKenzie); Island Veterinary Eye Specialist, 1045 Linden Avenue, Victoria, British Columbia V8V 4H3 (Osinchuk); Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4 (Husulak).
Can Vet J. 2024 Apr;65(4):359-362.
A 20-year-old quarter horse gelding was presented for routine dental examination. Periodontal disease and luxation of tooth 108 was diagnosed and oral extraction was planned. After an unsuccessful blind maxillary nerve block, it was elected to perform the procedure under total intravenous anesthesia. Following recovery, a focal superficial corneal ulcer, severe retrobulbar swelling, mild exophthalmos, and marked swelling and prolapse of the third eyelid (nictitating membrane) were observed. Clinical signs persisted beyond 48 h despite the use of systemic anti-inflammatories and topical ocular anti-inflammatories and antibiotics. A temporary tarsorrhaphy was subsequently done at 48 h and the horse was discharged after 5 d of hospitalization and regression of clinical signs. Although it is very useful for easing dental extractions, the blind maxillary nerve block is associated with potential complications due to inadvertent vascular puncture. This case report describes a rare complication of prolapse of the third eyelid in a horse after a maxillary nerve block and successful treatment with a temporary tarsorrhaphy. Key clinical message: This case report explains how nictitating membrane swelling and prolapse can occur following a blind maxillary nerve block in the horse and describes treatment with a temporary tarsorrhaphy.
一只 20 岁的骟马驹因常规牙科检查而被送诊。诊断为牙周病和 108 号牙脱位，并计划进行口腔拔牙。在不成功的盲目上颌神经阻滞麻醉后，决定在全身静脉麻醉下进行手术。术后恢复时，发现患马出现局灶性浅层角膜溃疡、严重的眼球后肿胀、轻度眼球突出、第三眼睑（瞬膜）明显肿胀和脱垂。尽管使用了全身消炎药、眼部局部消炎药和抗生素，但临床症状持续超过 48 小时。48 小时后，患马进行了临时睑裂缝合，在住院 5 天后，临床症状消退，患马出院。虽然盲上颌神经阻滞麻醉在缓解拔牙方面非常有用，但由于无意中刺破血管，该麻醉方式存在潜在并发症。本病例报告描述了一例马在进行上颌神经阻滞麻醉后发生第三眼睑脱垂的罕见并发症，并成功采用临时睑裂缝合进行治疗。关键临床信息：本病例报告解释了在马进行盲目上颌神经阻滞麻醉后如何会发生瞬膜肿胀和脱垂，并描述了采用临时睑裂缝合的治疗方法。
