“Oh, My Nerves” – Regional Anesthetic Blocks for Veterinary Dentistry

This session reviews commonly used regional dental nerve blocks for veterinary patients, focusing on pain management and surgical support in dogs and cats. Participants will explore drug selection, indications, contraindications, and potential complications, along with a detailed review of relevant oral and skull anatomy. Step-by-step techniques, including landmark identification and needle placement, will be demonstrated to support accurate and safe application. Emphasis will be placed on minimizing complications and assessing block effectiveness in clinical practice.

• 1. Explain the pathophysiology of oral pain, including the four stages of nociception (transduction, transmission, modulation, perception) and the mechanism of central sensitization ("wind-up") and allodynia.
• 2. Articulate the rationale for locoregional anesthesia as the standard of care in veterinary dentistry, including its role in reducing inhalant anesthetic requirements, minimizing hemodynamic complications, and improving patient recovery.
• 3. Identify the pharmacologic properties of bupivacaine HCl 0.5%, including maximum safe dosing (2 mg/kg), volume calculations per quadrant, onset and duration of action, and the risks associated with accidental intravascular injection or toxicity.
• 4. Describe the anatomic landmarks, structures anesthetized, and technique for the infraorbital, caudal maxillary, and inferior alveolar (caudal mandibular) nerve blocks in both canine and feline patients, including safe needle-depth limits to avoid iatrogenic trauma.
• 5. Recognize potential complications of locoregional dental blocks — including nerve damage, globe penetration, and species-specific toxicity thresholds (particularly in feline patients) — and apply strategies (aspiration, dose calculation, landmark palpation) to minimize risk.