Bloqueos para Extracciones en Mandibula
World Small Animal Veterinary Association Congress Proceedings, 2016
Marco Antonio Leon-Roman, DVM, PhD
DENTISTAVET - Veterinary Dentistry Center and Oral Surgery, Veterinary Dentistry, São Paulo, Brazil

Pain control has been over the past few decades an important topic both in human medicine and in veterinary medicine. Thus, local anesthesia is being increasingly used as an adjunct to general anesthesia techniques during dental procedures in animals. Local anesthesia performed before the pain stimulus promotes called prophylactic or preemptive analgesia, thus preventing sensitization of spinal cord neurons and avoiding postoperative hyperalgesia. Remember that the anesthetic procedure, by itself, is not able to produce this desensitization.

Among the benefits promoted by preemptive analgesia, we highlight the reduction of central sensitization to pain, minimizing the inflammatory tissue reaction, reducing the amount of general anesthetic required during the surgical procedure, and decreasing the dose or frequency of analgesics used in the postsurgical period. The reduction in general anesthetic dose used during surgery, in turn, allows the patient to be kept in more superficial anesthetic plane and stable during the intraoperative period, minimizing the level of anesthetic-induced cardiopulmonary depression, providing greater safety and faster anesthetic recovery.

Among the various existing local anesthesia techniques, regional nerve block is the most commonly used technique in dental practice on animals. The main blocks performed are: infraorbital block and lock jaw, maxilla, and mentoniano block and inferior alveolar block, jaw, and are able to provide adequate analgesia in different regions of the oral cavity.

Thus, the anatomical knowledge of the innervation of the oral cavity and adjacent structures is essential for the achievement of local anesthesia techniques in dental procedures, seeking the effective administration of the drug and minimizing complications. Technical deficiencies and lack of anatomical knowledge and risks to anatomical structures, difficulties in obtaining anesthesia due to the deposition of the anesthetic solution in inappropriate areas. This may result in use of larger amounts of anesthetic than necessary and thus a higher risk of toxicity.

The fifth cranial nerve (trigeminal nerve) is responsible for most of the sensory innervation of the teeth, bones and soft tissues of the oral cavity. The sensory root of the trigeminal nerve originates three major nerve trunks: the maxillary nerve, the ophthalmic nerve and the mandibular nerve. Sensory nerve fibers innervating bones, teeth and soft tissues of the oral cavity originate from the mandibular branches of the trigeminal nerve and jaw.

The indications and the choice of technique and type of employee lock are mainly related to: surgery performed, the region to be desensitized, surgical time and necessary anesthetic, presence of local inflammation, local anesthetic chosen, need for hemostasis, age and general state of the patient.

  

Speaker Information
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Marco Antonio Leon-Roman
Professor, Doctor
Veterinary Dentistry
Veterinary Dentistry Center & Oral Surgery
DENTISTAVET
São Paulo, Brazil


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