• Simplest technique • Local anaesthetic is infiltrated along the line of incision • The green line in this picture • Chances of haematoma / infection at the site of incision • Skin, muscles and parietal peritoneum along the line of incision is desensitised 2.INVERTED L BLOCK • Local anaesthetic is infiltrated along the caudal border of last rib and ventral aspect of lumbar transverse processes. • Blocks the region of flank caudal and ventral to site. • Incision site is untouched • Dotted and red lines represent the technique 3.PROXIMAL PARAVERTEBRAL • Area blocked: flank of side on which technique is performed
• Nerves blocked: dorsal and ventral branches of T13, L1,
and L2
• Farquharson, Hall, or Cambridge technique
TECHNIQUE • Site: 2.5 to 5 cm from midline in the required side
• T13- immediately in front of transverse process of L1
• L1- immediately in front of transverse process of L2
• L2- immediately in front of transverse process of L3
• Use 14 G needle as guide, insert 18 G needle to inject 20 ml of
lidocaine per site. PROXIMAL PARAVERTEBRAL 4.DISTAL PARAVERTEBRAL • Nerves blocked are T13, L1, L2
• Needles inserted on dorsal and ventral aspects of transverse
processes of respective vertebra.
• 15- 20 ml of lidocaine is injected
• Magda, Cakala, or Cornell technique
• Injected in a fan shape manner
DISTAL PARAVERTEBRAL ANESTHESIA FOR OBSTETRIC PROCEDURES AND RECTAL TENESMUS • Caudal epidural anesthesia
LOW POSTERIOR OR CAUDAL EPIDURAL ANESTHESIA • Area blocked: anus, perineum, vulva, and vagina
• Nerves blocked: coccygeal and posterior sacral nerves
• Site: first intercoccygeal space (Co1 to Co2)
or sacrococcygeal space (S5 to Co1)
• 5-6ml of lidocaine EPIDURAL - TECHNIQUE • Aseptic prepaparations, • move the tail up and down- identify sacrococcygeal joint/intercoccygeal joint • located just anterior to the anal folds • Co1 - co2 joint located posterior to the anal folds • insert the needle at the midline intercoccygeal space • at a right angle • push the needle ventrally through the interarcuate ligament to the floor of the neural canal • withdraw the needle slightly (about 0.5 cm) and inject into epidural space PUDENTAL NERVE BLOCK
• Indications - Analgesia and relaxation of the penis for
examination • Relief of tenesmus associated with vaginal and uterine prolapse • Nerves blocked: internal pudendal (fibers of the ventral branches of S3 and S4), • caudal rectal (fibers of the ventral branches of S4 and S5), and pelvic splanchnic nerves • Site: identified by rectal palpation • Needle: spinal, preferably 18-gauge, 10.2-cm TECHNIQUE • Anesthetic: up to 35 mL of 2% lidocaine per side
• Method: use rectal palpation to locate the lesser sciatic
foramen, a soft, circumscribed depression in the sacrosciatic ligament; find the nerve a finger’s width dorsal • to the pudendal artery present in the fossa • pass the needle through the disinfected skin in the ischiorectal fossa • deposit up to 25 mL of 2% lidocaine around the nerve PUDENTAL NERVE BLOCK NERVE BLOCKS IN THE HEAD CORNUAL NERVE BLOCK • Area blocked: horn and base of the horn • Nerves blocked: cornual branch of zygomaticotemporal (lacrimal) nerve, a portion of the ophthalmic division of the trigeminal nerve • Site: temporal ridge, 2 to 3 cm from the base of horn • needle penetration is from 1 cm in small cattle to2.5 cm in large bulls • Anesthetic: 5 to 10 mL of 2% lidocaine • Method: palpate the lateral temporal ridge of the frontal • bone; the nerve is relatively superficial, 7 to 10 mm deep on • the upper third of the ridge, lying between the thin frontalis • muscle and the temporal muscle, and can usually be palpated • between these muscles; aspiration ensures that the needle • point is not inadvertently intravascular; inject 2 to 3 cm in • front of the base of the horn TECHNIQUE Method: palpate the lateral temporal ridge of the frontal bone; the nerve is relatively superficial, 7 to 10 mm deep on the upper third of the ridge, lying between the thin frontalis muscle and the temporal muscle, and can usually be palpated between these muscles; aspiration ensures that the needle point is not inadvertently intravascular; inject 2 to 3 cm in front of the base of the horn Cornual nerve block Cornual nerve block -goat Goats Area blocked: horn and base of the horn Nerves blocked: cornual branch of the zygomaticotemporal (lacrimal) nerve and cornual branch of the infratrochlear nerve Site: halfway between lateral canthus of the eye and lateral base of the horn (lacrimal nerve) and halfway between medial canthus of the eye and medial base of the horn (cornual branch of infratrochlear nerve) Needle: 22-gauge, 2.54-cm Anesthetic: 2 to 3 mL of 2% lidocaine at each site in the adult goat; no more than 0.5 mL of 2% lidocaine per site (or 1 mL of 1% lidocaine) for ring block at the horn base in young kids 7 to 14 days of age AURICULOPALPEBRAL NERVE BLOCK AKINESIA OF EYELID
• Site : midway between the
base of ear and lateral canthus • Dorsal most portion of zygomatic arch • 10 ml lidocaine • Motor nerve block no analgesia Auriculo palpalpebral NERVE BLOCKS FOR PROCEDURES IN THE EYE Topical and regional anesthetic techniques are used for surgery of the eye and its associated structures; paralysis of the eyelids(without analgesia) is accomplished by selectively desensitizing the auriculopalpebral branch of the facial nerve (producing akinesia) anesthesia of the eye and orbit and immobilization of the globe are commonly achieved by the Peterson technique PETERSONS BLOCK Nerves blocked: oculomotor, trochlear, and abducens nerves and the three branches of the trigeminal nerve (ophthalmic, maxillary, and mandibular) Sites: the points at which these nerves emerge from the foramen orbitorotundum Needle: 14-gauge, 2.5-cm to serve as a cannula; 18-gauge, 10.2- to 12.7-cm Anesthetic: 7 to 15 mL of 2% lidocaine at the foramen orbitorotundum; TECHNIQUE • Method • Fully extend cow’s head in a standing position with frontal • and nasal bones parallel to the ground • Surgically prepare area posterior and ventral to the eye • Inject several milliliters of anesthetic with a small-gauge • needle into the skin and subcutaneously into the notch • formed by the zygomatic and temporal process of the • malar bone (where the supraorbital process of the frontal • bone meets the zygomatic arch) • Place a 14-gauge, 1.3- to 2.54-cm needle (to serve as a • cannula) through the skin as far anterior and ventral as • possible in the notch • Direct a straight, 18-gauge, 12.7-cm needle through the cannula in a horizontal and slightly posterior direction, until it • strikes the coronoid process of the mandible • Reposition the point of the needle anteriorly until it passes • medially around this bone • Advance needle slightly posteriorly and somewhat • ventrally until it strikes a solid bony plate, which is at a • depth of 7.6 to 10.2 cm • Inject 15 mL of 2% lidocaine anterior to the foramen • orbitorotundum • Block the auriculopalpebral branch of the facial nerve Peterson’s block • Technique is useful for surgery of the cornea, enucleation of the eyeball, and removal of tumors from the eye and eyelids AURICULOPALPEBRAL NERVE BLOCK AKINESIA OF EYELID
• Site : midway between the
base of ear and lateral canthus • Dorsal most portion of zygomatic arch • 10 ml lidocaine • Motor nerve block no analgesia Retrobulbar nerve block RETROBULBAR OR THREE POINT NERVE BLOCK SUPRAORBITAL NERVE BLOCK • Anesthesia of the upper eyelid and forehead • Area blocked: upper eyelid except medial and lateral canthi • Nerve blocked: supraorbital (or frontal) nerve • Site: supraorbital foramen (Fig. 6-1, A) • Needle: 22- to 25-gauge, 2.54-cm • Anesthetic: 5 mL of 2% lidocaine • TECHNIQUE Method: palpate the supraorbital foramen approximately 5 to 7 cm above the medial canthus where it perforates the supraorbital process of the frontal bone; insert the needle into the foramen to a depth of 1.5 to 2 cm; inject 2 mL of lidocaine into the foramen; 1 mL as the needle is withdrawn and 2 mL subcutaneously over the foramen SUPRA ORBITAL INFRAORBITAL AND AURICULO PALPEBRAL INFRAORBITAL • Anesthesia of the upper lip and nose • Area blocked: upper lip and nostril, roof of nasal cavity, and • related skin up to the infraorbital foramen • Nerve blocked: infraorbital nerve • Site: external opening of the infraorbital canalNeedle: 20- to 25-gauge, 2.54-cm • E. Anesthetic: 5 mL of 2% lidocaine • F. TECHNIQUE Method: insertion site is halfway along the bony lip of the infraorbital foramen, about 2.5 cm dorsal to a line connecting the nasomaxillary notch and the rostral end of the facial crest; push upward with the fingertips the flat levator labii superioris muscle, which runs over the foramen, and place the needle tip at the foramen opening Mental • Anesthesia of the lower lip and premolars • Area blocked: lower lip, all parts of mandible rostral up to • and including the third premolar tooth (PM3) • Nerve blocked: mandibular alveolar nerve • Site: within mandibular canal • Needle: 20-gauge, 7.6-cm • Anesthetic: 10 mL of 2% lidocaine TECHNIQUE Method: palpate the lateral border of the mental foramen as a ridge along the lateral aspect of the ramus in the middle of the interdental space; insert the needle into the foramen as far as possible in a ventromedial direction; injection requires pressure, and fluid might partially drain back from the canal under the skin INFRA ORBITAL MANDIBULAR AND MENTAL Maxillary/ Infraorbital MENTAL NERVE BLOCK MANDIBULAR LOCAL ANESTHESIA FOR THE FOOT: THREE METHODS • I. Infiltrating the tissues around the limb with local anesthetic • solution (ring block) • II. Desensitizing specific nerves (regional anesthesia) • A. Brachial plexus block • B. Epidural anesthesia • III. Injecting local anesthetic solution into an accessible superficial vein in an extremity isolated from circulation by placing a tourniquet on an animal’s leg (intravenous regional anesthesia IVRA) IVRA
• Intravenous regional anesthesia:
Tourniquet and needle placement for intravenous regional anesthesia of the cow. • The needle tip is placed at the common dorsal metacarpal vein, the radial vein, or the plantar metacarpal vein in the thoracic limb. • The needle tip is placed at the cranial branch of the lateral saphenous vein in the pelvic limb
