A Retrospective Study of the Incidence and Management of Complications Associated With Regional Nerve Blocks in Equine Dental Patients

Regional anesthesia of the equine head is commonly performed to allow oral extraction of diseased teeth in the standing horse. The use of 4 blocks (infraorbital nerve, maxillary nerve, mental nerve, and mandibular nerve) is well documented for desensitization of dental quadrants for oral surgery for exodontia, but descriptions of associated complications are limited. A total of 270 regional nerve blocks were performed on 162 equine patients in a second opinion referral hospital setting. Criteria for inclusion in the study included a 24-hour stay in hospital, that the blocks be performed by one clinician and at minimum, a 2-week follow-up examination be performed. A total of 8 complications were identified in 7 patients representing a 2.96% incidence of complication. Complications included supraorbital hematoma (3), local hematoma (2), lingual self-trauma (2), and nerve block failure to desensitize (1). Treatment and management of complications are discussed. Complications associated with regional anesthesia may be reduced by reducing anesthetic volumes, precise needle placement, familiarity with the facial anatomy relevant to nerve blocks, adequate restraint, aseptic technique, postprocedural muzzling, and the use of a newly opened bottle of local anesthetic.