A Retrospective Study of the Incidence and Management of Complications Associated With Regional Nerve Blocks in Equine Dental Patients
Authors: R. Tanner, J. Hubbell
Journal: Journal of Veterinary Dentistry
Summary
# Editorial Summary: Regional Nerve Block Complications in Equine Dentistry Regional anesthesia enables standing oral surgery in horses, with four nerve blocks (infraorbital, maxillary, mental, and mandibular) routinely used for tooth extraction, yet detailed complication data have remained sparse in the literature. Tanner and Hubbell reviewed 270 regional blocks performed on 162 horses by a single clinician in a referral setting, with strict inclusion criteria requiring 24-hour hospitalisation and minimum two-week follow-up. Eight complications occurred in seven patients (2.96% incidence): three cases of supraorbital haematoma, two of local haematoma, two of lingual self-trauma, and one complete block failure. The authors emphasise that complication risk can be substantially mitigated through reduced anesthetic volumes, precise needle placement, anatomical familiarity, adequate restraint, aseptic technique, postoperative muzzling, and use of fresh anesthetic solutions—practical measures that practitioners can implement immediately to enhance safety during standing dental procedures. For equine professionals performing regional blocks, this study provides reassuring baseline complication data whilst highlighting specific, evidence-based protocols to minimise patient morbidity.
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Practical Takeaways
- •Regional nerve blocks for equine dental extractions have a low complication rate (~3%) when performed with proper technique; ensure precise needle placement and anatomical knowledge to minimize hematoma and self-trauma risks
- •Post-block muzzling is an effective preventive measure against lingual self-trauma, and using freshly opened anesthetic bottles reduces complications
- •If complications occur, recognize supraorbital hematoma and lingual self-trauma as expected potential outcomes; have a management plan ready and ensure adequate follow-up monitoring
Key Findings
- •8 complications occurred in 7 of 162 equine patients (2.96% incidence) undergoing regional nerve blocks for dental procedures
- •Supraorbital hematoma was the most common complication (3 cases), followed by local hematoma (2 cases) and lingual self-trauma (2 cases)
- •One case of block failure to desensitize was documented among 270 regional nerve blocks
- •Complications can be reduced through reduced anesthetic volumes, precise needle placement, anatomical familiarity, adequate restraint, aseptic technique, postprocedural muzzling, and use of fresh local anesthetic