Evaluation and clinical use of an intraoral inferior alveolar nerve block in the horse.
Authors: Henry T, Pusterla N, Guedes A G P, Verstraete F J M
Journal: Equine veterinary journal
Summary
# Editorial Summary: Intraoral Inferior Alveolar Nerve Block in Horses Standing dental procedures on horses' mandibles require effective locoregional anaesthesia, but conventional extraoral approaches to the inferior alveolar nerve carry risks of self-trauma to the tongue once soft tissues are desensitised. Henry et al. investigated whether an intraoral technique could reliably block this nerve by first measuring anatomical landmarks (mandibular foramen position relative to the third molar, ramus and ventral margin) across 26equine skulls of varying ages and breeds, then validating needle placement using CT imaging on cadaver heads with a custom delivery device, before applying the technique in 43 clinical cases requiring mandibular quadrant procedures. The intraoral approach successfully delivered local anaesthetic to the mandibular foramen using a standard 38 mm needle and 5 ml dose, with all clinical patients tolerating invasive procedures without developing self-inflicted lingual trauma—a significant advantage over extraoral blocks that deposit larger volumes of anaesthetic diffusely through soft tissues. This technique offers equine practitioners and dental specialists a safer, more anatomically precise method for standing sedation procedures on the lower jaw, particularly valuable for complex restorative work where prolonged desensitisation would otherwise risk the horse damaging its own tongue.
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Practical Takeaways
- •Intraoral inferior alveolar nerve blocks enable effective desensitization of mandibular teeth in standing sedated horses without major complications
- •The smaller volume of anesthetic (5ml) required with this intraoral technique may reduce the risk of self-inflicted tongue trauma compared to extraoral approaches
- •Landmark-based anatomy using the distal edge of the third molar, rostral edge of the ramus, and ventral margin of the mandible allows reliable nerve localization with a 38mm needle
Key Findings
- •Intraoral inferior alveolar nerve block successfully desensitized the inferior alveolar nerve in 43 clinical cases using a 38mm needle
- •CT verification on 4 cadaver heads confirmed accurate local anesthetic deposition at the mandibular foramen
- •A 5ml dose of local anesthetic was sufficient for clinical procedures without self-inflicted lingual trauma
- •Anatomical measurements from 26 equine skulls established consistent landmarks for mandibular foramen location