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This clinical review summarises the pharmacological and anaesthetic properties of alfaxalone in the dog. Available pharmacokinetic-pharmacodynamic data and factors affecting the induction dose have been reported. Furthermore, quality of induction and recovery after alfaxalone administration, the use of alfaxalone for total intravenous anaesthesia, and its effects on the cardio-respiratory system, on laryngeal motion, on intraocular pressure and tear production have been evaluated. Finally, the use of alfaxalone in dogs undergoing caesarean section and the effect of intramuscular alfaxalone administration have been considered., (© 2021 British Small Animal Veterinary Association.)

Background: Erector spinae plane block (ESPB) is an ultrasound-guided interfascial plane block used to provide analgesia in dogs undergoing hemilaminectomy. The aim of this study is to compare the analgesic efficacy of a bilateral ESPB with a fentanyl constant rate infusion (CRI) in dogs undergoing hemilaminectomy., Methods: This is a retrospective cohort study. Anaesthetic records of client-owned dogs undergoing hemilaminectomy (June 2019-August 2020), and in which a bilateral ESPB was performed (group ESPB), were retrieved and compared to a cohort of 39 dogs that underwent hemilaminectomy (September 2014 - June 2017) and in which a fentanyl CRI (2 μg/kg bolus followed by 5 μg/kg/hour) was used as a primary intraoperative analgesia (group CRI). The prevalence of dogs in which intraoperative rescue fentanyl boluses were administered, the total dose of rescue fentanyl boluses administered, the postoperative methadone requirement and anaesthetic complications during the first 24 postoperative hours were evaluated. Univariate statistical analysis was used., Results: Group ESPB comprised of 93 dogs. The bilateral ESPB was performed using a median (range) levobupivacaine volume of 1 (0.5-1.7) mL/kg per side, at a concentration of 0.125% (0.12-0.25). At least one rescue fentanyl bolus was administered in 54.8% and in 56.4% of dogs in group ESPB and CRI, respectively (p > 0.99). The number of rescue fentanyl boluses was higher in group CRI (p = 0.006), especially during lumbar hemilaminectomy. Rescue fentanyl boluses were more frequently administered from skin incision to end of vertebral lamina drilling in group CRI (p = 0.001), and from end of vertebral lamina drilling to end of surgery in group ESPB (p = 0.0002). During the first 6 (p = 0.0035) and 6-12 (p = 0.0005) postoperative hours, the number of dogs that required at least one dose of methadone was higher in group CRI. In group ESPB, dogs were more likely to become hypothermic (p = 0.04). One dog, not included in the study, developed sinus arrest after performing a caudal thoracic ESPB., Conclusions: Under the conditions of this study, a bilateral ESPB was associated with a lower number of rescue fentanyl boluses administered in dogs undergoing hemilaminectomy, especially between skin incision to end of vertebral lamina drilling. Despite ESPB being associated with a reduced opioid consumption during the first 12 hours postoperatively, differences in the postoperative management precluded any firm conclusion regarding its postoperative effect., (© 2022. The Author(s).)

Objective: To compare the effect of alfaxalone and propofol on heart rate (HR) and blood pressure (BP) after fentanyl administration in healthy dogs., Study Design: Prospective, randomised clinical study., Animals: Fifty healthy client owned dogs (ASA I/II) requiring general anaesthesia for elective magnetic resonance imaging for neurological conditions., Methods: All dogs received fentanyl 7 μg kg(-1) IV and were allocated randomly to receive either alfaxalone (n = 25) or propofol (n = 25) to effect until endotracheal (ET) intubation was possible. Heart rate and oscillometric BP were measured before fentanyl (baseline), after fentanyl (Time F) and after ET intubation (Time GA). Post-induction apnoea were recorded. Data were analysed using Fisher's exact test, Mann Whitney U test and one-way anova for repeated measures as appropriate; p value <0.05 was considered significant., Results: Dogs receiving propofol showed a greater decrease in HR (-14 beat minute(-1) , range -47 to 10) compared to alfaxalone (1 beat minute(-1) , range -33 to 26) (p = 0.0116). Blood pressure decreased over the three time periods with no difference between groups. Incidence of post-induction apnoea was not different between groups., Conclusion: Following fentanyl administration, anaesthetic induction with propofol resulted in a greater negative chronotropic effect while alfaxalone preserved or increased HR., Clinical Relevance: Following fentanyl administration, HR decreases more frequently when propofol rather than alfaxalone is used as induction agent. However, given the high individual variability and the small change in predicted HR (-7.7 beats per minute after propofol), the clinical impact arising from choosing propofol or alfaxalone is likely to be small in healthy animals. Further studies in dogs with myocardial disease and altered haemodynamics are warranted., (© 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.)

Introduction: Anaesthesia in lambs undergoing experimental surgery may develop problems associated with age-related immune incompetency: a postoperative complication in a 3 week old Scottish blackface lamb after spinal surgery is presented. CASE HISTORY AND MANAGEMENT: Both lamb and ewe were in good condition. The ewe was vaccinated against Clostridium perfringens and Clostridium tetani 5 weeks pre-partum. There were no apparent problems with the lamb's intake of colostrum. Pre-anaesthetic medication was intramuscular medetomidine (10 μg kg(-1)). Anaesthesia was induced and maintained with sevoflurane in oxygen. Morphine (0.5 mg kg(-1)), meloxicam (0.6 mg kg(-1)) and ketamine (1 mg kg(-1) followed by 10 μg kg(-1) minute(-1)) were administered intravenously (IV) for perioperative analgesia. Atracurium (0.5 mg kg(-1) IV, followed by 0.17 mg kg(-1) injected when the first twitch of the four, train-of four count was palpated) was used to improve muscle relaxation. The lamb's trachea was intubated and the lungs mechanically ventilated to maintain normocapnia. Intrathecal morphine (0.2 mg kg(-1)), IV meloxicam (0.3 mg kg(-1)) and edrophonium (0.5 mg kg(-1)) were administered before recovery. Operative and initial recovery periods were unremarkable. Three hours after surgery the lamb became depressed. Tachycardia (180-250 beats minute(-1)), tachypnoea (30 breaths minute(-1)), poor peripheral perfusion and cold pelvic limb extremities were present mimicking severe pain, and/or hypovolaemic shock. Analgesics - morphine (total dose 1.3 mg kg(-1)) - and IV fluid therapy boluses - crystalloids (300 mL), colloids (120 mL) and fresh whole blood (60 mL) - failed to ameliorate clinical signs and so the lamb was euthanized 10 hours after surgery. Post-mortem findings supported a possible diagnosis of peracute Clostridium perfringens enterotoxaemia., Conclusion: Clostridium perfringens enterotoxaemia should be considered when clinical signs of severe pain and/or hypovolaemic shock fail to respond to analgesics and fluid resuscitation in lambs after major surgery., (© 2011 The Authors. Veterinary Anaesthesia and Analgesia © 2011 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.)

Background: In equine anaesthesia, the recovery period is a time of considerable risk and has been the focus of prolific research. Risk factors, including age, type and duration of procedure or temperament may influence recovery quality. Unfortunately, the anaesthetist is unable to control for these factors, therefore various pharmacological interventions and recovery methods have been developed with the objective of improving recovery quality. However, no consensus among anaesthetists has been reached for many of these interventions and their implications for recovery-related mortality and morbidity., Objectives: To conduct a systematic review of the published evidence relating to risk factors and interventions in the recovery period which may influence recovery quality from equine general anaesthesia (GA)., Study Design: A systematic evaluation of the equine veterinary literature using the GRADE framework., Methods: A literature search was performed and studies were assessed for eligibility by both authors utilising PRISMA guidelines. Studies meeting inclusion criteria were evaluated by both authors, categorically summarised and the quality of evidence for each sub-topic was assessed using the GRADE framework., Results: Thirty-nine studies were identified which directly assessed the impact of risk factors and recovery interventions on recovery quality after equine GA. There was evidence to support that peri-anaesthetic risk factors such as anaesthesia duration, American Society of Anesthesiologists (ASA) physical status and surgical procedure influenced recovery quality. We also identified sufficient evidence that administration of α-2 adrenoreceptor agonists immediately prior to recovery, improves recovery quality., Main Limitations: The validity of the results of some studies may have been compromised by missing data and small sample sizes., Conclusions: Recovery quality is influenced by factors including: anaesthesia duration, ASA physical status and surgical procedure. Recovery quality can be improved by the administration of an α-2 adrenoreceptor agonist immediately prior to recovery., (© 2021 EVJ Ltd.)

Urodynamic studies, used to understand bladder function, diagnose bladder disease, and develop treatments for dysfunctions, are ideally performed with awake subjects. However, in small and medium-sized animal models, anesthesia is often required for these procedures and can be a research confounder. This study compared the effects of select survival agents (dexmedetomidine, alfaxalone, and propofol) on urodynamic (Δpressure, bladder capacity, bladder compliance, non-voiding contractions, bladder pressure slopes) and anesthetic (change in heart rate [∆HR], average heart rate [HR], reflexes, induction/recovery times) parameters in repeated cystometrograms across five adult male cats. The urodynamic parameters under isoflurane and α-chloralose were also examined in terminal procedures for four cats. Δpressure was greatest with propofol, bladder capacity was highest with α-chloralose, non-voiding contractions were greatest with α-chloralose. Propofol and dexmedetomidine had the highest bladder pressure slopes during the initial and final portions of the cystometrograms respectively. Cats progressed to a deeper plane of anesthesia (lower HR, smaller ΔHR, decreased reflexes) under dexmedetomidine, compared to propofol and alfaxalone. Time to induction was shortest with propofol, and time to recovery was shortest with dexmedetomidine. These agent-specific differences in urodynamic and anesthetic parameters in cats will facilitate appropriate study-specific anesthetic choices.

This anesthetic case study outlines the rationale behind and describes the successful use of butorphanol as a premedicant and as an intraoperative analgesic in a dog undergoing unilateral arytenoid lateralization. Given the antiemetic, sedative, and analgesic effects of butorphanol, it may be the opioid of choice in certain veterinary surgeries (especially those where anxiolysis, sedation, antiemesis, and moderate analgesia are beneficial). [ABSTRACT FROM AUTHOR]

Simple Summary: In recent years, loco-regional anesthesia has become a common practice in both human and veterinary medicine. In particular, it is widely used in the treatment of perioperative analgesia for neurological and orthopedic surgery. The advantage of successfully applying loco-regional anesthesia is better perioperative pain relief with a lesser need for systemic analgesic drugs. This case series aims to show how the practice of loco-regional anesthesia (retrobulbar block) has allowed good management of perioperative analgesia without the use of systemic opioids in 13 out of 14 dogs. A multimodal approach to perioperative analgesia focused on the use of a retrobulbar ultrasound-guided block with a supra-temporal approach was used in 14 dogs undergoing elective unilateral enucleation. A total of 2 out of 14 patients received rescue analgesia intraoperatively, while no patients required rescue analgesia during the postoperative period. No complications were recorded during the perioperative period, and all patients were discharged within the same day. The objective of this retrospective case series is to report the outcomes of an opioid-free anesthetic plan in dogs undergoing enucleation surgery. A total of 14 dogs were admitted for enucleation between March and December 2020. A multimodal approach to perioperative analgesia was used, with a focus on retrobulbar anesthesia. A combination of an ultrasound-guided retrobulbblock with a supratemporal approach in association with ketamine, dexmedetomidine and non-steroidal anti-inflammatory drugs was used in the reported cases. Intraoperative nociception was defined as an increase of 20% from the baseline in one or more of the following parameters: heart rate, respiratory rate or mean arterial pressure. An ultrasound-guided retrobulbar block in an opioid-free anesthesia regime was effective at managing the perioperative analgesia of 13 out of 14 dogs. In only one case, a bolus of fentanyl was administered to treat intraoperative nociception. Recovery was uneventful in all the dogs, and the postoperative pain scores remained below the intervention threshold at all time points. To the authors' knowledge, this is the first reported case series of opioid-free anesthesia for enucleation in dogs. [ABSTRACT FROM AUTHOR]

Multimodal analgesia is the foundation of opioid‐sparing analgesia protocols in major surgery, being locoregional anaesthesia their keystone. Its aim is to provide adequate analgesia while minimising opioid requirements, and thus opioid‐related adverse effects. The blossoming of ultrasound‐guided fascial plane blocks offers a new spectrum of safer and simpler alternatives to traditional locoregional anaesthesia techniques. This report describes the anaesthetic management of a dog and a cat that underwent bilateral thoracotomy for treatment of chylothorax. The multimodal analgesia protocol consisted of preoperative methadone, ultrasound‐guided serratus plane and erector spinae plane blocks, and epidural catheter for postoperative analgesia management. The combination of these techniques allowed for a reduction of perioperative opioid requirements, good‐quality recovery and opioid‐free analgesia in the postoperative period. [ABSTRACT FROM AUTHOR]

Simple Summary: A pain assessment is essential to provide appropriate pain relief. The Feline Grimace Scale© (FGS) is a facial expression-based acute pain scale used in feline medicine; increased FGS scores could indicate acute pain in cats requiring analgesia. However, it is unknown if some sedatives and/or anesthetics can bias pain assessment using the FGS. This study aimed to investigate the effects of sedation with dexmedetomidine-butorphanol followed by anesthesia with propofol-isoflurane on the FGS scores of healthy cats. The cats were video-recorded before and up to 24 h after sedation and general anesthesia. Images collected from the videos were randomized and scored independently by four raters who were masked to the treatments. Dexmedetomidine and butorphanol significantly increased the FGS scores at 20 min after administration. General anesthesia with propofol and isoflurane significantly increased the FGS scores at 0.5 h post-anesthesia, but not after. There were no other statistically significant findings. In conclusion, sedation with dexmedetomidine and butorphanol and general anesthesia with propofol and isoflurane increase FGS scores and may bias clinical pain assessment. Although the effects were short-lived, they should be taken into account during acute pain assessment. This study aimed to evaluate the effects of sedation and anesthesia on Feline Grimace Scale© (FGS) scores. Twelve healthy cats were included in a prospective, blinded and randomized, cross-over study with a 14 day wash-out. Saline or dexmedetomidine-butorphanol (Dex-But) was administered intramuscularly before an anesthetic induction with propofol and maintenance with isoflurane. Saline or atipamezole (Dex-But) was administered at the end of the general anesthesia. Video-filming/image capturing was performed before and up to 24 h post-anesthesia. A total of 125 images were evaluated by four raters blinded to the treatment groups using the FGS (ear position/orbital tightening/muzzle tension/whiskers change/head position; action units (AU); scores 0–2 for each AU). The effects of the sedation/anesthesia were analyzed (p < 0.05). The total FGS and each AU scores were significantly higher with Dex-But than with saline 20 min post-sedation. In the saline group, the total FGS, orbital tightening, and whiskers and head position scores were significantly higher than baseline at 0.5 h post-anesthesia. In the Dex-But group, the total FGS and each AU scores were significantly higher after sedation, whereas the orbital tightening scores were significantly higher at 0.5 h post-anesthesia when compared with the baseline. None of the other comparisons between or within the groups was significantly different. The sedation with dexmedetomidine-butorphanol and anesthesia with propofol-isoflurane changed the FGS scores on a short-term basis; consequently, they may bias acute pain assessment. [ABSTRACT FROM AUTHOR]

Common injectable anesthetics in cats are alpha-2 receptor agonists and tiletamine/zolazepam. Xylazine shows higher rate of side effects because its lower specificity to alpha-2 receptors than dexmeditomidine. However, the use of drug combinations in cats is not much known. Therefore, alternative anesthetic combination should be investigated. Here, we examined the use of tiletamine/zolazepam with two doses of dexmedetomidine in cats. A total of 24 female cats, weight 3.05 ± 0.10 kg (mean ± SEM). Cats were randomly blinded given intramuscularly injection (IM) with either of such drug combination, representing dosage of low dose dexmedetomidine 7.5 µg/kg with tiletamine/zolazepam 3 mg/kg; TD-Lo (n=8), high dose dexmedetomidine 15 µg/kg with tiletamine/zolazepam 3 mg/kg; TD-Hi (n=8), or xylazine 0.6 mg/kg with tiletamine/zolazepam 3 mg/kg; TX (n=8). After the IM injection, the sedative, analgesic, and cardiorespiratory effects and body temperature were assessed. All treatments showed clinically comparable induction effects resulting in spontaneous lateral/sternal recumbency and loss of paw withdrawal reflex within 7 minutes; TDLo (4.125 ± 0.74 min), TD-Hi (4.5 ± 0.32 min), and TX (4.12 ± 0.58 min). Notably, anesthesia time or the time from absent to regain of paw withdrawal reflex (Time LOPR to ROPR) was significantly higher in TD-Hi (52.75 ± 1.17 min) compared to TD-Lo (42.62 ± 2.51 min) and TX (41.12 ± 2.53 min); p<0.01. Likewise, a significant higher of time from IM to ROPR in TD-Hi (57.25 ± 1.29 min) were indicated vs in TD-Lo (46.75 ± 2.88 min; p<0.05), and vs in TX (45.25 ± 2.43 min; p<0.01). No vomiting or any adverse events were reported in all groups. TD-Lo, TD-Hi, and TX produced overall comparable cardiorespiratory effect with no significantly differences in all physiological values; heart rate (HR), respiratory rate (RR), body temperature (T), systolic arterial pressure (SAP), mean arterial pressure (MAP), diastolic arterial pressure (DAP), and tissue oxygen saturation (SpO2). TD supplied the effective anesthesia duration for ≥ 42 minutes, which can be fully reversed by atipamizole. [ABSTRACT FROM AUTHOR]

The objective of the present study was to compare between three anesthetic protocols for long-term anesthesia (2 h); protocol 1: xylazine (1mg/kg)/ketamine (10mg/kg) and inhalation of isoflurane in 100% of oxygenprotocol 2: xylazine (1mg/kg)/ketamine (10mg/kg) and propofol (24mg/kg/h) by CRI, and protocol 3: propofol (5mg/kg) and propofol (12mg/kg/h) by CRI. Three clinically healthy adult mongrel dogs of both sexes were used. Food and water were withheld for 12 and 6 h before induction of anesthesia, respectively. Intravenous catheter was placed in the cephalic vein. A wash-out period of 15 days was allowed between protocols. For all protocols (1, 2, and 3), physiological parameters were recorded using a patient monitor. Depth of anesthesia and muscle relaxation were determined by recording various reflexes. Times of first limb movement, regaining swallowing reflex and extubation, sternal recumbency, and standing were recorded. Quality of recovery was also recorded. Venous blood samples were collected into EDTA-containing Vacutainer tubes immediately before anesthesia, 10min after induction with ketamine/propofol, one hour and two h of anesthesia and after complete recovery for hematological analysis by using an automated machine. Data were recorded and expressed as mean ± SD and analyzed with commercial statistical software. Results revealed slight variations among animals of the three protocols in the physiological parameters. The quality and depth of anesthesia were excellent in dogs anesthetized with isoflurane and were good in dogs during propofol infusion. The duration of deep anesthesia during propofol infusion was shorter than isoflurane, with the shortest duration in protocol 3. There were variations among animals of the three protocols in the recovery parameters. The mean scores of the recovery quality were 4.3, 4.7, and 4 for protocols 1, 2, and 3, respectively, which sited between good and excellent scores of recoveries. Slight ataxia was recorded in a dog of protocol 1. However, ataxia and urination were recorded in dogs of protocols 1 and 2. In conclusion, the effect of isoflurane and propofol on physiological parameters of dogs during long-term anesthesia was minimum and recovery was uneventful. The quality and depth of anesthesia were excellent in dogs anesthetized with isoflurane and were good in dogs during propofol infusion. The duration of deep anesthesia during propofol infusion was shorter than isoflurane, with the shortest duration in protocol 3 (12mg/kg/h). Isoflurane provides more reliable and consistent anesthetic plane plus it's not expensive as propofol. However, it requires special equipment. Propofol achieved effective anesthesia, with fast induction and less hypothermia than isoflurane administration. Apnea was recorded in two dogs after initial induction with propofol. [ABSTRACT FROM AUTHOR]

Pain management in veterinary patients is a crucial component of appropriate patient care. Multimodal analgesia that includes both systemically and locally/regionally administered drugs is generally the most effective approach to providing pain relief. Local anaesthetic drugs used in local and regional blockade are unique in that they can completely block the transmission of pain (in conscious patients) or nociceptive (in anaesthetized patients) signals, thereby providing profound analgesia. In addition, local and regional administration of drugs, when compared with systemic bolus administration, generally results in a lower incidence of dose‐related adverse effects. Due to the potential to provide profound analgesia and the high safety margin (when used correctly) of this drug class, local anaesthetics are recommended as part of the analgesic protocol in the majority of patients undergoing surgical procedures or suffering traumatic injuries. This manuscript, Part 1 of a two‐part instalment, emphasizes the importance of using local and regional anaesthesia as a component of multimodal analgesia, provides a review of the basic pharmacokinetics/pharmacodynamics of local anaesthetic drugs in general, lists information on commonly used local anaesthetic drugs for local and regional blockade in dogs and cats, and briefly introduces the novel liposome‐encapsulated bupivacaine (NOCITA®). Part 2 is a review of local and regional anaesthetic techniques used in dogs and cats (Grubb & Lobprise, 2020). [ABSTRACT FROM AUTHOR]

Peripheral nerve blocks are becoming increasingly popular for perioperative use as anesthetics and analgesics in small animals. This prospective study was performed to investigate the duration of motor and sensory blockade following use of bupivacaine for ultrasound-guided femoral and sciatic nerve blocks in dogs and to measure the plasma concentrations of bupivacaine that result from these procedures. Six dogs were anesthetized twice using a randomized cross-over design. At the first anesthetic, dogs were assigned to receive either an ultrasound-guided femoral nerve block or sciatic nerve block with 0.15 mL kg-1 of bupivacaine 0.5%. Two months later, the other nerve block was performed during a second anesthetic. At 5, 10, 15, 20, 30 and 60 minutes after injection, arterial blood samples were collected for laboratory measurement of bupivacaine. After 60 minutes, dogs were recovered from anesthesia. Starting at two hours post-injection, video-recordings of the dogs were made every two hours for 24 hours. The videos were randomized and the degree of motor and sensory blockade was evaluated using a three-point scoring system (0 = no effect, 1 = mild effect, 2 = complete blockade) by two blinded assessors. The median (range) times to full recovery from motor blockade were 11 (6–14) hours (femoral) and 12 (4–18) hours (sciatic), and 15 (10–18) hours (femoral) and 10 (4–12) hours (sciatic) for sensory blockade. There were no differences in the median times to functional recovery for the two techniques. Plasma concentrations of bupivacaine were no different following the blocks and were less than 0.78 μg mL-1 at all times. These results suggest that these ultrasound-guided nerve blocks do not result in potentially toxic systemic levels of local anesthetic and that their duration of action is useful for providing anesthesia and analgesia for pelvic limb procedures. [ABSTRACT FROM AUTHOR]

The analgesic effects of peripheral nerve blocks can be prolonged with the placement of perineural catheters allowing repeated injections of local anaesthetics in humans. The objectives of this study were to evaluate the clinical suitability of a perineural coiled catheter ( PCC) at the sciatic nerve and to evaluate pain during the early post-operative period in dogs after tibial plateau levelling osteotomy. Pre-operatively, a combined block of the sciatic and the femoral nerves was performed under sonographic guidance (ropivacaine 0.5%; 0.3 mL kg−1 per nerve). Thereafter, a PCC was placed near the sciatic nerve. Carprofen (4 mg kg−1 intravenously) was administered at the end of anaesthesia. After surgery, all dogs were randomly assigned to receive four injections of ropivacaine (group R; 0.25%, 0.3 mL kg−1) or NaCl 0.9% (group C; 0.3 mL kg−1) every 6 h through the PCC. Pain was assessed by use of a visual analogue scale (VAS) and a multi-dimensional pain score (4Avet) before surgery (T-1), for 390 min (T0, T30, T60, T120, T180, T240, T300, T360 and T390) as well as 1 day after surgery (Day 1). Methadone (0.1 mg kg−1) was administered each time the VAS was ≥40 mm or the 4Avet was ≥5. At T390 dogs received buprenorphine (0.02 mg kg−1). Data were compared using Mann-Whitney rank sum tests and repeated measures analysis of variance. Regardless of group allocation, 55% of dogs required methadone. VAS was significantly lower at T390 ( P = 0.003), and at Day 1 ( P = 0.002) and so was 4Avet at Day 1 ( P = 0.012) in group R than in group C. Bleeding occurred in one dog at PCC placement and PCC dislodged six times of 47 PCCs placed. Minor complications occurred with PCC but allowed four repeated administrations of ropivacaine or saline over 24 h in 91.5% of the cases. [ABSTRACT FROM AUTHOR]

Dental disease is common, particularly in geriatric animals, and often requiring general anaesthesia for dental procedures. The use of multimodal analgesia may help to minimise morbidity in patients as part of balanced anaesthesia, and provide effective perioperative analgesia. Locoregional anaesthesia can be used to reduce the amount of inhalational anaesthetic agent required, and provide better analgesia both during and after surgery, facilitating smoother anaesthetics and potentially better recoveries. This article will discuss the commonly used drugs, equipment, anatomy and techniques required to provide effective nerve blocks for dental procedures. [ABSTRACT FROM AUTHOR]