Comparison of the efficacy and duration of desensitization of oral structures following injection of a lidocaine-bupivacaine mixture via lateral percutaneous and modified infraorbital approaches in dogs.

Abstract

To compare efficacy and duration of desensitization of oral structures with a lidocaine-bupivacaine mixture administered via a lateral percutaneous or modified infraorbital approach. 6 healthy adult hound-type female dogs. In this crossover study, dogs were randomized for side (left or right) and maxillary nerve approach (lateral percutaneous or infraorbital), with a 2-week washout period. Dogs were anesthetized, and a 2-mL mixture of 2% lidocaine and 0.5% bupivacaine (50:50 [vol/vol]) was administered with a 22-gauge, 4.5-cm-long catheter inserted through the infraorbital canal (infraorbital approach) or with a shielded stimulating needle to the maxillary nerve (percutaneous approach). Reflex-evoked motor potentials were measured for the maxillary canine tooth, fourth premolar tooth, second molar tooth, and hard palate mucosa ipsilateral to the injected mixture and for the contralateral maxillary canine tooth (control) at three 10-minute intervals before injection (baseline) and at predetermined times after injection for up to 6.7 hours. For each oral structure, the proportion of dogs with desensitization (efficacy) and time to onset and duration of desensitization were compared between approaches. The proportion of dogs with successful nerve blockade did not significantly differ between infraorbital and percutaneous approaches and among the 4 oral structures. Time to onset of desensitization did not differ between approaches, but duration was significantly longer with the infraorbital approach. A modified infraorbital approach with the lidocaine-bupivacaine mixture had similar effects to a lateral percutaneous approach but provided a longer duration of desensitization. Neither approach was universally successful at desensitizing all oral structures.