RU2794430C1 - Method for mandibular anesthesia in dogs - Google Patents

Abstract

FIELD: veterinary medicine.

SUBSTANCE: invention relates to veterinary medicine, namely to small domestic animal dentistry. The method of conducting mandibular anaesthesia in dogs consists in the introduction of an anaesthetic solution into the mental foramen in the aboral direction and the mandibular foramen from the lingual side in the aboral direction. At the same time, based on the interpretation of the survey radiograph and the definition of the mental foramen, drawing a line from it to the incisal edge of the lower jaw and perpendicular to the ventral edge of the lower jaw, 1/3 of the anaesthetic solution is injected. Then the mandibular foramen is determined by drawing a line from the angular process of the mandible to the mandibular canal and a perpendicular from this canal to the ventral edge of the mandible, and 2/3 of the anaesthetic solution is injected.

EFFECT: method is distinguished by a high degree of information content, accuracy, availability for clinical use, speed and ease of execution, economic feasibility, and can be used for manipulations and operations in the lower jaw region of dogs, regardless of breed and age.

1 cl, 2 dwg, 2 ex

Description

SUBSTANCE: invention relates to veterinary medicine, namely to small animal dentistry. The invention can be used for anesthesia of premolars and molars of the lower jaw, lower lip, hard palate, and partial analgesia of the tongue.

Mandibular anesthesia is a common procedure in veterinary dentistry when mandibular teeth are manipulated. With the development of veterinary medicine, it became possible not only to remove plaque and resect teeth, but also to treat caries and osteosynthesis for fractures of the body of the lower jaw. All these procedures require high-quality analgesia, since toothache is characterized by the most severe pain syndrome.

Local conduction anesthesia of the mandibular nerve allows using only hypnotic drugs as drugs for general anesthesia, since it has a pronounced analgesic effect. This reduces the systemic side effects on the animal's body, expressed when using general anesthesia.

To perform mandibular anesthesia, it is important to know the topical landmarks of the anatomical structures that form the mandibular canal. The rostral mental foramen projects in the area of the first and second premolars in dogs regardless of their head morphotype, while the aboral mental foramen is located under the third premolar. In cases of anesthesia of the chewing group of teeth, the mandibular foramen serves as the main skeletal reference point.

At the same time, dogs have significant breed characteristics that depend on the head morphotype. Therefore, it is not always possible to qualitatively perform this type of anesthesia without using the method of visual diagnostics.

A known method of rostral and mandibular blockade of the mandibular nerve in dogs, Holmstron S.E., "Veterinary Dentistry", p. 130-137, 2019. To inject an anesthetic into the mental foramen, the frenulum of the lower jaw lip is visualized, the needle is inserted at the level of the second premolar at an angle of 30 degrees to the body of the lower jaw, one third of the distance between the ventral and dorsal borders of the lower jaw. To introduce an anesthetic into the mandibular foramen, an extraoral notch is palpated somewhat dorsal to the angle of the mandible and ventral to the condylar process. The needle is inserted intraorally along the body of the lower jaw from its aboral end to the third molar.

The disadvantages of this method are: palpatory determination of the needle insertion site, which may be inaccurate, the position of the teeth as guidelines for the insertion of the needle, which may be absent, soft tissue trauma during attempts to enter the mandibular foramen.

A known method of blockade of the mandibular and mental nerves Carroll G.L., Matthews N.S., Gardsfield S.M. "Anesthesiology and analgesia in small animals", p. 129, 2009. For distal blockade of the alveolar branch of the mandibular nerve, the mental foramen is palpated ventral to the first and second premolars. To inject the anesthetic into the mandibular foramen, it is palpated medially rostral to the angle of the mandible, advancing the needle approximately 0.5 cm.

The disadvantages of this method are: palpation and approximate determination of the needle insertion site, which may be inaccurate and sometimes impossible due to the significant mass of surrounding tissues, the topical position of the teeth as guidelines for the insertion of the needle, which may be absent.

The closest is the method of anesthesia of the mental and non-mandibular alveolar nerves Verstraete F.J.M., Lommer M.J. "Oral and Maxillofacial Surgery in Dogs and Cats", p. 31-33, 2012. An anesthetic solution is injected into the mental foramen, palpating it, using the mesial root of the second premolar and the frenulum of the lower lip as a visual guide. The needle is inserted into the hole in the aboral direction. To introduce an anesthetic into the mandibular foramen, it is palpated from the lingual side aborally and ventrally to the last molar. The needle is inserted in the aboral direction.

The disadvantages of this method are: palpation definition holes, which is often impossible due to the large mass of surrounding tissues; Orientation by teeth, which may be absent or in a deployed position, as in some breeds of dogs (brachycephalic), so it is not suitable for dogs of all morphotypes.

The essence of the claimed invention lies in the original technique of introducing an anesthetic solution.

The claimed method is distinguished by the efficiency and atraumaticity of the administration of the anesthetic, since it takes into account the topographic and anatomical individual and breed features of the structure of the skull of dogs. With the introduction of an anesthetic in less accurate ways, it is easy to get a complication in the form of bleeding when traumatizing well-perfused tissues of the oral cavity. The degree of anesthesia will then decrease, since the anesthetic solution will not reach the perineural space.

The purpose of the proposed invention is to establish the exact localization of the openings of the lower jaw for the introduction of anesthetic using the method of radiography and morphometry.

The technical result of the claimed invention is the accuracy, safety and efficiency of anesthetic administration, as well as the ease of performing blockades.

The claimed technical result is achieved due to the fact that the method of conducting mandibular anesthesia in dogs is based on the accuracy of finding the mental and mandibular foramina.

To achieve this goal, a method for mandibular anesthesia in dogs has been proposed, which consists in introducing an anesthetic solution into the mental foramen in the aboral direction and the mandibular foramen from the lingual side in the aboral direction, based on the interpretation of the survey radiograph and the definition of the mental foramen, drawing a line from it to the incisal edge of the lower jaw and perpendicular to the ventral edge of the lower jaw and the introduction of 1/3 of the anesthetic solution, then the mandibular opening is determined by drawing a line from the angular process of the lower jaw to the mandibular canal and a perpendicular from this canal to the ventral edge of the lower jaw, and 2/3 of the part is injected anesthetic solution (Fig. 1, 2).

The method of anesthesia is carried out as follows. The animal is weighed, the dose of drugs is calculated on the basis of the mass indicator, the animal is immersed in a medical sleep with the help of a hypnotic agent (propofol), and placed on an X-ray cassette in a lateral position. With the help of digital programs (RadiAnt DICOM Viewer, Carestream Image Suite, etc.) or a ruler with film radiography, the mental foramen is determined, a line is drawn from it to the incisal edge of the lower jaw and perpendicular to its ventral edge, then the location of the mandibular foramen is determined by drawing a line from angular process of the mandible to the mandibular canal and a perpendicular from this canal to the ventral edge of the mandible. Next, the needle is inserted into the chin hole in the aboral direction and 1/3 of the anesthetic solution is injected, then 2/3 of the anesthetic solution is injected into the mandibular hole from the lingual side in the aboral direction.

clinical cases.

Example 1. A dog of the Belgian Shepherd breed was admitted to the clinic with a chip on the lower right canine. Needed a tooth filling.

The animal was weighed (22 kg), an intravenous catheter was placed, put into drug-induced sleep, and placed in a lateral position on an x-ray cassette. Based on the obtained radiograph (Fig. 1), the mental foramen (point A) was determined, a line was drawn in the RadiAnt DICOM Viewer program to the incisal edge of the lower jaw (15.7 mm) and a perpendicular to the ventral edge of the lower jaw body (10.6 mm). Transferring these measurements to the animal, using a 26 G needle in the aboral direction, 0.7 ml (which is 1/3 of the total volume) of a 2% lidocaine solution was injected into point A. The point of injection of the anesthetic into the mandibular foramen (point B) was determined by drawing a line from the angular process of the mandible to the mandibular canal (27.7 mm) and a perpendicular from this canal to the ventral edge of the mandible (12.4 mm). Transferring these measurements to the animal, using a 23 G needle, 1.5 ml (which is 2/3 of the total volume) of a 2% lidocaine solution was injected in the aboral direction. After 10 minutes, the treatment of the tooth began.

Example 2. A dog of the Bichon Frize breed with tartar was admitted to the clinic. Required sanitation of the oral cavity.

The animal was weighed (4.5 kg), an intravenous catheter was placed, put into drug-induced sleep, and placed in a lateral position on an x-ray cassette. Based on the obtained radiograph (Fig. 2), the mental foramen (point B) was determined, in the RadiAnt DICOM Viewer program, a line was drawn to the incisal edge of the lower jaw (8.6 mm) and a perpendicular to the ventral edge of the lower jaw body (6.8 mm) . After transferring these measurements to the animal, 0.15 ml (which is 1/3 of the total volume) of a 2% lidocaine solution was injected aborally with a 26 G needle. The point of injection of the anesthetic into the mandibular foramen (point D) was determined by drawing a line from the angular process of the mandible to the mandibular canal (13.7 mm) and a perpendicular from this canal to the ventral edge of the mandible (8.1 mm). Transferring these measurements to the animal, using a 26 G needle in the aboral direction, 0.3 ml (which is 2/3 of the total volume) of a 2% lidocaine solution was injected. After 10 minutes, they began to sanitize the oral cavity.

The proposed method for conducting mandibular anesthesia in dogs ensures the accuracy of the anatomical and topographic orientation of the doctor and allows you to determine the exact distance from the skeletal landmarks to the mental and mandibular foramina. In addition, it allows you to easily find the points of needle injection, determine the depth of the mandibular nerve and ensure its rapid analgesia.

Thus, the proposed method for mandibular anesthesia in dogs is characterized by a high degree of information content, accuracy, availability, economic feasibility and ease of execution, low cost, and can be used in manipulations and operations in the lower jaw in dogs, regardless of breed and age.

Claims (1)

A method for performing mandibular anesthesia in dogs, which consists in injecting an anesthetic solution into the mental foramen in the aboral direction and the mandibular foramen from the lingual side in the aboral direction, characterized in that based on the interpretation of the survey radiograph and the definition of the mental foramen, drawing a line from it to the incisal edge of the lower jaw and perpendicular to the ventral edge of the lower jaw, 1/3 of the anesthetic solution is injected, then the mandibular foramen is determined by drawing a line from the angular process of the lower jaw to the mandibular canal and perpendicular from this channel to the ventral edge of the mandible, and 2/3 of the anesthetic solution is injected.

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