{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T17:10:15Z","timestamp":1773681015867,"version":"3.50.1"},"reference-count":51,"publisher":"American Veterinary Medical Association (AVMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:p><jats:bold>OBJECTIVE<\/jats:bold> To determine whether a maxillary nerve block via a modified infraorbital approach, applied before rhinoscopy and nasal biopsy of dogs, would decrease procedural nociception, minimize cardiorespiratory anesthetic effects, and improve recovery quality.<\/jats:p>\n<jats:p><jats:bold>ANIMALS<\/jats:bold> 8 healthy adult hound-type dogs<\/jats:p>\n<jats:p><jats:bold>PROCEDURES<\/jats:bold> In a crossover study, dogs received 0.5% bupivacaine (0.1 mL\/kg) or an equivalent volume of saline (0.9% NaCl) solution as a maxillary nerve block via a modified infraorbital approach. A 5-cm, 20-gauge over-the-needle catheter was placed retrograde within each infraorbital canal, and bupivacaine or saline solution was administered into each pterygopalatine region. Rhinoscopy and nasal biopsy were performed. Variables monitored included heart rate, systolic arterial blood pressure (SAP), mean arterial blood pressure (MAP), diastolic arterial blood pressure (DAP), plasma cortisol and norepinephrine concentrations, purposeful movement, and pain scores. After a 14-day washout period, the other treatment was administered on the contralateral side, and rhinoscopy and nasal biopsy were repeated.<\/jats:p>\n<jats:p><jats:bold>RESULTS<\/jats:bold> SAP, MAP, and DAP were significantly higher for the saline solution treatment than for the bupivacaine treatment, irrespective of the time point. Plasma cortisol concentrations after saline solution treatment were significantly higher 5 minutes after nasal biopsy than at biopsy. Heart rate, norepinephrine concentration, purposeful movement, and pain score were not significantly different between treatments.<\/jats:p>\n<jats:p><jats:bold>CONCLUSIONS AND CLINICAL RELEVANCE<\/jats:bold> Maxillary nerve block via a modified infraorbital approach prior to rhinoscopy and nasal biopsy reduced procedural nociception as determined on the basis of blood pressures and plasma cortisol concentrations during anesthesia. These findings warrant further evaluation in dogs with nasal disease.<\/jats:p>","DOI":"10.2460\/ajvr.78.9.1025","type":"journal-article","created":{"date-parts":[[2017,8,24]],"date-time":"2017-08-24T13:16:08Z","timestamp":1503580568000},"page":"1025-1035","source":"Crossref","is-referenced-by-count":21,"title":["Evaluation of a modified infraorbital approach for a maxillary nerve block for rhinoscopy with nasal biopsy of dogs"],"prefix":"10.2460","volume":"78","author":[{"given":"Kristen M.","family":"Fizzano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew K.","family":"Claude","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lan-Hsin","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey B.","family":"Eells","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone B.","family":"Hinz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brittany E.","family":"Thames","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew K.","family":"Ross","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert L.","family":"Linford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert W.","family":"Wills","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia K.","family":"Olivier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd M.","family":"Archer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"key":"ref1","series-title":"J Am Vet Med Assoc","first-page":"1425","article-title":"Evaluation of rhinoscopy and rhinoscopy-assisted mucosal biopsy in diagnosis of nasal disease in dogs: 119 cases (1985\u20131989)","volume":"201","author":"Lent","year":"1992"},{"key":"ref2","series-title":"Vet Clin North Am Small Anim Pract","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/S0195-5616(01)50065-0","article-title":"Rhinoscopy, pharyngoscopy, and laryngoscopy","volume":"31","author":"Noone","year":"2001"},{"key":"ref3","series-title":"Vet Clin North Am Small Anim Pract","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1016\/j.cvsm.2009.05.008","article-title":"Anesthesia for endoscopy in small animals","volume":"39","author":"Weil","year":"2009"},{"key":"ref4","series-title":"J Am Anim Hosp Assoc","doi-asserted-by":"publisher","first-page":"13","DOI":"10.5326\/15473317-35-1-13","article-title":"Complications and mortality associated with anesthesia in dogs and cats","volume":"35","author":"Gaynor","year":"1999"},{"key":"ref5","series-title":"Compend Contin Educ Pract Vet","first-page":"728","article-title":"Hypotension during anesthesia in dogs and cats: recognition, causes, and treatment","volume":"23","author":"Mazzaferro","year":"2001"},{"key":"ref6","series-title":"Lumb and Jones' veterinary anesthesia and analgesia","first-page":"395","article-title":"Local anesthetics","author":"Skarda","year":"2007"},{"key":"ref7","series-title":"Am J Vet Res","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.2460\/ajvr.2003.64.1155","article-title":"Effects of morphine, lidocaine, ketamine, and morphine-lidocaine-ketamine drug combination on minimum alveolar concentration in dogs anesthetized with isoflurane","volume":"64","author":"Muir","year":"2003"},{"key":"ref8","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1111\/j.1467-2995.2004.00165.x","article-title":"Effect of lidocaine on the minimum alveolar concentration of isoflurane in dogs","volume":"31","author":"Valverde","year":"2004"},{"key":"ref9","series-title":"Anesth Analg","first-page":"1048","article-title":"The value of \u201cmultimodal\u201d or \u201cbalanced analgesia\u201d in postoperative pain treatment","volume":"77","author":"Kehlet","year":"1993"},{"key":"ref10","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1111\/vaa.12032","article-title":"Assessment of maxillary and infraorbital nerve blockade for rhinoscopy in sevoflurane anesthetized dogs","volume":"40","author":"Cremer","year":"2013"},{"key":"ref11","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1111\/j.1467-2995.2012.00781.x","article-title":"A cadaver study comparing two approaches for performing maxillary nerve block in dogs","volume":"40","author":"Viscasillas","year":"2013"},{"key":"ref12","series-title":"Braz J Morphol Sci","first-page":"187","article-title":"Anatomical description of the trigeminal nerve [V] and its branching in mongrel dogs","volume":"26","author":"Esteves","year":"2009"},{"key":"ref13","series-title":"Miller's anatomy of the dog","first-page":"953","article-title":"Cranial nerves and cutaneous innervation of the head","author":"Evans","year":"1993"},{"key":"ref14","series-title":"Textbook of veterinary anatomy","first-page":"259","article-title":"The nervous system","author":"Dyce","year":"2002"},{"key":"ref15","series-title":"Anatomy of the dog","first-page":"88","article-title":"Head","author":"Budras","year":"2007"},{"key":"ref16","series-title":"Can Vet J","first-page":"949","article-title":"Local and regional anesthetic and analgesic techniques in the dog and cat: part II, infiltration and nerve blocks","volume":"41","author":"Duke","year":"2000"},{"key":"ref17","series-title":"Behav Res Methods","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: a flexible statistical power analysis for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007"},{"issue":"suppl 1","key":"ref18","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"i97","DOI":"10.1093\/bja\/aeq273","article-title":"Complications of peripheral nerve blocks","volume":"105","author":"Jeng","year":"2010"},{"key":"ref19","series-title":"Minerva Anestesiol","first-page":"54","article-title":"Intraneural injections and regional anesthesia: the known and the unknown","volume":"77","author":"Jeng","year":"2011"},{"key":"ref20","series-title":"Cousins & Bridenbaugh's neural blockade in clinical anesthesia and pain medicine","first-page":"96","article-title":"Clinical pharmacology of local anesthetics","author":"Butterworth","year":"2009"},{"key":"ref21","series-title":"Anim Welf","first-page":"97","article-title":"Development of the short-form Glasgow Composite Pain Scale (CMPS-SF) and derivation of an analgesic intervention score","volume":"16","author":"Reid","year":"2007"},{"key":"ref22","series-title":"Colorado State University Canine Acute Pain Scale","author":"Hellyer","year":"Feb 1, 2015"},{"key":"ref23","series-title":"Vet Ophthalmol","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1111\/vop.12043","article-title":"Quantification and comparison of baseline cortisol levels between aqueous and plasma from healthy anesthetized hound dogs utilizing mass spectrometry","volume":"17","author":"Claude","year":"2014"},{"key":"ref24","series-title":"Multiple comparisons and multiple tests using the SAS system","first-page":"83","article-title":"Multiple comparisons among treatment means in the general linear model","author":"Westfall","year":"1999"},{"key":"ref25","series-title":"Multiple comparisons and multiple tests using the SAS system","first-page":"203","article-title":"Multiple comparisons in heteroscedastic, mixed, and multivariate models using PROC MIXED","author":"Westfall","year":"1999"},{"key":"ref26","series-title":"Reg Anesth","first-page":"46","article-title":"Critical exposure length for nerve block of myelinated fibers with lidocaine exceeds 3 nodes","volume":"13","author":"Raymond","year":"1988"},{"key":"ref27","series-title":"Anesth Analg","first-page":"563","article-title":"The role of length of nerve exposed to local anesthetics in impulse blocking action","volume":"68","author":"Raymond","year":"1989"},{"key":"ref28","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1111\/j.1467-2995.2007.00390.x","article-title":"Distribution of a lidocaine-methylene blue solution staining in brachial plexus, lumbar plexus and sciatic nerve blocks in the dog","volume":"35","author":"Campoy","year":"2008"},{"key":"ref29","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1111\/vaa.12381","article-title":"A transorbital approach to the maxillary nerve block in dogs: a cadaver study","volume":"44","author":"Langton","year":"2017"},{"key":"ref30","series-title":"Anesthesiology","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1097\/ALN.0000000000000171","article-title":"Bilateral suprazygomatic maxillary nerve block for cleft palate repair in children: a prospective, randomized, double-blind study versus placebo","volume":"120","author":"Chiono","year":"2014"},{"key":"ref31","series-title":"Paediatr Anaesth","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1111\/j.1460-9592.2010.03262.x","article-title":"A new approach for peri-operative analgesia of cleft palate repair in infants: the bilateral suprazygomatic maxillary nerve block","volume":"20","author":"Mesnil","year":"2010"},{"key":"ref32","series-title":"Paediatr Anaesth","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1111\/pan.12480","article-title":"Clinical anatomy of the maxillary nerve block in pediatric patients","volume":"24","author":"Prigge","year":"2014"},{"key":"ref33","series-title":"Paediatr Anaesth","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1111\/j.1460-9592.2012.03861.x","article-title":"Ultrasound guidance characteristics and efficiency of suprazygomatic maxillary nerve blocks in infants: a descriptive prospective study","volume":"22","author":"Sola","year":"2012"},{"key":"ref34","series-title":"J Anesth","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1007\/s005400170014","article-title":"Effect of infraorbital nerve block under general anesthesia on consumption of isoflurane and postoperative pain in endoscopic endonasal maxillary sinus surgery","volume":"15","author":"Higashizawa","year":"2001"},{"key":"ref35","series-title":"Can J Anaesth","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1007\/s12630-009-9119-5","article-title":"Bilateral infraorbital nerve blocks decrease postoperative pain but do not reduce time to discharge following outpatient nasal surgery","volume":"56","author":"Mariano","year":"2009"},{"key":"ref36","series-title":"Reg Anesth Pain Med","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/j.rapm.2005.07.192","article-title":"The use of infraorbital nerve block for postoperative pain control after transsphenoidal hypophysectomy","volume":"30","author":"McAdam","year":"2005"},{"key":"ref37","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1093\/bja\/76.1.151","article-title":"Regional anaesthesia for outpatient nasal surgery","volume":"76","author":"Molliex","year":"1996"},{"key":"ref38","series-title":"Hormones","doi-asserted-by":"publisher","first-page":"283","DOI":"10.14310\/horm.2002.1412","article-title":"Laparoscopic vs. open abdominal surgery in male pigs: marked differences in cortisol and catecholamine response depending on the size of surgical incision","volume":"12","author":"Krikri","year":"2013"},{"key":"ref39","series-title":"SAGE Open Med","first-page":"2050312115576432","article-title":"Chromogranin A and cortisol at intraoperative repeated noxious stimuli: surgical stress in a dog model","volume":"3","author":"H\u00f6glund","year":"2015"},{"key":"ref40","series-title":"J Clin Endocrinol Metab","first-page":"1956","article-title":"Time kinetics of the endocrine response to acute psychological stress","volume":"81","author":"Richter","year":"1996"},{"key":"ref41","series-title":"Horm Behav","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1006\/hbeh.1996.0033","article-title":"The use of saliva cortisol, urinary cortisol, and catecholamine measurements for a noninvasive assessment of stress responses in dogs","volume":"30","author":"Beerda","year":"1996"},{"key":"ref42","series-title":"Paediatr Anaesth","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1111\/j.1460-9592.2011.03714.x","article-title":"Effects of regional analgesia on stress responses to pediatric surgery","volume":"22","author":"Wolf","year":"2012"},{"key":"ref43","series-title":"Eur J Anaesthesiol","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1017\/S0265021502001084","article-title":"Postoperative pain management in orthopaedic patients: no differences in pain score, but improved stress control by epidural anaesthesia","volume":"19","author":"Adams","year":"2002"},{"key":"ref44","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1093\/bja\/85.1.109","article-title":"The stress response to trauma and surgery","volume":"85","author":"Desborough","year":"2000"},{"key":"ref45","series-title":"Am J Vet Res","doi-asserted-by":"publisher","first-page":"969","DOI":"10.2460\/ajvr.2002.63.969","article-title":"Evaluation of the perioperative stress response in dogs administered medetomidine or acepromazine as part of the preanesthetic medication","volume":"63","author":"V\u00e4is\u00e4nen","year":"2002"},{"key":"ref46","series-title":"Scand J Clin Lab Invest","doi-asserted-by":"publisher","first-page":"823","DOI":"10.3109\/00365519009104948","article-title":"Autonomic response to an experimental psychological stressor in healthy subjects: measurement of sympathetic, parasympathetic, and pituitary-adrenal parameters: test-retest reliability","volume":"50","author":"J\u00f8rgensen","year":"1990"},{"key":"ref47","series-title":"Appl Anim Behav Sci","first-page":"307","article-title":"Manifestations of chronic stress in dogs","volume":"52","author":"Beerda","year":"1991"},{"key":"ref48","series-title":"Physiol Behav","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/S0031-9384(98)00290-X","article-title":"Chronic stress in dogs subjected to social and spatial restriction. II. Hormonal and immunological responses","volume":"66","author":"Beerda","year":"1999"},{"key":"ref49","series-title":"Anesth Analg","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1213\/00000539-200206000-00011","article-title":"The effects of local anesthetics on perioperative coagulation, inflammation, and microcirculation","volume":"94","author":"Hahnenkamp","year":"2002"},{"key":"ref50","series-title":"Br J Cancer","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.1038\/sj.bjc.6605964","article-title":"Prevention of tumour cell dissemination in diagnostic needle procedures","volume":"103","author":"Wiksell","year":"2010"},{"key":"ref51","series-title":"Dis Colon Rectum","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1007\/s10350-004-6581-6","article-title":"Risk of dissemination with biopsy of colorectal liver metastases","volume":"46","author":"Rodgers","year":"2003"}],"container-title":["American Journal of Veterinary Research"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/78\/9\/ajvr.78.9.1025.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/78\/9\/ajvr.78.9.1025.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/78\/9\/ajvr.78.9.1025.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T12:42:09Z","timestamp":1741351329000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/78\/9\/ajvr.78.9.1025.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9]]},"references-count":51,"journal-issue":{"issue":"9"},"URL":"https:\/\/doi.org\/10.2460\/ajvr.78.9.1025","relation":{},"ISSN":["0002-9645"],"issn-type":[{"value":"0002-9645","type":"print"}],"subject":[],"published":{"date-parts":[[2017,9]]}}}