Validation of the accuracy of needle placement as used in diagnostic local analgesia of the maxillary nerve for investigation of trigeminally mediated headshaking in horses

Abstract

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms Conclusions: A negative response to diagnostic local anaesthesia of the maxillary nerve does not 28 disprove facial dysaesthesia as the cause of headshaking in that horse as a false negative response 29 could arise due to failure to deposit local anaesthetic around the target area. Increased experience 30 in performing the procedure decreases the probability of false negative results. 31

Maxillary nerve blocks in horses: an experimental comparison of surface landmark and ultrasound-guided techniques

“…Surface landmark success rates (50%) were slightly higher when compared to those previously reported (40%) (Wilmink et al 2015). Both studies reported success rates for veterinary students performing the injections, however, study design differences make direct comparison difficult, notably the use of differing contrast medium volumes (0.5 mL in this study compared to 0.1 mL), and different outcome measures (direct hit and miss used in this study compared to a zonal system) (Wilmink et al 2015).…”

“…Both studies reported success rates for veterinary students performing the injections, however, study design differences make direct comparison difficult, notably the use of differing contrast medium volumes (0.5 mL in this study compared to 0.1 mL), and different outcome measures (direct hit and miss used in this study compared to a zonal system) (Wilmink et al 2015). Higher success rates of up to 80% have been seen with more experienced operators, when performing the surface landmark-guided technique (Bardell et al 2010;Wilmink et al 2015), however smaller volumes (0.25 mL and 0.1 mL) of methylene blue dye were used in these studies and successful injection was defined by dissection rather than three dimensional imaging (Bardell et al 2010).…”

“…The relevant literature was provided for all three blocks at the beginning to minimize the effects of learning from one block to another. This methodology was based upon previous literature, which has described learning operators to be statistically similar to completely inexperienced operators, when performing maxillary nerve blocks (Wilmink et al 2015). Teaching material was standardized throughout the trial and no feedback was given until after the three injections had been performed and questionnaires completed, in order to prevent bias.…”

Local anaesthetic techniques for the equine head, towards guided techniques and new applications

“…; Wilmink et al . ). Where few horses with idiopathic headshaking showed improvement on anaesthesia of the infraorbital nerve, the majority (13 out of 16 = 81%) showed complete or partial improvement after anaesthesia of the posterior ethmoidal branch of the maxillary nerve (Newton et al .…”

“…Experience of the performer is very important in the success rates of local anaesthetic techniques, as was shown by Wilmink et al . () for the perineural block of the maxillary nerve. Although blind techniques used to be the gold standard, nowadays ultrasound‐guided techniques are quickly being adopted.…”