The greater auricular nerve block is performed alongside the auriculotemporal block for ear surgery and ear flushes.

The auriculotemporal nerve block is performed along with the greater auricular nerve block to provide anaesthesia for ear surgery and ear flushes.

The erector spinae plane (ESP) block is typically used for hemilaminectomy surgery. The ESP block infiltrates local in the fascial plane through which the dorsal rami nerves run. These nerves provide sensory innervation to the surgical site. The video shows the needle advancing towards the anatomical target and entering the fascial plane. One the left of the needle tip you can see an area of hypointensity which represents fluid in the fascial plane. As the local anesthetic is injected you can see the injectate spreading in this plane.

The serratus plane block provides anaesthesia to the thoracic wall and is excellent as part of a multimodal plan for a lateral thoracotomy.

In addition to watching this video which demonstrates the retrobulbar block, please read our pain update on how to estimate the volume of local anaesthetic required for this block.

In this video we demonstrate the ultrasound guided approach to the radial nerve in a dog. This is often paired with the UMM block which you can see in a separate video.

This video describes the ultrasound guided approach to the ulnar, musculocutaneous and median nerves

This dog was scheduled for an interdigital mass removal between digits 4 & 5 of the thoracic limb. Rather than a ring block I looked at blocking individual nerves, as per the guidance on the Nocita website here: www.my.elanco.com/us/nocita This website has lovely diagrams of the individual nerves to desensitise all digits. In this case I used bupivacaine 0.5% to provide a long duration of action (8hrs). The block worked beautifully!

Sound on for commentary! The lumbar plexus block has a few names - also called the pre-iliac approach to the lumbar plexus or the psoas compartment block. The target is the femoral and obturator nerve within the psoas major muscle. The approach is pre-iliac - so needle insertion right in front of the cranial ilial wing. The needle is advanced at an angle (as shown) between the transverse processes and towards the psoas muscle. The nerve locator is set to 1.0mA and the desired muscle response is stifle extension. The ENL current is decreased to 0.7, 0.5, 0.3mA and we should have no twitch at 0.2-0.3mA. Always aspirate! Volume to inject is 0.2ml/kg local. Filmed on location at Guernsey Vets4Pets, a Zero Pain Practice.

Sound on for commentary! The sciatic nerve is block with the femoral nerve (see separate videos) for stifle surgery and surgery distal to the stifle. The nerve is located caudal to the greater trochanter. The nerve locator starts on a searching current of 0.7mA. Once a foot flick (dorsi or plantaroflexion) is seen, decrease the current to 0.5, then 0.3mA. Prior to injecting you should have no twitch at 0.2mA - aspirate before injecting. If you see hamstrings twitch, you are stimulating the muscular branch and not the main branch so withdraw and redirect. Volume of local = 0.05 ml/kg. Filmed on location at Guernsey Vets4Pets, a Zero Pain Practice.

This video demonstrates the blind block of the auriculotemporal and greater auricular nerves, as described in the BSAVA Manual Of Anaesthesia & Analgesia 3rd Edn and Veterinary Anaesthesia Principles to Practice

The RUMM block aims to anaesthetise the radial, ulnar, median & musculocutaneous nerves at mid-humeral level to provide anaesthesia distal to the elbow (Trumpatori et al., 2010). Approach the radial laterally mid humerus – you can flick the radial nerve with you finger - and the UMM medially, proximal to the elbow. Volume (20-30kg dog)– radial nerve 1-1.5ml, UMM 3ml

Peribulbar technique This is an alternative technique to retrobulbar block and may be more suited for providing anaesthesia for the globe in cats. A short needle (23G 1”) needle is passed through the bulbar conjunctiva (inserting at 10 and 4 o’clock positions) along the bony orbit, but unlike the retrobulbar technique is not curved to end caudal to the globe. Local anaesthetic solution (0.2ml/kg) is injected after aspiration. Gentle massage of the globe should be performed following this technique to encourage spread of local anaesthetic into the intraconal space. This technique requires a larger volume than retrobulbar block to ensure sufficient spread, but avoids the risk of penetrating the optic nerve sheath. A 2014 study by Shilo-Benjamini, entitled comparison of peribulbar and retrobulbar regional anesthesia with bupivacaine in cats demonstrated better deposition of local anaesthetic using this technique compared to retrobulbar injection. Peribulbar injection may therefore be a more suitable technique in the cat.

Area desensitised- maxillary teeth, nasal planum, skin over maxilla, upper lip, palate Indications- maxillary tooth removal, maxillectomy, mass excision, palate surgery Volume to inject 0.03-0.05 ml/kg. Needle size 23G 5/8” Site for injection- ventral to the zygomatic arch, caudal to the lateral canthus direct the needle into the pterygopalatine fossa as indicated until bone is contacted. Aspirate. Inject. Do not move the needle excessively as you may hit the venous plexus.

This video talks you through the ultrasound guided saphenous nerve block

This video demonstrates the ultrasound-guided approach to the sciatic nerve block

Intra-testicular local anaesthetic is an easy technique for castration analgesia, recommended by ISFM. Video credit Jenny Davies MRCVS Wright & Morten Vets

The needle is inserted along the proposed line of incision. The operator aspirates to confirm no blood and then injects, redirecting along the incision line. You can see how tough cat skin is in this video!

This video demonstrates the maxillary tuberosity approach to the maxillary nerve in a cat. The needle is inserted behind the caudal molar and advanced. Bupivacaine 0.5% 0.2ml is used to provide anaesthesia prior to dental extractions.