Ultrasound-guided trigeminal nerve block with contrast-enhanced CT evaluation for extensive oncologic maxillofacial surgery in 7 dogs: a prospective case series.

Ultrasound-guided trigeminal nerve blocks with CT verification are feasible, safe, and reduce intraoperative analgesia requirements.

This prospective case series evaluated ultrasound-guided trigeminal nerve blocks in seven dogs undergoing extensive oncologic maxillofacial surgery. Using a temporal approach, clinicians performed ten unilateral or bilateral injections of ropivacaine, dexmedetomidine, and iohexol contrast medium (0.07 mL/kg per site). Contrast-enhanced CT imaging obtained 5-10 minutes post-injection confirmed adequate injectate distribution within 5 mm of targeted foramina in 8/10 cases, with no intracranial spread observed. Sonoanatomical landmarks were consistently identified during ultrasound guidance. Intraoperatively, only 4/7 dogs required rescue analgesia (single fentanyl bolus), with no dogs needing redosing. No immediate or delayed adverse effects were documented. The integration of ultrasound-guided trigeminal nerve blocks into multimodal anesthesia protocols appeared to reduce intraoperative nociceptive responses and minimize additional systemic analgesic requirements in this small cohort. The technique provides valuable real-time anatomical guidance and post-injection verification through CT imaging.

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