Bovis ISSN 2398-2993

Auriculopalpebral nerve block

Contributor(s): Gayle Hallowell , Alex Dugdale

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Introduction

  • The orbicularis oculi muscle causes tight lid closure, especially in painful eye conditions, and eyelid akinesia and anesthesia may be essential for complete examination of the eye.
  • The auriculopalpebral nerve, a branch of the facial nerve, is a motor nerve supplying the orbicularis oculi muscle, the frontalis muscle (which provides some muscling to the upper eyelid) and the external muscles of the ear.
  • Cattle do not have a corrugator supercilii muscle, which is otherwise known as the levator anguli oculi medialis, but use their frontalis muscle for the same purpose.
  • The auriculopalpebral nerve runs from the base of the ear along the dorsal aspect of the zygomatic arch, past and ventral to the eye, giving off branches along its route.
  • When blocked, this allows manipulation of the eyelids without undue pressure on a painful globe.
The auriculopalpebral block is purely a motor block and does not remove sensation.

Uses

  • To facilitate examination of the eye especially in painful conditions.
  • To control eyelid movement during minor surgical procedures.

Advantages

  • Provides excellent eyelid akinesis.
  • Can be used in conjunction with sedation and other regional blocks. 

Disadvantages

  • The auriculopalpebral block is purely a motor block and does not remove sensation.
  • As such it can be used for ocular examination, but should not be used alone as analgesia for any form of ocular surgery.
  • The supraorbital, lacrimal, infratrochlear and zygomatic nerves require blocking to remove all periocular sensation.
  • As well as the orbicularis oculi muscle, the palpebral nerve supplies motor innervation to the frontalis muscle so that it may sometimes appear that the strongest motor block is apparent in the upper eyelid.
  • The supraorbital, lacrimal, infratrochlear and zygomatic nerves require blocking to remove all periocular sensation.
  • To block motor activity of the levator palpebrae superioris and the extraocular muscles controlling globe movement, cranial nerves III, IV and VI require blocking.
  • Block of the more proximal auricular part of the auriculopalpebral nerve is occasionally achieved, inadvertently, when performing this block – noted by drooping and akinesia of the ipsilateral ear pinna.

Requirements

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Preparation

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Procedure

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Edmondson M A (2016) Local, Regional, and Spinal Anesthesia in Ruminants. Vet clin north am food anim pract 32 (3), 535-552 PubMed.

Other sources of information

  • Valverde A & Sinclair M (2015) Chapter 51 Ruminant and Swine Local Anesthetic and Analgesic Techniques. In: Veterinary Anesthesia and Analgesia. Blackwell Publishing.
  • Clarke K & Trim C (2014) Anaesthesia of Cattle. In: Veterinary Anaesthesia. 11th edn. Elsevier.


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