Ultrasound‐guided trigeminal nerve block as an analgesic adjunct in feline maxillectomy

Summary A 6‐year‐old, female, neutered, domestic shorthair cat was presented to our hospital for surgical management of an osteosarcoma involving the left maxilla. Computed tomography revealed a mass affecting the caudal aspect of the left maxilla with evidence of local invasion. Perioperative pain management was achieved using a balanced analgesic strategy. Premedication consisted of methadone (0.2 mg kg −1 ) and dexmedetomidine (0.003 mg kg −1 ). Regional anaesthesia was provided by an ultrasound‐guided trigeminal nerve block using bupivacaine hydrochloride 0.5% at a dose of 0.05 mL cm −1 of cranial length (total volume 0.37 mL). A constant rate infusion of ketamine (0.3 mg kg −1 h −1 ) was administered to support the multimodal protocol. No nociceptive responses were observed throughout the majority of the procedure, and limited postoperative rescue analgesia was required, suggesting that the nerve block contributed to effective perioperative analgesia. This case report describes the successful application of an ultrasound‐guided trigeminal nerve block as part of a comprehensive multimodal pain management protocol in a cat undergoing partial maxillectomy.