Williams et al: Evaluation of the addition of adrenaline in a bilateral maxillary nerve block to reduce hemorrhage in dogs undergoing sharp staphylectomy for brachycephalic obstructive airway syndrome. A prospective, randomized study
Veterinary Surgery 8, 2024

🔍 Key Findings

  • The addition of adrenaline (0.00198%) to bilateral maxillary nerve blocks significantly reduced intraoperative hemorrhage in dogs undergoing sharp staphylectomy (median reduction: 77.1%).
  • Normalized hemorrhage (g/kg) and total hemorrhage (g) were significantly lower in the adrenaline group (p = .021 and p = .013, respectively).
  • Surgeon-assessed hemorrhage scores were also significantly lower in the adrenaline group (median 2 vs. 3; p = .029), indicating improved surgical visibility.
  • No adverse effects (e.g. tachycardia, arrhythmia, or hypertension) were observed with adrenaline administration.
  • A standardized intraoral approach to the maxillary nerve block was used with 0.5 mL per side regardless of dog size.
  • Breed effect observed: English Bulldogs had higher normalized hemorrhage, possibly due to anatomical variation or underdosing relative to size.
  • Adrenaline may also prolong local anesthetic action and reduce blood aspiration risks, though this was not directly measured.
  • The study supports the routine inclusion of adrenaline in maxillary nerve blocks for staphylectomy in BOAS patients to improve surgical field and reduce bleeding.

Simini Surgery Review Podcast

How critical is this paper for crushing the Boards?

🚨 Must-know. I’d bet on seeing this.

📚 Useful background, not must-know.

💤 Skip it. Doubt it’ll ever show up.

Thanks for the feedback!
We'll keep fine-tuning the articles vault.
Oops — didn’t go through.
Mind trying that again?