Table 9.

Summary of common local anaesthetic techniques used in cats

Technique	Indications	Needle	Volume of local anaesthetic*	Landmarks	Comments
Topical anaesthesia (lidocaine–prilocaine cream) (Figure 15)	Pain and stress associated with intravenous puncture or catheterisation	Not applicable (cream applied to skin)	1 ml	Over the vein	Apply cream to clipped skin and cover with an occlusive bandage. Wait for onset – 20–30 mins in non-sedated cats
Incisional (infiltration) analgesia (Figure 16)	OVH, castration and any other surgical procedure	22-27 G, 1–1.5 inch	1-2 ml or 0.4 ml/kg have been suggested, but generally this will depend on the length of the incision and on local anaesthetic concentration	Incision area	Can be performed prior to incision, but also after surgery for postoperative analgesia. It is recommended that the local anaesthetic is diluted if long incision/large volume is required
Intraperitoneal analgesia (Figure 17)	OVH and other abdominal surgeries	22 G, 1.16 inch catheter (without stylet)	2 mg/kg 0.5% bupivacaine (0.4 ml/kg) diluted 1:1 with saline 0.9% (ie, 0.8 ml/kg)	Ovary pedicles and caudal uterine body, or ‘splash’ over the area of interest	Caution should be taken not to exceed the maximum recommended dose for cats (Table 8)
Intratesticular block (Figure 18)	Castration	25 G, 5/8 inch	0.1-0.25 ml per testis	Into the centre of each testis	The testes become firm. Combination with incisional infiltration is recommended
Dental blocks: Infraorbital (Figures 19 [needle A] and 20) Inferior alveolar (mandibular) (Figures 19 [needle B] and 21)	Dental cleaning, extractions, sutures, fracture repair, oral mass removal, maxillectomy and mandibulectomy	25 G, 5/8 inch or 27 G, 0.5 inch	0.1–0.3 ml at each nerve (usually 0.2 ml per site)	Infraorbital Above premolar 3, into the infraorbital canal (4–5 mm). The infraorbital canal is short in cats and the needle should be introduced with caution to avoid globe penetration Inferior alveolar (mandibular) The lower angle of the jaw, against the medial side of the mandible in the direction of the mandibular foramen	Infraorbital Blocks innervation to the skin, hard and soft tissues of the rostral maxillae, including the teeth and dorsal nasal cavity Inferior alveolar (mandibular) Blocks innervations of the mandible including teeth, lower lip, part of the tongue, and hard and soft tissues

The information in this table represents a consensus of opinion of the Guidelines panel members

^*Refer to Table 8 for the maximum recommended dose of the particular drug being used, to avoid toxicity OVH = ovariohysterectomy