For additional information on other dental nerve block techniques, see the 2019 AAHA Dental Care Guidelines for Dogs and Cats . Caudal mandibular (inferior alveolar) regional blocks INDICATIONS: Dental and orofacial surgery on the mandible (i.e., dental extractions, mass removals, fracture repair, etc.) This desensitizes all tissues to midline on the ipsilateral side. INSTRUCTIONS: 1. Select and calculate the full dose of a local anesthetic, i.e., lidocaine (cats = 2–4 mg/kg, dogs = 4–6 mg/kg), bupivacaine (cats = 1 mg/kg, dogs = 2 mg/kg), or ropivacaine (cats = 1 mg/kg, dogs = 2 mg/kg).* 2. Prior to the procedure or extraction is performed, choose intraoral vs. extraoral approach, based on clinical indication, and personal preference. 3. The mandibular foramen or nerve can often be palpated on the lingual side of the mandible, just rostral to the angle of the mandible and just caudal to the last molar in approximately the middle 1/3 rd of the mandible (as measured from dorsal to ventral). NOTE: The foramen is often difficult to palpate in very small patients like cats and small dogs.