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Campos S, Picavet P, Bertrand O, Sandersen C, Tutunaru A. Immobilisation and Epidural Anaesthesia in a Eurasian Lynx ( Lynx lynx) Undergoing Pelvic Limb Orthopaedic Surgery. Case Rep Vet Med 2024; 2024:6373424. [PMID: 39157579 PMCID: PMC11329305 DOI: 10.1155/2024/6373424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/29/2024] [Accepted: 07/09/2024] [Indexed: 08/20/2024] Open
Abstract
Immobilisation and anaesthesia of wild felids may be complex and potentially dangerous events, making it difficult to implement more advanced anaesthetic techniques such as neuraxial anaesthesia. A Eurasian lynx was referred for femur fracture repair after it was seen with lameness of the left pelvic limb sustained in its natural environment. The animal was remotely darted using a combination of ketamine (5 mg/kg) and xylazine (5 mg/kg) intramuscularly. Once immobilised, the lynx was transported to the veterinary hospital in a restraining cage. After induction and endotracheal intubation, pelvic limb radiographs confirmed a closed, comminuted fracture of the left femur that required open reduction and internal stabilisation. A sacrococcygeal epidural was performed before surgery using lidocaine (2 mg/kg) and morphine (0.1 mg/kg) to complement the ketamine-xylazine-isoflurane anaesthesia, which allows a low-end-tidal isoflurane concentration. Clinical signs were continuously monitored and remained stable during the entire procedure, with the exception of a temperature that decreased to 35.8°C. No intraoperative analgesic rescues were necessary. Recovery was smooth and uneventful. The lynx showed no signs of motor weakness after surgery or other side effects related to the anaesthetic procedure. The successful management of this surgical case suggests that the described anaesthetic protocol could be recommended in orthopaedic procedures of the pelvic limbs in wild Felidae.
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Affiliation(s)
- Sonia Campos
- CECAV-Veterinary and Animal Research CentreFaculty of Veterinary MedicineLusófona University, Lisbon, Portugal
| | - Pierre Picavet
- University Veterinary ClinicFaculty of Veterinary MedicineLiége University, Liége, Belgium
| | | | - Charlotte Sandersen
- University Veterinary ClinicFaculty of Veterinary MedicineLiége University, Liége, Belgium
| | - Alexandru Tutunaru
- University Veterinary ClinicFaculty of Veterinary MedicineLiége University, Liége, Belgium
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Gomez-Martinez MI, Hughes J, Alderson B, Deutsch J. A randomized clinical trial comparing the efficacy of lidocaine administered intravenously, intranasally or as infraorbital nerve block in dogs undergoing rostral rhinosocopy. Vet Anaesth Analg 2024; 51:372-380. [PMID: 38772853 DOI: 10.1016/j.vaa.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/31/2024] [Accepted: 04/09/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVE To compare the efficacy of lidocaine administered intravenously, intranasally or as an infraorbital nerve block in dogs undergoing rostral rhinoscopy. STUDY DESIGN Randomized clinical trial. ANIMALS A total of 43 client-owned dogs. METHODS After premedication with medetomidine 0.01 mg kg-1 and methadone 0.2 mg kg-1 intramuscularly, anaesthesia was induced with propofol and maintained with isoflurane in oxygen. Dogs were randomly allocated to receive 2 mg kg-1 of 2% lidocaine as a bilateral infraorbital nerve block (INB) via the caudal intraoral approach, via bilateral topical intranasal administration (TIA) or as an intravenous bolus (IVB). At 5 minutes following lidocaine administration, responses to rhinoscopy (RR) and biopsies (RB) were evaluated using a simple scoring system (0: no reaction; 1: reaction). Response to the rhinoscopy in the recovery period (RE) was recorded. Recovery quality was scored using a simple descriptive score. Heart rate, respiratory rate and noninvasive arterial blood pressure were recorded. Intravenous (IV) fentanyl 0.001 mg kg-1 was administered if an increase > 20% in any variable occurred. Gross movement was attenuated using propofol 0.5 mg kg-1 IV. Scores were analysed using the Chi-square test with Monte Carlo method. Cardiorespiratory changes among and overtime between groups were compared using one-way anova and one-way anova for repeated measures, respectively, or the correspondent non-parametric tests; p < 0.05. RESULT Of the 43 dogs, 42 completed the study. No statistically significant differences were detected in either physical reactions or changes in cardiorespiratory variables for RR, RB, RE or recovery quality, although RB tended to be higher in group TIA (7/10 versus 1/10 INB and 3/13 IVB).Various cardiorespiratory variables changed overtime within groups. CONCLUSIONS AND CLINICAL RELEVANCE In dogs, all three investigated techniques attenuated responses during rostral rhinoscopy in dogs, although INB and IVB were more efficacious when biopsies were taken.
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Affiliation(s)
| | - Jodie Hughes
- North Down Specialist Referrals, Bletchingley, UK
| | - Briony Alderson
- Small Animal Teaching Hospital, University of Liverpool, Neston, UK
| | - Julia Deutsch
- Langford Vets Small Animal Referral Hospital, University of Bristol, Langford, UK
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Herrera-Linares ME, Rico-Pérez B, Yaffy D, Fernández-Parra R, Llanos C, Parra-Martínez C, Herrera-Gutiérrez ME, Sanchis-Mora S. Cadaveric study of the ultrasound-guided erector spinae plane block over the transverse process of the twelfth thoracic vertebra in dogs: Transversal vs longitudinal approach. Vet J 2024; 304:106094. [PMID: 38452849 DOI: 10.1016/j.tvjl.2024.106094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
This study describes a transversal (TV) ultrasound-guided erector spinae plane (ESP) block technique over the transverse process of T12. And evaluates the distribution of the dye and affected nerves branches compared to a longitudinal (LNG) approach over the transverse process of T12 in canine cadavers. Secondly, it also compares de anatomy and dimensions of the transverse processes of T12 with T9 and T5. For this double-masked, cadaveric experimental study, 12 adult Beagle cadavers were injected with 0.6 mL/kg of dye/contrast. Spread was evaluated by computed tomography (CT) and dissection. Mean bodyweight was 9.76 (±0.59) kg. The TV and LNG approaches stained a median (range) of four (2-6) and three (1-6) medial branches of the dorsal rami of the spinal nerves, three (2-6) and three (2-5) lateral branches, and one (0-3) and one (0-4) ventral branches, respectively. Dye was detected in the epidural space in 55.6% and 66.7% of cases for the TV and LNG approaches, respectively (P=0.63). And in the ventral paravertebral compartment in 22.2% and lymphatics in 88.8% in both approaches. There were no statistical differences for the spread. The dorsolateral edge of the transverse process (TP) was not visible with CT at T12. The mean (±SD) length of the TP was significantly shorter at T12 [3.34 (±0.22)] mm, compared to T9 [6.08 (±0.47)] mm and T5 [5.93 (±0.62)] mm (P <0.001). This study showed similar distribution whether using a TV or LNG approach and differences in the anatomy and length of the T12 TP.
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Affiliation(s)
- M E Herrera-Linares
- Doctoral School, Catholic University of Valencia San Vicente Mártir, San Agustín Square, 3, 46002, Spain; Department of Clinical Science and Services. The Royal Veterinary College, Hawkshead Ln, Hatfield AL9 7TA, United Kingdom.
| | - B Rico-Pérez
- Department of Clinical Science and Services. The Royal Veterinary College, Hawkshead Ln, Hatfield AL9 7TA, United Kingdom
| | - D Yaffy
- Department of Pathobiology and Population Sciences. The Royal Veterinary College, Hawkshead Ln, Hatfield AL9 7TA, United Kingdom
| | - R Fernández-Parra
- Department of Small Animal Medicine and Surgery, Faculty of Veterinary Medicine and experimental Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, C/ de Quevedo, 2, 46001, Spain
| | - C Llanos
- Department of Clinical Science and Services. The Royal Veterinary College, Hawkshead Ln, Hatfield AL9 7TA, United Kingdom
| | - C Parra-Martínez
- Department of Clinical Science and Services. The Royal Veterinary College, Hawkshead Ln, Hatfield AL9 7TA, United Kingdom
| | - M E Herrera-Gutiérrez
- Department of Intensive Care Medicine. Regional University Hospital of Málaga, Av., 84, Málaga 29010, Spain
| | - S Sanchis-Mora
- Department of Small Animal Medicine and Surgery, Faculty of Veterinary Medicine and experimental Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, C/ de Quevedo, 2, 46001, Spain
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Hon SA, Parry S, Boesch JM, Miguel Garcia CD. A Feasibility Study for a Novel Trans-infraorbital Canal Approach to the Maxillary Nerve in Pigs ( Sus domesticus). Comp Med 2024; 74:49-54. [PMID: 38378179 PMCID: PMC11078273 DOI: 10.30802/aalas-cm-23-000045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/08/2023] [Accepted: 01/03/2024] [Indexed: 02/22/2024]
Abstract
Experimental maxillofacial surgery is commonly performed in pigs; however, locoregional anesthesia of this area has not been described. This study evaluated the feasibility of a novel maxillary nerve block approach. In part I, cadavers were used to determine anatomic landmarks and assess maxillary nerve dye staining by using 0.03 mL kg-1 of a 1:10 mixture of commercial food dye and 0.5% bupivacaine. In part II, 10 additional pig cadavers underwent bilateral ultrasound-guided maxillary nerve blocks by using trans-infraorbital canal needle placement. The maxillary nerve was harvested and scored based on degree of staining (0 and 1, absent or incomplete staining; 2, staining; >1 cm circumferentially). Intracranial and intraconal spread of dye was evaluated. A Kruskal-Wallis test was used to compare infraorbital canal length estimated either externally via landmarks, internally via ultrasound, or actually measured after dissection. In 18 of 20 (90%) injections, successful staining (score = 2) of maxillary nerves was obtained for a nerve length of 2.4 ± 0.3 cm. Two of 20 cases (10%) had inadequate staining (score <2). At dissection of these 2 cases, the needle tip was observed to have collided with an unerupted tooth (third molar). No intracranial or intraconal spread of dye was observed. We detected no statistical differences between the estimated external, estimated internal, or actual dissection methods for measurement of infraorbital canal length (P = 0.3). Ultrasound-guided trans-infraorbital maxillary nerve block in pigs is a feasible technique, warranting further work to evaluate its in vivo efficacy and safety.
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Affiliation(s)
- Stephanie A Hon
- Section of Anesthesiology and Pain Management, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York;,
| | - Stephen Parry
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, New York
| | - Jordyn M Boesch
- Section of Anesthesiology and Pain Management, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Cristina de Miguel Garcia
- Section of Anesthesiology and Pain Management, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
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El-Sherif MW, Nazih MA. A novel extraoral ultrasound-guided approach for mandibular nerve block in Rahmani sheep. BMC Vet Res 2024; 20:74. [PMID: 38402395 PMCID: PMC10893670 DOI: 10.1186/s12917-024-03924-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/08/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Regional anesthesia is the favored choice in ruminant animals compared to general anesthesia, primarily due to its high safety margin and reduced demand for cost-intensive equipment in addition to its field applicability. Ultrasound-guided nerve block has gained significant attention in the field of veterinary medicine. This study utilized twenty-seven sheep of the native Rahmani breed to both demonstrate and evaluate the effectiveness of the ultrasound guided inferior alveolar nerve block technique. METHODS The research comprised three phases: Phase 1 involved an anatomical examination of mandibles and sheep heads to locate the mandibular foramen and delineate the mandibular nerve course. Phase 2 included ultrasound-guided injection of methylene blue dye at specific sites along the mandibular nerve in cadaveric sheep heads. In Phase 3, clinical implementation of ultrasound-guided inferior alveolar nerve blocks was conducted in 27 live sheep, assessing efficacy, onset, and duration. RESULTS Vertical extraoral ultrasound-guided nerve block was achieved successfully in 25 sheep (98%). A preliminary cadaveric study showed good distribution of the injectate at the mandibular nerve site. The mean onset time was 138 ± 18 s, and the mean duration time was 54 ± 4.1 min. Prominent analgesia of the ipsilateral mandible, medial surface of the cheek, and lateral border of the tongue was observed. CONCLUSIONS Ultrasound-guided mandibular nerve block holds promise as a technique for providing effective and safe anesthesia in sheep undergoing mandibular procedures.
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Affiliation(s)
- Mohamed Wefky El-Sherif
- Department of Surgery, Faculty of Veterinary Medicine, New Valley University, El Kharga, 72511, New Valley, Egypt.
| | - Mohamed Ahmed Nazih
- Department of Anatomy, Faculty of Veterinary Medicine, New Valley University, El Kharga, 72511, New Valley, Egypt
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Gomes VH, Peixoto AJ, EdosSL Fernandes M, de Souza Campos AC, Coelho CM, da Silva MF. Evaluation of lidocaine administration into the ovarian pedicle for the control of intraoperative and early postoperative pain during ovariohysterectomy in dogs. Vet Anaesth Analg 2024; 51:64-70. [PMID: 37919174 DOI: 10.1016/j.vaa.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To evaluate effects of lidocaine 2% administration into the ovarian pedicle on intraoperative nociception and early postoperative pain in dogs undergoing ovariohysterectomy. STUDY DESIGN Prospective, randomized, blinded clinical study. ANIMALS A total of 20 healthy adult female dogs of different breeds. METHODS Dogs were premedicated with acepromazine (0.02 mg kg-1) and morphine (0.5 mg kg-1) intramuscularly, anesthesia induced with propofol and maintained with isoflurane. Dogs were randomly assigned to be administered 2 mL of saline (group S) or lidocaine 2% (group L) into the mesovarium (1 mL each side). Heart rate (HR) and noninvasive systemic arterial pressure were recorded before surgery (T0), before (T1) and during ligation of the right ovarian pedicle (T2), before (T3) and during ligation of the left ovarian pedicle (T4). Rescue treatment (propofol) was administered if HR or systolic arterial pressure (SAP) increased by 20% compared with the previous time point. Pain, assessed with the Glasgow Composite Measure Pain Scale-Short Form (CMPS-SF) was recorded before premedication (baseline) and after extubation. Administration of postoperative rescue analgesia was recorded. RESULTS In group S, HR was higher at T2 than T1 (112 ± 18 versus 89 ± 21 beats minute-1, p = 0.001) There were no significant differences between treatments at any time. SAP was higher at T2 than T1 in group S (110 ± 12 versus 100 ± 10 mmHg, p = 0.031). SAP was higher in group S than group L at T3 (113 ± 12 and 91 ± 10 mmHg, respectively, p = 0.001). No dogs required propofol intraoperatively. All dogs required postoperative rescue analgesia. Compared with baseline, CMPS-SF increased 60 minutes after extubation (group S; p = 0.019, group L; p = 0.043). CONCLUSIONS AND CLINICAL RELEVANCE Administration of lidocaine 2% into the mesovarium did not reduce intraoperative nociception and did not improve postoperative analgesia.
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Affiliation(s)
- Viviane H Gomes
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil.
| | - Anna Jr Peixoto
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
| | - Maria EdosSL Fernandes
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
| | - Ana Carolina de Souza Campos
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
| | - Cassia Mm Coelho
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
| | - Marta Fa da Silva
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil
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Kazmir-Lysak K, Torres-Cantó L, Ingraffia S, Romanelli G, Massari F, Rossanese M, Compagnone K, Pisani G, Cinti F, Montinaro V, Collivignarelli F, Okushima S, Vallefuoco R. Use of wound infusion catheters for postoperative local anaesthetic administration in cats. J Feline Med Surg 2023; 25:1098612X231193534. [PMID: 37713178 PMCID: PMC10812034 DOI: 10.1177/1098612x231193534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
OBJECTIVES The present study aimed to document the use of the wound infusion catheter (WIC) following a variety of surgical procedures in cats, investigating complications and risk factors associated with catheter placement or local anaesthetic (LA) administration. METHODS A retrospective, multicentric study was performed. Medical databases of eight veterinary referral hospitals from 2010 to 2021 were searched to identify records of cats where WICs were used. Information regarding signalment, type of surgery, size and type of WIC placed, and LA protocol used, as well as postoperative complications, were retrieved. RESULTS One hundred and sixty-six cases fulfilled the inclusion criteria. Feline injection site sarcoma resection was the most common surgery. Overall complications were identified in 22/166 cats (13.2%). Thirteen cats (7.8%) experienced wound-related complications, whereas nine cats (5.4%) experienced drug-delivery complications. The only factor associated with an increased risk of complications was the amount of a single dose of LA delivered through the catheter (P <0.001). An amount higher than 2.5 ml of LA delivered at each administration was associated with an increased risk of complications. All complications were minor and self-limiting. CONCLUSIONS AND RELEVANCE WICs were used for a large variety of surgical procedures with different protocols of LA administration as part of a multimodal analgesic plan in cats. The risk of complications was relatively low and self-limiting, suggesting its safe use in cats. Further prospective studies are required to evaluate efficacy of postoperative analgesia and to determine the suitable protocol for WIC handling and maintenance.
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Affiliation(s)
- Kristina Kazmir-Lysak
- Section of Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Lucía Torres-Cantó
- Anaesthesia Department, Southern Counties Veterinary Specialists, Ringwood, Hampshire, UK
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Kellner B, Duffee L. Liposomal Bupivacaine in Dentistry and Oral and Maxillofacial Surgery. A Review of Human and Veterinary Literature. J Vet Dent 2023:8987564231157041. [PMID: 36855302 DOI: 10.1177/08987564231157041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
This article reviews the human and veterinary literature regarding liposome encapsulated bupivacaine use in dentistry and oral and maxillofacial surgery. The purpose of this review is to present available information on this local anesthetic in a manner that will allow veterinary dentists and oral and maxillofacial surgeons to use evidence-based information when considering incorporating liposomal bupivacaine into their practice. The twelve human clinical studies and three veterinary reports that met the literature search criteria do not support the use of liposomal bupivacaine in veterinary dentistry and oral and maxillofacial surgery.
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Affiliation(s)
- Bill Kellner
- Dentistry and Oromaxillofacial Surgery, Burlington Emergency and Veterinary Specialists, Williston, USA
| | - Lauren Duffee
- Anesthesia, 302399Massachusetts Veterinary Referral Hospital, Woburn, USA
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Stabile M, Lacitignola L, Acquafredda C, Scardia A, Crovace A, Staffieri F. Evaluation of a constant rate intravenous infusion of dexmedetomidine on the duration of a femoral and sciatic nerve block using lidocaine in dogs. Front Vet Sci 2023; 9:1061605. [PMID: 36713886 PMCID: PMC9880291 DOI: 10.3389/fvets.2022.1061605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/19/2022] [Indexed: 01/14/2023] Open
Abstract
Objectives This study investigated the effects of 1 μg/kg/h intravenous constant rate infusion (CRI) of dexmedetomidine on the sensory and motor blockade for femoral and sciatic nerve blocks in dogs undergoing stifle surgery. Materials and methods Client-owned dogs referred for stifle surgery were enrolled in this prospective, randomized, blinded study. Dogs were pre-medicated with acepromazine (0.005-0.01 mg/kg intramuscularly, IM); anesthesia was induced with propofol intravenously and maintained with isoflurane in a mixture of air and oxygen. Electrolocation-guided sciatic and femoral nerve blocks with lidocaine 2% (0.15 mL/kg) were performed using the parasacral and lateral pre-iliac approaches, respectively. After performing local block, a systemic infusion of saline solution (group C) or dexmedetomidine (group D) was started at a CRI at 1 ml/kg/h and continued until the end of surgery. Dexmedetomidine was infused at a dose of 1 μg/kg/h. Respiratory and hemodynamic variables were recorded during surgery. Sensory and motor blockade was evaluated by response to pinching the skin innervated by the sciatic/femoral nerves, with forceps and by observing the dogs' ability to walk and testing proprioception at 30, 60, 120, 180, and 240 min after extubation. Analgesia was monitored with SF-GCPS. Methadone IM was administered as rescue analgesia. Intraoperative data were analyzed by analysis of variance, while postoperative data were analyzed by the independent two-tailed t-test and a Kaplan-Meier test (p < 0.05). Results Twenty dogs were included in this study (10/group). A significant difference in the recovery of sensory nerve function was observed between the groups. The mean durations of the sensory blockade for femoral and sciatic nerves, respectively, was longer (p < 0.001) for group D [168 (146-191, 95% CI), 161 (143-179, 95% CI) min] than in group C [120 (96.1-144, 95% CI), 116 (90.9-142, 95% CI]. No differences in the recovery of patellar and tibial reflexes, proprioceptive function, and ability to walk were found among groups. The overall postoperative rescue analgesia requirement was significantly different (p = 0.019) between groups, with an incidence of 5/10 (50%) dogs in group D and 10/10 (100%) dogs in group C. Conclusion Dexmedetomidine administered as a CRI (1 μg/kg/h) combined with local lidocaine increases the duration of the sensory component of the sciatic and femoral nerve blocks and reduces the requirement for additional analgesia during the immediate postoperative hours.
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Ruíz‐López P, Felisberto R, Haardt H, Martens A, Schauvliege S. Ultrasound‐guided sciatic nerve block in two alpacas (
Vicugna pacos
) as part of an anaesthesia plan for hindlimb fractures. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Patricia Ruíz‐López
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine University of Ghent Merelbeke Belgium
| | | | - Hanna Haardt
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine University of Ghent Merelbeke Belgium
| | - Ann Martens
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine University of Ghent Merelbeke Belgium
| | - Stijn Schauvliege
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine University of Ghent Merelbeke Belgium
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Paolini A, Santoro F, Bianchi A, Collivignarelli F, Vignoli M, Scialanca S, Parrillo S, Falerno I, De Bonis A, Rosto M, Tamburro R. Use of Transversus Abdominis Plane and Intercostal Blocks in Bitches Undergoing Laparoscopic Ovariectomy: A Randomized Controlled Trial. Vet Sci 2022; 9:604. [PMID: 36356081 PMCID: PMC9694432 DOI: 10.3390/vetsci9110604] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/16/2022] [Accepted: 10/28/2022] [Indexed: 10/17/2023] Open
Abstract
In humans and dogs, loco-regional anesthesia is associated with lower peri-operative opioid consumption and less related side effects. The combination of transversus abdominis plane (TAP) and intercostal blocks can be used to desensitize the entire abdominal wall in dogs. The aim of this study was to evaluate the effectiveness of TAP and intercostal blocks in bitches undergoing laparoscopic ovariectomy. Twenty client-owned bitches were enrolled in this double-blinded randomized controlled trial. After premedication with dexmedetomidine, methadone and ketamine, the animals were randomized into two groups. Dogs in the TAP group received intercostal blocks from T8 to T10 and a TAP block with ropivacaine. Dogs in the FEN group received a fentanyl bolus and a constant rate infusion for the entire duration of the procedure. Intra-operative cardiovascular stability, post-operative pain scores, rescue opioid requirement, dysphoria during recovery, time to attain sternal recumbency and interest in food at 6 h post-extubation were compared. Bitches in the TAP group received a statistically significant lower amount of rescue fentanyl intra-operatively and methadone post-operatively. Pain scores were lower in the TAP group until 6 h post-extubation. No difference was found for dysphoric recoveries, time to attain sternal recumbency and appetite at 6 h post-extubation. No adverse event was recorded for any of the dogs. The combination of TAP and intercostal blocks can be part of an effective multi-modal analgesic strategy in bitches undergoing laparoscopic ovariectomy.
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Affiliation(s)
- Andrea Paolini
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Francesco Santoro
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hatfield AL9 7TA, UK
| | - Amanda Bianchi
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | | | - Massimo Vignoli
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Silvia Scialanca
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Salvatore Parrillo
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Ilaria Falerno
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Andrea De Bonis
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Martina Rosto
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
| | - Roberto Tamburro
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy
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12
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Monteiro BP, Lascelles BDX, Murrell J, Robertson S, Steagall PVM, Wright B. 2022
WSAVA
guidelines for the recognition, assessment and treatment of pain. J Small Anim Pract 2022. [DOI: 10.1111/jsap.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. P. Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. D. X. Lascelles
- Comparative Pain Research Laboratory and Surgery Section North Carolina State University 4700 Hillsborough Street Raleigh NC USA
| | - J. Murrell
- Highcroft Veterinary Referrals 615 Wells Rd, Whitchurch Bristol BS149BE UK
| | - S. Robertson
- Senior Medical Director Lap of Love Veterinary Hospice 17804 N US Highway 41 Lutz FL 33549 USA
| | - P. V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. Wright
- Mistral Vet 4450 Thompson Pkwy Fort Collins CO 80534 USA
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Gomez‐Martinez MI, Kumaratunga V, Khenissi L. Use of bupivacaine‐infused absorbable gelatin haemostatic sponge following eye enucleation in a corn snake. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Vim Kumaratunga
- Small Animal Referral Hospital Langford Vets, University of Bristol Bristol UK
- Queen Mother Hospital for Small Animals. Royal Veterinary College University of London London UK
| | - Latifa Khenissi
- Small Animal Referral Hospital Langford Vets, University of Bristol Bristol UK
- Rainbow Equine Hospital, Old Malton Malton UK
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Armour M, Borland K, Michou J. Unilateral exophthalmos in a dog following bilateral maxillary nerve block for rhinoscopy. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Marc Armour
- Anaesthesia Department Lumbry Park Veterinary Specialists Alton Hampshire UK
| | - Karla Borland
- Anaesthesia Department Lumbry Park Veterinary Specialists Alton Hampshire UK
| | - Joanne Michou
- Anaesthesia Department Lumbry Park Veterinary Specialists Alton Hampshire UK
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RUBLENKO S, RUBLENKO M, YAREMCHUK A, BAKHUR T. Clinical-haemostasis assessment of anaesthesia regimens in dogs with visceral and somatic types of pain response. ANKARA ÜNIVERSITESI VETERINER FAKÜLTESI DERGISI 2022. [DOI: 10.33988/auvfd.979508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The article investigates the influence of visceral (surgical treatment of abdominal pathologies) and somatic pain syndrome (osteosynthesis) on dogs’ clinical parameters and haemostasis. It was found, that the best variant for abdominal operations in dogs is acepromazine-ketamine-propofol anaesthesia and for osteosynthesis – acepromazine-butorphanol-ketamine. The use of neuroleptics (acepromazine, xylazine) with general anaesthetics (ketamine, propofol, sodium thiopental) in abdominal operations ensured rapid entry into anaesthesia (< 2 min) and duration 19–23 min. The use of acepromazine-ketamine-propofol provided well-managed anaesthesia during 11.1 ± 0.5 min, rapid recovery (17.3 ± 2.4 min), without significant changes in heart rate (HR), respiratory rate (RR), blood pressure (BP), haemoglobin saturation (SpO2). Unbalanced anaesthesia and insufficient analgesia under xylazine-ketamine caused a sharp decrease in HR, BP, RR with their increase due to visceral pain, led to hypoxia (SpO2 < 92%). During the osteosynthesis, acepromazine-butorphanol-propofol-ketamine anaesthesia provided complete analgesia with twice the rapid recovery of dogs without significant changes in HR, RR, BP, SpO2 during surgery. Acepromazine-ketamine-thiopental anaesthesia accompanied by pronounced analgesia with a decrease in HR and BP. Xylazine-ketamine-thiopental anaesthesia, under apparent analgesia, led to hypotension (decreased HR, BP) and hypoxia (decreased RR, SpO2). The data obtained will optimize the selection of drugs' combinations for dogs' anaesthesia, taking into account the type of pain response.
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Local and Regional Anaesthetic Techniques in Canine Ovariectomy: A Review of the Literature and Technique Description. Animals (Basel) 2022; 12:ani12151920. [PMID: 35953908 PMCID: PMC9367435 DOI: 10.3390/ani12151920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/05/2022] [Accepted: 07/26/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary This review stems from a general trend of increasing attention toward surgical nociception in the veterinary field. Indeed, veterinarian anaesthetists are becoming more careful in relieving perioperative nociception, improving the analgesic protocols and therefore optimising surgical outcomes. Canine ovariectomy is a common surgical procedure with a moderate level of pain. Therefore, intraoperative analgesia is very important because pain causes various systemic inflammatory effects that slow patient recovery. This review aims to collect all recent information about local and regional anaesthetic/analgesic techniques in a review of the literature describing the technique utilised. In addition, the present review aims to provide practical guidelines for veterinary practitioners to improve the anaesthetic techniques in canine neutering through an overview of the available literature. In fact, the methods described, considering the relative simplicity of execution, can be used in daily routine practice. Abstract Canine ovariectomy is an elective surgery with a moderate level of pain. Despite its relative simplicity, it requires surgical pain management. This study aimed to collect all recent information about local and regional anaesthetic/analgesic techniques in a review of the literature describing the technique utilised. The various procedures described in this review use local anaesthetics to improve analgesia in the routine systemic anaesthetic protocol. The approach described in this paper is called multimodal analgesia and is used in addition to the normal standard anaesthetic protocol. These techniques proved effective in minimising responses to the surgical stimulus and ensured adequate intraoperative and postoperative analgesia. The routine use of multimodal analgesia is considered a useful alternative for pain management in canine ovariectomy, in that it minimises patient suffering, improves the recovery of rescue analgesia, increases drug savings, and improves animal outcomes. In addition, the use of these local and regional techniques ensures satisfactory analgesic coverage that lasts for the first hours postoperatively.
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Cicirelli V, Lacalandra GM, Cshe S, Mrenoshki D, Lillo E, Bianchi FP, Aiudi GG. Analgesic comparison between topical irrigation (splash block) versus injection of lidocaine on the ovarian pedicle in canine ovariectomy. Vet Med Sci 2022; 8:1893-1897. [PMID: 35611806 PMCID: PMC9514456 DOI: 10.1002/vms3.843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives The aim of this study was to compare the analgesic efficacy of topical irrigation versus injection of lidocaine on the ovarian pedicle to provide analgesia in bitches ovariectomy. In the current study were monitored: increased blood pressure, heart rate and respiratory rate to identify an acute intraoperative nociceptive response. These parameters were registered at six times during the surgical procedure: grasping of the ovary (time 1), dissection of the mesosalpinx (time 2), tightening of the first loop ligature (time 3), tightening of the second loop ligature (time 4), transection of the ovarian pedicle (time 5) and release of the ovary (time 6). Material and Methods Forty healthy bitches were randomly assigned in two groups (n = 20) to receive topical irrigation (splash block) of 2% lidocaine (C group) on both ovarian pedicle (2 mg/kg each), or an equal volume of lidocaine was injected at the same sites (R group). Results The results of the present study suggest that splash block may provide intraoperative analgesic effects equivalent to injection in the ovarian pedicle in dogs that have undergone ovariectomy. The lidocaine improved surgical analgesia during canine ovariectomy in both groups, and this action is not affected by the inoculation technique. Clinical significance Pain management in veterinary patients is a crucial component of appropriate patient care. Therefore, the need for achieving safer anaesthesia for surgical intervention is gaining much attention. Ovariectomy is a common surgical procedure in bitches with medium level of pain. This study concluded that considering its relative simplicity, low cost, and safety, both techniques could be used in daily clinical practice.
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Affiliation(s)
- Vincenzo Cicirelli
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | | | - Sandor Cshe
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Daniela Mrenoshki
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Edoardo Lillo
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Paolo Bianchi
- Department and Clinic of Obstetrics and Animal Reproduction, University of Veterinary Medicine, Budapest, Hungary
| | - Giulio Guido Aiudi
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
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Cicirelli V, Matteo B, Di Bella C, Lacalandra GM, Aiudi G. The ultrasound-guided funicular block in cats undergoing orchiectomy: ropivacaine injection into the spermatic cord to improve intra and postoperative analgesia. BMC Vet Res 2022; 18:169. [PMID: 35538544 PMCID: PMC9088067 DOI: 10.1186/s12917-022-03279-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The orchiectomy in cats is a common surgical procedure with medium level of pain and for this reason requires intra and postoperative analgesia management. The aim of this study was to compare intra and postoperative pain in two groups of cats undergoing orchiectomy. Sixty healthy cats were randomly assigned in two groups (n = 30) to receive pre surgery ropivacaine hydrochloride (0.2 mL/kg at 0.5%) (R Group) or NaCl 0.9% (C group) into the spermatic cord. The intraoperative evaluation was carried out using the cardiorespiratory stability parameters and eventually administration of rescue analgesia. A rescue analgesia (fentanyl 2 µg/kg) was administered during orchiectomy in case of considerable increase of blood pressure, heart rate or respiratory rate. The postoperative evaluation was been done using scores following a UNESP-Botucatu multimodal scale for 6 h post-surgery. RESULTS As result, cats in R group responded better to surgical procedure, maintaining lower postoperative pain scores than C group. CONCLUSIONS The ultrasound-guided funicular block used in this study, as already demonstrated in dogs, is a good method to protect the cats from surgical pain and ensure a good level of surgical analgesia.
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Affiliation(s)
- Vincenzo Cicirelli
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy.
| | - Burgio Matteo
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Caterina Di Bella
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | | | - Giulio Aiudi
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
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19
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Gomez‐Martinez MI, Adams J, Langley‐Hobbs S, Khenissi L. Use of an ultrasound‐guided sciatic and saphenous nerve block as a part of the multimodal analgesic management in a cria for the stabilisation of a left tibial eminence avulsion fracture. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - James Adams
- Farm Animal Practice Langford Vets University of Bristol Bristol UK
| | | | - Latifa Khenissi
- Small Animal Referral Hospital Langford Vets University of Bristol Bristol UK
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20
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Gruen ME, Lascelles BDX, Colleran E, Gottlieb A, Johnson J, Lotsikas P, Marcellin-Little D, Wright B. 2022 AAHA Pain Management Guidelines for Dogs and Cats. J Am Anim Hosp Assoc 2022; 58:55-76. [PMID: 35195712 DOI: 10.5326/jaaha-ms-7292] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
These updated guidelines present a practical and logical approach to the assessment and management of acute and chronic pain in canine and feline patients. Recognizing pain is fundamental to successful treatment, and diagnostic guides and algorithms are included for assessment of both acute and chronic pain. Particularly for chronic pain, capturing owner evaluation is important, and pain-assessment instruments for pet owners are described. Expert consensus emphasizes proactive, preemptive pain management rather than a reactive, "damage control" approach. The guidelines discuss treatment options centered on preemptive, multimodal analgesic therapies. There is an extensive variety of pharmacologic and nonpharmacologic therapeutic options for the management of acute and chronic pain in cats and dogs. The guidelines include a tiered decision tree that prioritizes the use of the most efficacious therapeutic modalities for the treatment of acute and chronic pain.
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Affiliation(s)
- Margaret E Gruen
- North Carolina State University, Department of Clinical Sciences (M.E.G.)
| | - B Duncan X Lascelles
- North Carolina State University, Translational Research in Pain, Department of Clinical Sciences (B.D.X.L.)
| | | | | | | | | | - Denis Marcellin-Little
- University of California, Davis, Department of Surgical and Radiological Sciences (D.M-L.)
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21
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Phillips V, Ferreira J. Benefits of incorporating point of care ultrasound in the anaesthetic management of a dog requiring surgical correction of traumatic zygomatic fracture causing pseudoankylosis and severe dental malocclusion. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Beeston T, Israeliantz Gunz N, Leigh H, Lopez C, Lord S, Liuti T. Anatomical localisation of the maxillary nerve with the use of computed tomography to aid nerve block placement in dogs. Vet Rec 2022; 191:e1388. [PMID: 35122665 DOI: 10.1002/vetr.1388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/04/2021] [Accepted: 01/06/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND The maxillary block is a commonly used anaesthetic technique in dogs; however, no universal recommendations for the best method to perform this block exist. Differences between using this block in brachycephalic and non-brachycephalic breeds have not been examined. This study compared the position of the maxillary nerve using CT in brachycephalic and non-brachycephalic dogs. METHODS Forty CT images of the heads of dogs of varying conformation were analysed. The distances and angles to the maxillary nerve from the injection site within the oral cavity were measured. If present in the same plane, the distance to the eye was measured. Measurements of jaw width and length were taken to ascertain if they correlated to the distance to the maxillary nerve from the oral cavity. RESULTS There was no difference in angle between brachycephalic and non-brachycephalic dogs; however, the distance between nerve and injection point in brachycephalic dogs was generally greater. A regression equation relating maxillary nerve depth to jaw width was found. The eye was more likely to be in the plane of injection if the dog was non-brachycephalic. CONCLUSION The discovered relationship between jaw width and maxillary nerve depth may allow more accurate injections to be made.
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Affiliation(s)
- Thomas Beeston
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, UK
| | | | - Hannah Leigh
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, UK
| | | | - Samuel Lord
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, UK
| | - Tiziana Liuti
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, UK
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Steagall PV, Robertson S, Simon B, Warne LN, Shilo-Benjamini Y, Taylor S. 2022 ISFM Consensus Guidelines on the Management of Acute Pain in Cats. J Feline Med Surg 2022; 24:4-30. [PMID: 34937455 PMCID: PMC10845386 DOI: 10.1177/1098612x211066268] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PRACTICAL RELEVANCE Increases in cat ownership worldwide mean more cats are requiring veterinary care. Illness, trauma and surgery can result in acute pain, and effective management of pain is required for optimal feline welfare (ie, physical health and mental wellbeing). Validated pain assessment tools are available and pain management plans for the individual patient should incorporate pharmacological and non-pharmacological therapy. Preventive and multimodal analgesia, including local anaesthesia, are important principles of pain management, and the choice of analgesic drugs should take into account the type, severity and duration of pain, presence of comorbidities and avoidance of adverse effects. Nursing care, environmental modifications and cat friendly handling are likewise pivotal to the pain management plan, as is a team approach, involving the cat carer. CLINICAL CHALLENGES Pain has traditionally been under-recognised in cats. Pain assessment tools are not widely implemented, and signs of pain in this species may be subtle. The unique challenges of feline metabolism and comorbidities may lead to undertreatment of pain and the development of peripheral and central sensitisation. Lack of availability or experience with various analgesic drugs may compromise effective pain management. EVIDENCE BASE These Guidelines have been created by a panel of experts and the International Society of Feline Medicine (ISFM) based on the available literature and the authors' experience. They are aimed at general practitioners to assist in the assessment, prevention and management of acute pain in feline patients, and to provide a practical guide to selection and dosing of effective analgesic agents.
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Affiliation(s)
- Paulo V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montréal, Saint-Hyacinthe, Canada; and Department of Veterinary Clinical Sciences and Centre for Companion Animal Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
| | | | - Bradley Simon
- Department of Small Animal Clinical Sciences, Texas A&M College of Veterinary Medicine and Biomedical Sciences, College Station, Texas, USA
| | - Leon N Warne
- Veterinary Anaesthesia & Pain Management Australia, Perth, Western Australia; and Veterinary Cannabis Medicines Australia, Perth, Western Australia, Australia
| | - Yael Shilo-Benjamini
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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Shilo-Benjamini Y, Letz S, Peery D, Abu Ahmad W, Bar-Am Y. Comparison of three regional anaesthetic techniques for infraorbital or maxillary nerve block in cats: a cadaveric study. J Feline Med Surg 2021; 24:322-327. [PMID: 34106793 PMCID: PMC8961245 DOI: 10.1177/1098612x211020163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives The maxillary nerve courses very close to the globe, rendering cats – with their large
eyes – at risk of globe penetration during infraorbital or maxillary nerve blocks.
Therefore, the goals of the study were to compare the distribution and potential
complications of three infraorbital or maxillary regional injection techniques. Methods Twenty-three bilateral maxillae of cat cadavers were used in a randomised blinded
trial. Each maxilla was injected with a 0.2 ml 1:1 mixture of lidocaine 2% and a
contrast medium by one of three injection techniques: infraorbital foramen (IOF;
n = 14); infraorbital canal (IOC; n = 16); or maxillary foramen (MF; transpalpebral
approach; n = 16) using a 25 G 1.6 cm needle. CT imaging of each cadaver head was
performed before and after injections. A radiologist scored injectate distribution (none
[0], mild [1], moderate [2], large [3]) in four locations: rostral, central and caudal
IOC, and at the MF, for which the distribution side was also determined. Comparisons
were performed with ordinal logistic mixed effects (P <0.05). Results The median (range) total distribution score of the IOC and MF technique were
significantly higher compared with the IOF technique (6.5 [4–12], 4 [2–8] and 0 [0–10],
respectively). The total IOC score was also significantly higher compared with the MF
technique. Injectate distribution at the MF was significantly more central following IOC
injection compared with MF injection, which distributed centrolaterally. None of the
techniques resulted in intraocular injection. Conclusions and relevance The IOC and MF techniques produced a satisfactory spread of the mixture that could
result in effective maxillary anaesthesia in cats. Further studies are required to
determine the effectiveness and safety of these techniques.
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Affiliation(s)
- Yael Shilo-Benjamini
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Shachar Letz
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Dana Peery
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Wiessam Abu Ahmad
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Yoav Bar-Am
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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Vullo C, Tambella AM, Falcone A, Marino G, Catone G. Constant Rate Infusion of Lidocaine, Tumescent Anesthesia and Their Combination in Dogs Undergoing Unilateral Mastectomy. Animals (Basel) 2021; 11:ani11051280. [PMID: 33946987 PMCID: PMC8146467 DOI: 10.3390/ani11051280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022] Open
Abstract
Tumescent anesthesia (TUM) is a technique that was initially used to perform liposuction under local anesthesia, which consists of the injection of such large volumes of local anesthetic until to produce swelling and firmness (tumescence) of the surgical area. The aim of this study was to compare the intraoperative analgesic efficacy of lidocaine (LID) constant rate infusion (CRI), of TUM, or their combination (LID/TUM) and the postoperative pain and analgesic requirement in dogs undergoing unilateral mastectomy. Twenty-four dogs were premedicated with dexmedetomidine (3 μg/kg) and methadone (0.2 mg/kg) intravenously (IV). After induction with propofol IV to effect, dogs were randomly allocated to receive a loading dose of lidocaine (2 mg/kg) followed by a CRI of 100 μg/kg/min (Group LID) in addition to an equivalent volume of lactated Ringer's solution instead of local TUM; a loading dose of lactated Ringer's solution followed by a CRI of Ringer's solution in addition to TUM (Group TUM); a loading dose of lidocaine (2 mg/kg) followed by a CRI of 100 μg/kg/min in addition to TUM (Group LID/TUM). Anesthesia was maintained with isoflurane in oxygen. Postoperative pain scores were assessed once the dogs had fully recovered from the sedative effects, and following 15, 30, 45 and 60 min. The results of the current study allow us to assert that all three treatments provided satisfactory intraoperative antinociceptive effects but administration of LID/TUM induced greater inhibition on sympathetic stimulating effect up to 60 min from recovery, thus, providing better early postoperative pain relief in dogs undergoing mastectomy.
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Affiliation(s)
- Cecilia Vullo
- Department of ChiBioFarm, University of Messina, 98168 Messina, Italy
- Correspondence:
| | - Adolfo Maria Tambella
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy;
| | - Annastella Falcone
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (A.F.); (G.M.); (G.C.)
| | - Gabriele Marino
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (A.F.); (G.M.); (G.C.)
| | - Giuseppe Catone
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (A.F.); (G.M.); (G.C.)
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Ultrasound-Guided Funicular Block: Ropivacaine Injection into the Tissue around the Spermatic Cord to Improve Analgesia during Orchiectomy in Dogs. Animals (Basel) 2021; 11:ani11051275. [PMID: 33925210 PMCID: PMC8146739 DOI: 10.3390/ani11051275] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Orchiectomy is a common surgical procedure performed on small animals and postoperative analgesia is very important because pain causes various negative effects that prevent patient recovery. Our study aimed to compare the intraoperative ultrasound-guided funicular block with ropivacaine and general anaesthesia using hypnotic and/or analgesic drugs and the postoperative hemodynamic stability and pain scores. This study demonstrated that the use of ultrasound-guided funicular, using ropivacaine, guarantees long-lasting and high-quality analgesic coverage and minimises the post-surgical pain inevitably associated with orchiectomy. This study stemmed from a general trend towards increasing attention on postoperative pain after orchiectomy in dog. Since veterinarians are becoming more focused on relieving surgical pain, anaesthetists are expected to use better protocols that can minimise pain. In fact, acute postsurgical pain is of great interest due to potential risk of becoming chronic if not treated properly. The routine use of the intraoperative ultrasound-guided funicular block with ropivacaine block is considered a useful alternative for pain management for orchiectomy in dogs, which can be performed under sedation or superficial general anaesthesia. In addition, the intraoperative ultrasound-guided funicular block with ropivacaine block ensures satisfactory analgesic coverage that lasts for at least 6 h postoperatively. Abstract Orchiectomy is a common surgical procedure performed on small animals, and it requires postoperative pain management despite its relative simplicity. This study aimed to evaluate the hemodynamic stability, intraoperative administration of additional hypnotic and/or analgesic drugs, and postoperative pain scores following the combination of ultrasound-guided injection of ropivacaine hydrochloride into the spermatic cord and infiltration by the same anaesthetic of the incisional prescrotal line (ROP) or general anaesthesia. Dogs in the ROP group showed greater intraoperative hemodynamic stability and lower pain scores than the control group. The locoregional approach used in this study proved effective in minimising the responses to the surgical stimulus and ensured adequate analgesia intra- and postoperatively. This method, called ultrasound-guided funicular block, allows orchiectomy to be performed under deep sedation without general anaesthesia.
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Use of Spinal Anaesthesia with Anaesthetic Block of Intercostal Nerves Compared to a Continuous Infusion of Sufentanyl to Improve Analgesia in Cats Undergoing Unilateral Mastectomy. Animals (Basel) 2021; 11:ani11030887. [PMID: 33804684 PMCID: PMC8003676 DOI: 10.3390/ani11030887] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Postoperative analgesia is very important because pain causes various negative effects that prevent patient recovery. Our study aimed to evaluate the analgesic efficacy of subarachnoid anaesthesia combined with intercostal nerve block compared with a constant-rate infusion of sufentanyl citrate in cats undergoing unilateral mastectomy. This study demonstrated that the use of spinal anaesthesia with anaesthetic block of intercostal nerves, using levobupivacaine, guarantees long-lasting and high-quality analgesic coverage and minimises the post-surgical pain inevitably associated with invasive surgical procedures such as radical mastectomy. This study stemmed from a general trend towards increasing attention on postoperative pain after spaying procedures in cats. Since veterinarians are becoming more focused on relieving surgical pain, anaesthetists are expected to use better protocols that can minimise pain and therefore optimise surgical results. This method, considering the relative simplicity of its execution, can be used in daily clinical practice. Abstract Unilateral mastectomy is a common surgical procedure in feline species and requires postoperative pain management. Our study aimed to evaluate the analgesic efficacy of subarachnoid anaesthesia combined with an intercostal nerve block, in comparison with the use of sufentanyl citrate administered as a constant-rate infusion (CRI). Twenty cats were randomly divided into two groups (n = 10/group) based on the analgesic protocol used: the first received loco-regional anaesthesia with levobupivacaine (LR group), and the second received a CRI of sufentanyl (SUF group). The evaluation criteria during surgery were the need for a bolus of fentanyl in the event of an increased heart rate or increased blood pressure. In the postoperative period, the levels of comfort/discomfort and pain were used to obtain a score according to the UNESP-Botucatu multimodal scale. Subjects who scored above seven received analgesic drug supplementation. Intraoperative analgesia was satisfactory, with good haemodynamic stability in both groups. Four patients in the LR group required an extra dose of methadone after they achieved the sternal decubitus position, whereas those in the SUF group required many more doses. The analgesia achieved in the LR group was more satisfactory than that in the SUF group.
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Douglas H, Welsh S, Barr C. Clinical techniques in veterinary dermatology: regional anaesthesia of the canine and feline distal limb. Vet Dermatol 2020; 32:90-e17. [PMID: 33245205 DOI: 10.1111/vde.12916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/12/2020] [Accepted: 09/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Local anaesthesia for procedures involving the distal limb are a useful component of balanced protocols to achieve effective procedural analgesia for patients. A ring block is an effective and straightforward technique. HYPOTHESIS/OBJECTIVE To review and describe the ring block technique for local anaesthesia of the canine and feline distal limb. ANIMALS Images of hospitalized patients were used. These photographs were obtained with owner permission. RESULTS The clinical technique for the ring block of the canine or feline distal limb is described. CONCLUSIONS AND CLINICAL IMPORTANCE The ring block can be implemented simply and successfully for a variety of procedures involving the distal limb to provide effective analgesia.
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Affiliation(s)
- Hope Douglas
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Spruce Street, Philadelphia, PA, 19104, USA
| | - Stephanie Welsh
- Rood and Riddle Equine Hospital, 2150 Georgetown Road, Lexington, KY, 40511, USA
| | - Ciara Barr
- Rood and Riddle Equine Hospital, 2150 Georgetown Road, Lexington, KY, 40511, USA
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Neves ECD, Pelizzari C, Oliveira RSD, Kassab S, Lucas KDA, Carvalho YKD. 3D anatomical model for teaching canine lumbosacral epidural anesthesia. Acta Cir Bras 2020; 35:e202000608. [PMID: 32667587 PMCID: PMC7357831 DOI: 10.1590/s0102-865020200060000008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 05/14/2020] [Indexed: 11/22/2022] Open
Abstract
Purpose To develop a 3D anatomical model for teaching canine epidural anesthesia (3DMEA) and to assess its efficacy for teaching and learning prior to the use of live animals. Methods The creation of 3DMEA was based on 3D optical scanning and 3D printing of canine bone pieces of the fifth to the seventh lumbar vertebrae, sacrum and pelvis. A total of 20 male dogs were scheduled for castration. 20 veterinary students watched a video showing epidural anesthesia in dogs before the clinical attempt and were assigned to control or 3DMEA groups. Students in the 3DMEA group trained in the model after the video. For the clinical trial, the epidural procedure was performed by students under the veterinary supervision. When observed the absence of response to nociceptive stimuli, the epidural was considered successful. Then, all students answered a questionnaire evaluating the main difficulty founded in the technique and its degree of difficulty. Results The 3DMEA group reported a lower degree of difficulty to perform the epidural anesthesia technique when compared with the control group (p=0.0037). The 3DMEA reproduced the anatomical structures, allowing the perception of the distance of needle in relation to the iliac prominences during epidural anesthesia. Its mobility allowed simulation of the animal in standing position and sternal recumbency. Conclusion The use of 3DMEA demonstrated greater efficacy in the execution of the technique, being effective in the teaching and learning process before the epidural anesthesia in live animals.
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Grubb T, Lobprise H. Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1). Vet Med Sci 2020; 6:209-217. [PMID: 31965742 PMCID: PMC7196681 DOI: 10.1002/vms3.219] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 10/27/2019] [Indexed: 11/23/2022] Open
Abstract
Pain management in veterinary patients is a crucial component of appropriate patient care. Multimodal analgesia that includes both systemically and locally/regionally administered drugs is generally the most effective approach to providing pain relief. Local anaesthetic drugs used in local and regional blockade are unique in that they can completely block the transmission of pain (in conscious patients) or nociceptive (in anaesthetized patients) signals, thereby providing profound analgesia. In addition, local and regional administration of drugs, when compared with systemic bolus administration, generally results in a lower incidence of dose‐related adverse effects. Due to the potential to provide profound analgesia and the high safety margin (when used correctly) of this drug class, local anaesthetics are recommended as part of the analgesic protocol in the majority of patients undergoing surgical procedures or suffering traumatic injuries. This manuscript, Part 1 of a two‐part instalment, emphasizes the importance of using local and regional anaesthesia as a component of multimodal analgesia, provides a review of the basic pharmacokinetics/pharmacodynamics of local anaesthetic drugs in general, lists information on commonly used local anaesthetic drugs for local and regional blockade in dogs and cats, and briefly introduces the novel liposome‐encapsulated bupivacaine (NOCITA®). Part 2 is a review of local and regional anaesthetic techniques used in dogs and cats (Grubb & Lobprise, 2020).
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Grubb T, Lobprise H. Local and regional anaesthesia in dogs and cats: Descriptions of specific local and regional techniques (Part 2). Vet Med Sci 2020; 6:218-234. [PMID: 31965749 PMCID: PMC7196680 DOI: 10.1002/vms3.218] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 07/27/2019] [Accepted: 10/27/2019] [Indexed: 11/30/2022] Open
Abstract
Pain management in veterinary patients is a crucial component of appropriate patient care. Local anaesthetic drugs used in local and regional blockade can completely block the transmission of nociceptive impulses, decreasing both intra‐operative nociception and postoperative pain, while decreasing the potential incidence of adverse effects that can be associated with systemic boluses of drugs. For efficacy and safety, this class of drugs is recommended as part of the analgesic protocol in the majority of surgical procedures and traumatic injuries. Numerous local and regional blocks are proven effective in dogs and cats, thus providing the clinician with ample opportunity to include these blocks in practice. This manuscript, Part 2 of a two‐part instalment, focuses on brief descriptions of select commonly used local/regional anaesthesia techniques for dogs and cats that cover a multitude of painful surgeries/injuries and that can be implemented in any practice. In Part 1 of this topic, detailed information on local anaesthetic drugs commonly used in small animal practice was reviewed (Grubb & Lobprise, 2020).
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