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Bendinelli C, D'Angelo M, Leonardi F, Verdier N, Cozzi F, Lombardo R, Portela DA. Erector spinae plane block in dogs undergoing hemilaminectomy: A prospective randomized clinical trial. Vet Anaesth Analg 2024; 51:279-287. [PMID: 38553382 DOI: 10.1016/j.vaa.2024.02.002] [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: 04/15/2023] [Revised: 12/16/2023] [Accepted: 02/06/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVE To compare the perioperative cumulative opioid consumption and the incidence of cardiovascular complications in dogs undergoing hemilaminectomy in which either an erector spinae plane (ESP) block or systemic opioids were administered. STUDY DESIGN Prospective randomized clinical trial. ANIMALS A total of 60 client-owned dogs. METHODS Dogs were randomized to one of three groups: an ESP block (group ESP), a constant rate infusion of fentanyl (group FNT, positive control) or a single dose of methadone as premedication (group MTD, negative control). Intraoperative nociceptive response was treated with fentanyl [1 μg kg-1, intravenously (IV)] boli. Before closure of the surgical site, morphine (0.1 mg kg-1) was applied to the dura mater. The cumulative dose of opioids was recorded and compared between groups. The incidence of intraoperative bradycardia and/or hypotension and the time to extubation were compared between groups. The short form of the Glasgow Composite Pain Scale (SF-GCPS) was used to score nociception before anaesthetic induction and 1, 2, 6, 12,18 and 24 hours postoperatively. Methadone 0.2 mg kg-1 was administered IV if the SF-GCPS score was ≥ 5. RESULTS Group MTD required more intraoperative rescue analgesia than groups ESP (p = 0.008) and FNT (p = 0.001). The total cumulative intraoperative dose of fentanyl was higher in groups FNT (p < 0.0001) and MTD (p = 0.002) than in group ESP. The incidence of cardiovascular complications was similar between groups. Extubation time was longer in group MTD (p = 0.03). Postoperatively, the time to first rescue analgesia was longer in group ESP than in group MTD (p = 0.03). The cumulative postoperative opioid consumption and pain scores were similar between groups. CONCLUSIONS AND CLINICAL RELEVANCE The ESP block resulted in a reduced intraoperative opioid consumption compared with the control positive and negative groups.
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Affiliation(s)
| | - Marianna D'Angelo
- Clinica Veterinaria NVA (Neurologi Veterinari Associati), MIlan, Italy
| | - Fabio Leonardi
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - Natali Verdier
- Clinical Unit of Anaesthesiology and Perioperative Intensive-Care Medicine, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Francesca Cozzi
- Clinica Veterinaria NVA (Neurologi Veterinari Associati), MIlan, Italy
| | - Rocco Lombardo
- Clinica Veterinaria NVA (Neurologi Veterinari Associati), MIlan, Italy
| | - Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
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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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Pentsou J, Vagias M, Davies T, Hoey S, Huuskonen V. Thoracolumbar Retrolaminar Block: Anatomical and Radiological Study of Injectate Pattern Distribution in Canine Cadavers. Animals (Basel) 2023; 13:3008. [PMID: 37835614 PMCID: PMC10571983 DOI: 10.3390/ani13193008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
The retrolaminar block is a regional anaesthetic technique, first developed in humans, in which the local anaesthetic is deposited directly onto the dorsal aspect of the thoracic or lumbar vertebral lamina. This study aims to evaluate the distribution of landmark-guided thoracolumbar retrolaminar injections in greyhound cadavers. Thirteen injections of contrast-dye solution were performed in eight cadavers at the level of the twelfth thoracic vertebra (T12), with either 20 mL (n = 8, high volume, HV) or 10 mL (n = 5, low volume, LV) per site. The spread of the injectate was evaluated through computed tomography and transverse anatomical dissection. The groups were compared using the Mann-Whitney U test. The median (range) of the extent of the spread was 4 (2-5) and 3 (2-4) intervertebral foramina in the LV and HV groups, respectively. The median (range) of the spread along the retrolaminar space was 3 (2-3) retrolaminar segments in the LV and 3 (2-4) in the HV group. Epidural and retroperitoneal spread was identified in seven cadavers. Following landmark-guided retrolaminar injections, the injectate spread both in the retrolaminar and paravertebral spaces, without any obvious association between the volume of injectate and the extent of the spread. Further studies are warranted to determine the clinical efficacy of the technique.
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Affiliation(s)
- Julia Pentsou
- Department of Veterinary Anaesthesia and Analgesia, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh EH25 9RG, UK
| | - Michail Vagias
- Department of Small Animal Surgery, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh EH25 9RG, UK;
| | - Thomas Davies
- Bristol Vet Specialists, Unit 10, More Plus Central Park, Madison Way, Severn Beach, Bristol BS35 4ER, UK;
| | - Séamus Hoey
- Equine Clinical Studies, Diagnostic Imaging and Anaesthesia, UCD School of Veterinary Medicine, University College Dublin, D04 W6F6 Dublin, Ireland; (S.H.); (V.H.)
| | - Vilhelmiina Huuskonen
- Equine Clinical Studies, Diagnostic Imaging and Anaesthesia, UCD School of Veterinary Medicine, University College Dublin, D04 W6F6 Dublin, Ireland; (S.H.); (V.H.)
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Citarella G, Corona D, Parsons E, Giannikaki S, Rioja E. The Outcomes of an Opioid-Free Anaesthetic Plan in Fourteen Dogs Undergoing Enucleation Using an Ultrasound-Guided Supra-Temporal Retrobulbar Block: A Retrospective Case Series. Animals (Basel) 2023; 13:2059. [PMID: 37443857 DOI: 10.3390/ani13132059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
The objective of this retrospective case series is to report the outcomes of an opioid-free anesthetic plan in dogs undergoing enucleation surgery. A total of 14 dogs were admitted for enucleation between March and December 2020. A multimodal approach to perioperative analgesia was used, with a focus on retrobulbar anesthesia. A combination of an ultrasound-guided retrobulbblock with a supratemporal approach in association with ketamine, dexmedetomidine and non-steroidal anti-inflammatory drugs was used in the reported cases. Intraoperative nociception was defined as an increase of 20% from the baseline in one or more of the following parameters: heart rate, respiratory rate or mean arterial pressure. An ultrasound-guided retrobulbar block in an opioid-free anesthesia regime was effective at managing the perioperative analgesia of 13 out of 14 dogs. In only one case, a bolus of fentanyl was administered to treat intraoperative nociception. Recovery was uneventful in all the dogs, and the postoperative pain scores remained below the intervention threshold at all time points. To the authors' knowledge, this is the first reported case series of opioid-free anesthesia for enucleation in dogs.
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Affiliation(s)
- Gerardo Citarella
- Section of Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Daniele Corona
- Section of Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | | | | | - Eva Rioja
- Optivet Referrals, Ltd., Havant, PO9 2NJ, UK
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Viilmann I, Drozdzynska M, Vettorato E. Analgesic efficacy of a bilateral erector spinae plane block versus a fentanyl constant rate infusion in dogs undergoing hemilaminectomy: a retrospective cohort study. BMC Vet Res 2022; 18:423. [PMID: 36471374 PMCID: PMC9721043 DOI: 10.1186/s12917-022-03523-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/21/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Erector spinae plane block (ESPB) is an ultrasound-guided interfascial plane block used to provide analgesia in dogs undergoing hemilaminectomy. The aim of this study is to compare the analgesic efficacy of a bilateral ESPB with a fentanyl constant rate infusion (CRI) in dogs undergoing hemilaminectomy. METHODS This is a retrospective cohort study. Anaesthetic records of client-owned dogs undergoing hemilaminectomy (June 2019-August 2020), and in which a bilateral ESPB was performed (group ESPB), were retrieved and compared to a cohort of 39 dogs that underwent hemilaminectomy (September 2014 - June 2017) and in which a fentanyl CRI (2 μg/kg bolus followed by 5 μg/kg/hour) was used as a primary intraoperative analgesia (group CRI). The prevalence of dogs in which intraoperative rescue fentanyl boluses were administered, the total dose of rescue fentanyl boluses administered, the postoperative methadone requirement and anaesthetic complications during the first 24 postoperative hours were evaluated. Univariate statistical analysis was used. RESULTS Group ESPB comprised of 93 dogs. The bilateral ESPB was performed using a median (range) levobupivacaine volume of 1 (0.5-1.7) mL/kg per side, at a concentration of 0.125% (0.12-0.25). At least one rescue fentanyl bolus was administered in 54.8% and in 56.4% of dogs in group ESPB and CRI, respectively (p > 0.99). The number of rescue fentanyl boluses was higher in group CRI (p = 0.006), especially during lumbar hemilaminectomy. Rescue fentanyl boluses were more frequently administered from skin incision to end of vertebral lamina drilling in group CRI (p = 0.001), and from end of vertebral lamina drilling to end of surgery in group ESPB (p = 0.0002). During the first 6 (p = 0.0035) and 6-12 (p = 0.0005) postoperative hours, the number of dogs that required at least one dose of methadone was higher in group CRI. In group ESPB, dogs were more likely to become hypothermic (p = 0.04). One dog, not included in the study, developed sinus arrest after performing a caudal thoracic ESPB. CONCLUSIONS Under the conditions of this study, a bilateral ESPB was associated with a lower number of rescue fentanyl boluses administered in dogs undergoing hemilaminectomy, especially between skin incision to end of vertebral lamina drilling. Despite ESPB being associated with a reduced opioid consumption during the first 12 hours postoperatively, differences in the postoperative management precluded any firm conclusion regarding its postoperative effect.
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Affiliation(s)
- Inga Viilmann
- Dick White Referrals, part of Linnaeus Veterinary Limited, Station Farm, London Road, Six Mile Bottom, Cambridgeshire, CB8 0UH UK
| | - Maja Drozdzynska
- Small Animal Specialist Hospital, Level 1, 1 Richardson Place, North Ryde, NSW 2113 Australia
| | - Enzo Vettorato
- grid.15276.370000 0004 1936 8091Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, FL Gainesville, USA
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Rufiange M, Ruel HLM, Monteiro BP, Watanabe R, Cruz Benedetti IC, Benito J, Steagall PVM. A randomized, prospective, masked clinical trial comparing an opioid-free vs. opioid-sparing anesthetic technique in adult cats undergoing ovariohysterectomy. Front Vet Sci 2022; 9:1002407. [PMID: 36439352 PMCID: PMC9691894 DOI: 10.3389/fvets.2022.1002407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/25/2022] [Indexed: 09/23/2023] Open
Abstract
This study aimed to compare the analgesic effects of an injectable protocol using multimodal analgesia with or without opioids in cats undergoing ovariohysterectomy (OVH). Thirty-two healthy cats were enrolled in a prospective, blinded, randomized trial after the caregiver's written consent. Cats received a combination of ketamine (4 mg/kg), midazolam (0.25 mg/kg) and dexmedetomidine (40 μg/kg), and either buprenorphine (20 μg/kg) or saline (same volume as buprenorphine) intramuscularly [opioid-sparing (OSA) and opioid-free anesthesia (OFA) groups, respectively]. Intraperitoneal bupivacaine 0.25% (2 mg/kg) and meloxicam (0.2 mg/kg subcutaneously) were administered before OVH. Atipamezole (400 μg/kg intramuscularly) was administered at the end of surgery. Pain and sedation were evaluated using the Feline Grimace Scale (FGS) and a dynamic interactive visual analog scale, respectively. Intravenous buprenorphine was administered as rescue analgesia if FGS scores ≥ 0.39/1. Statistical analysis included repeated measures linear mixed models, Fisher's exact test and Bonferroni adjustments when appropriate (p < 0.05). Twenty-seven cats were included. The prevalence of rescue analgesia was lower in OSA (n = 0/13) than in OFA (n = 5/14) (p = 0.04). The FGS scores (least square means and 95% CI) were higher in OFA at 1 [2.0 (1.3-2.7)] and 2 h [2.2 (1.5-2.9)] than baseline [0.7 (0.0-1.4)], but not in OSA. Sedation scores were not significantly different between groups. Opioid-free injectable anesthesia was appropriate for some cats using a multimodal approach. However, a single dose of intramuscular buprenorphine eliminated the need for rescue analgesia and assured adequate pain management after OVH in cats.
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Affiliation(s)
- Maxime Rufiange
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Helene L. M. Ruel
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Beatriz P. Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Ryota Watanabe
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Inga-Catalina Cruz Benedetti
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Javier Benito
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Paulo V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
- Department of Veterinary Clinical Sciences and Centre for Companion Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
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Campoy L. Development of Enhanced Recovery After Surgery (ERAS) protocols in veterinary medicine through a one-health approach: the role of anesthesia and locoregional techniques. J Am Vet Med Assoc 2022; 260:1751-1759. [DOI: 10.2460/javma.22.08.0354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Enhanced Recovery After Surgery (ERAS) is a new and emerging concept in human medicine that involves rethinking the preoperative, intraoperative, and postoperative periods. The ultimate, overarching aim is to improve patient outcome following surgery and, thus, return to a normal daily routine as soon as possible. The development and implementation of locoregional anesthetic techniques in humans is one of the key elements driving these protocols. In veterinary medicine, we are no exception: the rapidly growing interest, development, and refinement of these techniques in our veterinary species is changing the way we think of anesthesia and analgesia. The potential real benefits are yet to be determined, as this concept is implemented into our veterinary hospitals in general, and our surgical patients in particular, in a more systematic and routine way. In this article, we will introduce the reader to the concept of ERAS protocols and the role of regional anesthesia in some common surgical procedures.
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Affiliation(s)
- Luis Campoy
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
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Erector spinae plane block at the thoracolumbar spine: a canine cadaveric study. Vet Anaesth Analg 2022; 49:656-663. [DOI: 10.1016/j.vaa.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
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Herrera‐Linares ME, Martínez M. Transient respiratory arrest after quadratus lumborum block in a dog. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Miguel Martínez
- Anaesthesia Department Northwest Veterinary Specialists Runcorn UK
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Chiavaccini L, Cavalcanti M, De Gasperi D, Portela DA. Clinical efficacy of ultrasound-guided bilateral erector spinae plane block for standing lumbar spinous osteotomy in a horse. Vet Anaesth Analg 2022; 49:517-519. [PMID: 35764459 DOI: 10.1016/j.vaa.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Ludovica Chiavaccini
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
| | - Mariana Cavalcanti
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Diego De Gasperi
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
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Rodriguez A, Medina‐Serra R, Lynch N, Veres‐Nyeki K. Erector spinae plane block as part of a multimodal analgesic approach in an anaesthetised horse undergoing dorsal spinous process ostectomy and desmotomy. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.345] [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)
- Alfonso Rodriguez
- Royal Veterinary College Hatfield UK
- Highcroft Veterinary Referrals Bristol UK
| | - Roger Medina‐Serra
- Royal Veterinary College Hatfield UK
- North Downs Specialist Referrals Bletchingley UK
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Libera N, McFadzean W. An opioid‐free anaesthesia (OFA) technique for dorsal laminectomy in a dog subsequent to severe bradycardia and hypothermia after previous subcutaneous methadone administration. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.287] [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)
- Natalia Libera
- Small Animal Teaching Hospital, University of Liverpool Neston UK
- Cave Veterinary Specialists, George's Farm West Buckland UK
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Gómez Fernández L, Huuskonen V, Potter J. The combination of an ultrasound‐guided erector spinae plane (ESP) block and epidural morphine as effective intra‐operative adjuncts to opioid premedication in six dogs undergoing lateral thoracotomy. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.152] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | - Joanna Potter
- UCD Veterinary Hospital University College Dublin Belfield Ireland
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Portela DA, Romano M, Zamora GA, Garcia-Pereira F, Pablo LS, Gatson BJ, Johnson AN, Otero PE. The effect of erector spinae plane block on perioperative analgesic consumption and complications in dogs undergoing hemilaminectomy surgery: a retrospective cohort study. Vet Anaesth Analg 2020; 48:116-124. [PMID: 33277182 DOI: 10.1016/j.vaa.2020.10.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/06/2020] [Accepted: 10/24/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the perioperative use of analgesics and complication rates in dogs administered an erector spinae plane (ESP) block or a traditional opioid-based (OP) treatment as part of analgesic management during hemilaminectomy. STUDY DESIGN Retrospective cohort study. ANIMALS Medical records of 114 client-owned dogs. METHODS General data included demographics, duration of procedure, number of laminae fenestrated, perioperative use of steroid and non-steroidal anti-inflammatory drugs. Intra- and postoperative analgesics used in 48 hours and complications rates were compared between groups. Opioid use was expressed in morphine equivalents [ME (mg kg-1)]. Continuous data were compared using the Mann-Whitney U test and incidence of events with a Fisher's exact tests. Multiple linear regression was used to evaluate association between perioperative ME consumption (dependent variable) with other independent variables. Data are presented as median (range). Differences were considered significant when p < 0.05. RESULTS Group ESP comprised 42 dogs and group OP 72 dogs. No differences were observed in the general data. Intraoperative ME was 0.65 (0.20-3.74) and 0.79 (0.19-5.60) mg kg-1 in groups ESP and OP, respectively (p = 0.03). Intraoperative infusion of lidocaine was administered intravenously (IV) to 23.8% and 68% of groups ESP and OP, respectively (p < 0.0001). Intraoperative infusion of ketamine was administered IV to 21% and 40% of groups ESP and OP, respectively (p = 0.04). Regression analysis revealed the ESP block as the only independent variable affecting the perioperative ME consumption. Pharmacological intervention to treat cardiovascular complications was administered to 21.4% and 47.2% of dogs in groups ESP and OP, respectively (p = 0.008). There were no differences in postoperative complication rates. CONCLUSIONS AND CLINICAL RELEVANCE ESP block was associated with reduced perioperative opioid consumption, intraoperative adjuvant analgesic use and incidence of pharmacological interventions to treat cardiovascular complications in dogs undergoing hemilaminectomy.
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Affiliation(s)
- Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
| | - Marta Romano
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Gustavo A Zamora
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | | | - Luisito S Pablo
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Bonnie J Gatson
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Alana N Johnson
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Pablo E Otero
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
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