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Serino F, Pennasilico L, Galosi M, Palumbo Piccionello A, Tambella AM, Di Bella C. Transversus Abdominis Plane (TAP) Block in Rabbit Cadavers: Anatomical Description and Measurements of Injectate Spread Using One- and Two-Point Approaches. Animals (Basel) 2024; 14:684. [PMID: 38473069 DOI: 10.3390/ani14050684] [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: 01/28/2024] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
The aim of this study was to describe one-point (preiliac approach) and two-point (preiliac and retrocostal approach) blocks of the Transversus Abdominis Plane (TAP) on a cadaveric model. For this purpose, ultrasound-guided infiltration of the plane between the internal oblique and transversus abdominis muscles was performed and, after dissection of tissues, the areas and percentage of nerve fibers involved were analyzed. Injection into the TAP plexus of a 1 mL/kg solution of 2% lidocaine and 1% methylene blue (1:1) was performed in 30 rabbit cadavers. In fifteen rabbits (group S), the solution was inoculated at the preiliac level. In the other 15 rabbits (group D), the solution was divided into two inoculations (0.5 mL/kg at the retrocostal level and 0.5 mL/kg at the preiliac level). All cadavers were then dissected and stained spinal nerve branches were measured. Moreover, the percentage of length, height and the total area of the stained tissue were calculated. In the S group, T10, T11 and T12 nerve eminences were successfully stained in 18%, 52% and 75% of cases, respectively. Furthermore, L1, L2, L3 and L4 were stained in 95%, 100%, 60% and 40% of cases, respectively. In group D, the ventromedial eminence of T10, T11 and T12 were stained in 68.1%, 100% and 98% of cases, respectively, and L1, L2, L3 and L4 were stained in 88%, 100%, 62% and 31% of cases, respectively. In conclusion, a two-point TAP block is more effective in covering the nerve eminences of the cranial abdomen than the preiliac approach alone.
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Affiliation(s)
- Federica Serino
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy
| | - Luca Pennasilico
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy
| | - Margherita Galosi
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy
| | | | - Adolfo Maria Tambella
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy
| | - Caterina Di Bella
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy
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Marchina-Gonçalves A, Laredo FG, Gil F, Soler M, Agut A, Redondo JI, Belda E. An Ultrasound-Guided Latero-Ventral Approach to Perform the Quadratus Lumborum Block in Dog Cadavers. Animals (Basel) 2023; 13:2214. [PMID: 37444012 DOI: 10.3390/ani13132214] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/23/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
The QL block is a high-level locoregional anesthesia technique, which aims to provide analgesia to the abdomen. Several approaches of the QL block have been studied to find out which one allows a greater distribution of the injectate. The aim of this study is to compare the traditional interfascial QL block (IQL) with a new latero-ventral approach (LVQL). We hypothesize that this new approach could be safer and easier to perform, since the injectate is administered more superficially and further away from vital structures. Our second objective is to assess whether a higher volume of injectate (0.6 mL/kg) could reach the ventral branches of the last thoracic nerves, leading to a blockade of the cranial abdomen. Six thawed canine cadavers (12 hemiabdomens) were used for this purpose. Both approaches were performed in all cadavers. A combination of methylene blue/iopromide was administered to each hemiabdomen, randomly assigned to the LVQL or IQL. No differences were found regarding the ease of perform the LVQL with respect to IQL. The results show that both techniques reached the ventral branches from L1 to L3, although only the IQL consistently stained the sympathetic trunk (5/6 IQL vs. 1/6 LVQL). The use of a higher volume did not enhance a more cranial distribution of the injectate.
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Affiliation(s)
- André Marchina-Gonçalves
- Escuela Internacional de Doctorado, Programa en Ciencias Veterinarias, Universidad de Murcia, 30100 Murcia, Spain
| | - Francisco G Laredo
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain
| | - Francisco Gil
- Departamento de Anatomía y Anatomía Patológica Comparada, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain
| | - Marta Soler
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain
| | - Amalia Agut
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain
| | - José Ignacio Redondo
- Departamento Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
| | - Eliseo Belda
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain
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Garbin M, Ruel HLM, Watanabe R, Malo A, Monteiro BP, Steagall PV. Analgesic efficacy of an ultrasound-guided transversus abdominis plane block with bupivacaine in cats: a randomised, prospective, masked, placebo-controlled clinical trial. J Feline Med Surg 2023; 25:1098612X231154463. [PMID: 36848291 PMCID: PMC10812078 DOI: 10.1177/1098612x231154463] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVES This randomised, prospective, masked clinical trial evaluated the postoperative analgesic efficacy of an ultrasound-guided transversus abdominis plane block (TAPB) with bupivacaine in cats undergoing ovariohysterectomy. METHODS Thirty-two healthy adult female cats undergoing elective ovariohysterectomy were randomised to undergo TAPB with bupivacaine (treatment group [TG], n = 16) vs placebo (control group [CG], n = 16) in addition to preoperative analgesia with buprenorphine (0.02 mg/kg IM). All patients received a general anaesthetic and, before surgical incision, a bilateral two-point (subcostal and lateral-longitudinal) TAPB was performed using 1 ml/kg bupivacaine 0.25% (0.25 ml/kg/point) or saline. Each cat was assessed by a blinded investigator before premedication (0 h) and at 1, 2, 3, 4, 8, 10 and 24 h postoperatively using the UNESP-Botucatu Feline Pain Scale - short form. Buprenorphine (0.02 mg/kg IV) and meloxicam (0.2 mg/kg SC) were administered when pain scores were ⩾4/12. Ten hours postoperatively, meloxicam was administered to cats that did not receive rescue analgesia. Statistical analysis included Student's t-tests, Wilcoxon tests and χ2 tests, and a linear mixed model with Bonferroni corrections (P <0.05). RESULTS Of the 32 cats enrolled, three in the CG were excluded from the analysis. The prevalence of rescue analgesia was significantly higher in the CG (n = 13/13) than in the TG (n = 3/16; P <0.001). Only one cat in the CG required rescue analgesia twice. Pain scores were significantly higher in the CG compared with the TG at 2, 4 and 8 h postoperatively. Mean ± SD pain scores were significantly higher in the CG, but not in the TG, at 2 (2.1 ± 1.9), 3 (1.9 ± 1.6), 4 (3.0 ± 1.4) and 8 h postoperatively (4.7 ± 0.6) than at 0 h (0.1 ± 0.3). CONCLUSIONS AND RELEVANCE A bilateral ultrasound-guided two-point TAPB with bupivacaine in combination with systemic buprenorphine provided superior postoperative analgesia than buprenorphine alone in cats undergoing ovariohysterectomy.
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Affiliation(s)
- Marta Garbin
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Hélène LM Ruel
- 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
| | - Annie Malo
- 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
| | - Paulo V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
- Department of Veterinary Clinical Sciences, Centre for Companion Animal Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
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Burrows CS, Duncan JC, Martinez-Taboada F. Transversus abdominis plane block in rats: Preliminary cadaveric studies. Lab Anim 2023; 57:50-58. [PMID: 36173023 DOI: 10.1177/00236772221122133] [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: 11/17/2022]
Abstract
The transversus abdominis plane (TAP) block is an ultrasound guided regional anaesthetic technique used to provide analgesia to the abdominal wall. Research in humans and cats has demonstrated that TAP blocks reduce pain and post-operative opioid requirements after abdominal surgery. To date TAP blocks have not been described in rats. The optimal technique to employ when performing TAP blocks is controversial with single point injection techniques failing to reliably provide adequate coverage of the cranial abdominal wall. It has been suggested that performing a two point injection may provide more reliable coverage of the cranial abdominal wall.The objective of this study was to determine the feasibility of performing ultrasound guided TAP blocks in rat cadavers and to evaluate whether performing a two point technique provides greater spread of injectate than a one point technique when administering the same total volume of methylene blue solution.Twenty-three, four-month-old, female Sprague Dawley rat cadavers weighing 506 ± 78 g were used. TAP blocks were performed using a total of 1 ml/kg of methylene blue solution.Overall success rates for injections were 21.7% (13.6-32.8%). Single point injection area of spread was 87.8 ± 32 mm2 compared with 102.4 ± 17 mm2 for the two point injection technique.Due to the low success rate the use of TAP blocks using the current technique cannot be recommended. Two point injection technique appears to provide greater spread; however, additional data is required to draw meaningful conclusions.
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Affiliation(s)
- Chris S Burrows
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, UK.,Laboratory Animal Services, University of Sydney, Australia
| | - Juliet C Duncan
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, UK
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Evaluation of the Two-Point Ultrasound-Guided Transversus Abdominis Plane Block for Laparoscopic Canine Ovariectomy. Animals (Basel) 2022; 12:ani12243556. [PMID: 36552477 PMCID: PMC9774418 DOI: 10.3390/ani12243556] [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: 11/18/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
The transversus abdominis plane (TAP) block causes desensitization of the abdominal wall and peritoneum. Of all the approaches proposed to perform it, the two-injection-point TAP showed the best results in terms of the area reached by the anesthetic solution. However, to date, no clinical data exist. The aim of this study was to evaluate the intra- and postoperative analgesic efficacy of a two-injection-point TAP block in dogs undergoing laparoscopic ovariectomy. A total of 26 animals were assigned to receive general inhalation anesthesia (control group), and 26 dogs were assigned to general inhalation anesthesia combined with TAP block (TAP group). The ultrasound-guided TAP block was carried out with a subcostal and cranial-to-ilium injection per hemiabdomen. The end-tidal concentration of isoflurane (EtISO) was recorded at different moments during the surgery. Postoperative pain was assessed at different time points during the first 24 h after surgery. The control group required significantly higher EtISO concentration during the ovarian resection and showed higher postoperative pain scores than the TAP group. Fewer dogs in the TAP group required intra- or postoperative rescue analgesia. TAP block can be implemented to improve postoperative pain management after laparoscopy, reducing the dosage of the systemic drugs used and, hence, their possible side effects.
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Gavet M, Conde Ruiz C. Partial intravenous anaesthesia and opioid‐sparing analgesia in a dog undergoing surgical management of insulinoma. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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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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An Anatomical, Sonographic, and Computed Tomography Study of the Transversus Abdominis Plane Block in Cat Cadavers. Animals (Basel) 2022; 12:ani12192674. [PMID: 36230415 PMCID: PMC9559481 DOI: 10.3390/ani12192674] [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] [Received: 09/06/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 11/17/2022] Open
Abstract
This study compared the distribution of a bupivacaine-iopamidol-dye solution following ultrasound-guided in-plane TAP injection using a 1-point (TAP-L) or 2-point (TAP-SL) approach in cat cadavers. Two cadavers were used to study the TAP sonoanatomy while eight cadavers were enrolled in a randomized, prospective, blinded investigation. Each cat randomly received a TAP-L with 0.5 mL/kg in one hemiabdomen and a TAP-SL with 0.25 mL/kg/point in the contralateral hemiabdomen. After injection, computed tomography and dissection were performed to assess contrast distribution and number of stained target nerves. TAP-SL resulted in a wider contrast spread (mm) compared with TAP-L (87 ± 7 versus 71 ± 9; p = 0.002). The prevalence of nerve staining was higher using TAP-SL than TAP-L (p = 0.001). The ventral branches of T10, T11, T12, T13, L1 and L2 were stained in 2/8, 2/8, 5/8, 7/8, 4/8 and 1/8, and in 7/8, 7/8, 8/8, 8/8, 8/8 and 1/8 using TAP-L and TAP-SL approaches, respectively. Computed tomography and dissection identified minimal injectate intraperitoneally or within the falciform ligament fat following 1 TAP-L and 2 TAP-SL. Ultrasound-guided TAP-SL provided better injectate distribution around the thoracolumbar spinal nerve branches than TAP-L.
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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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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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Garbin M, Benito J, Ruel HLM, Watanabe R, Monteiro BP, Cagnardi P, Steagall PV. Pharmacokinetics of Bupivacaine Following Administration by an Ultrasound-Guided Transversus Abdominis Plane Block in Cats Undergoing Ovariohysterectomy. Pharmaceutics 2022; 14:pharmaceutics14081548. [PMID: 35893804 PMCID: PMC9331386 DOI: 10.3390/pharmaceutics14081548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/19/2022] [Accepted: 07/19/2022] [Indexed: 02/06/2023] Open
Abstract
Bupivacaine is commonly used for peripheral nerve block in veterinary medicine. This study described the pharmacokinetics of two doses of bupivacaine following administration by an ultrasound-guided transversus abdominis plane (TAP) block in cats undergoing ovariohysterectomy. Twelve healthy female adult cats were included in a randomized, prospective, blinded clinical trial. Anaesthetic protocol included acepromazine–buprenorphine–propofol–isoflurane–meloxicam. Each cat received 1 mL/kg of bupivacaine 0.2% or 0.25% (BUPI-2 and BUPI-2.5, respectively) via bilateral two-point TAP block before surgery (n = 6/group). Plasma concentrations of bupivacaine were detected using liquid chromatography-mass spectrometry. A one-compartment model and non-compartmental analysis described the pharmacokinetic parameters. Bupivacaine was detected up to 480 min (335 ± 76 in BUPI-2 and 485 ± 198 ng/mL in BUPI-2.5). For BUPI-2 and BUPI-2.5, maximum plasma concentrations were 1166 ± 511 and 1810 ± 536 ng/mL at 33 ± 14 and 47 ± 22 min, clearance was 5.3 ± 1.8 and 4.9 ± 1.5 mL/min/kg, and elimination half-life were 253 ± 55 and 217 ± 52 min, respectively. The two doses of bupivacaine via TAP block produced concentrations below toxic levels in cats. A dose of 2.5 mg/kg bupivacaine was safe to be administered using this block in healthy cats.
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Affiliation(s)
- Marta Garbin
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.G.); (J.B.); (H.L.M.R.); (R.W.); or (B.P.M.)
| | - Javier Benito
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.G.); (J.B.); (H.L.M.R.); (R.W.); or (B.P.M.)
| | - Hélène L. M. Ruel
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.G.); (J.B.); (H.L.M.R.); (R.W.); or (B.P.M.)
| | - Ryota Watanabe
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.G.); (J.B.); (H.L.M.R.); (R.W.); or (B.P.M.)
| | - Beatriz P. Monteiro
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.G.); (J.B.); (H.L.M.R.); (R.W.); or (B.P.M.)
| | - Petra Cagnardi
- Department of Veterinary Medicine and Animal Sciences, University of Milan, 26900 Lodi, Italy;
| | - Paulo V. Steagall
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (M.G.); (J.B.); (H.L.M.R.); (R.W.); or (B.P.M.)
- Department of Veterinary Clinical Sciences and Centre Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
- Correspondence:
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Ferreira TH, Schroeder CA, St James M, Hershberger-Braker KL. Description of an ultrasound-guided rectus sheath block injection technique and the spread of dye in calf cadavers. Vet Anaesth Analg 2022; 49:203-209. [PMID: 35067478 DOI: 10.1016/j.vaa.2021.12.006] [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: 11/18/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To describe an ultrasound-guided rectus sheath (RS) block technique in calves with injections of methylene blue and assess the extent of injectate spread and nerve staining in calf cadavers. STUDY DESIGN Prospective, experimental, blinded cadaveric study. ANIMALS A total of 16 calf cadavers weighing 30.7 ± 7.1 kg. METHODS Using an ultrasound-guided, in-plane technique, each cadaver was injected with both a low (LV; 0.25 mL kg-1) and high (HV; 0.5 mL kg-1) volume of methylene blue dye. Volumes were randomly assigned to the left or right hemiabdomen. Ultrasound imaging was scored based on landmarks and needle visualization, and duration to perform injections were assessed. Dissections were performed immediately after injections. Staining of ventral branches of spinal nerves and the extent of dye spread were recorded by an anatomist unaware of treatment allocation. RESULTS The number of nerves stained in treatments LV and HV were 2.3 ± 1.7 and 4.4 ± 1.3, respectively (p = 0.0001). Branches of thoracic nerves T7-13 and lumbar nerves L1-2 were completely stained 6.3%, 6.3%, 31.3%, 62.5%, 56.3%, 37.5%, 31.3%, 6.3% and 0%, respectively, in treatment LV and 0%, 12.5%, 50%, 93.8%, 100%, 93.8%, 62.5%, 25% and 6.3%, respectively, in treatment HV. Ultrasound imaging was scored excellent in most cadavers and needle visualization deemed excellent in all injections. The mean duration to perform RS injections in both treatments was 2 (range, 1-6) minutes. CONCLUSIONS AND CLINICAL RELEVANCE Nerve staining results from treatment HV suggest that this RS injection technique could be clinically useful in ventral midline surgical procedures, including umbilical procedures, in calves. This study supports future clinical trials in calves.
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Affiliation(s)
- Tatiana H Ferreira
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.
| | - Carrie A Schroeder
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Mariko St James
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Karen L Hershberger-Braker
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA; Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
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Filipas M, Riggs J, Self I. Intraoperative management of acute portal hypertension during liver lobectomy in a dog. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Malina Filipas
- Department of Veterinary Medicine University of Cambridge Cambridge UK
| | - Julia Riggs
- Department of Veterinary Medicine University of Cambridge Cambridge UK
| | - Ian Self
- Department of Veterinary Medicine University of Cambridge Cambridge UK
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Ultrasound-Guided Lateral Transversus Abdominis Plane (TAP) Block in Rabbits: A Cadaveric Study. Animals (Basel) 2021; 11:ani11071953. [PMID: 34208857 PMCID: PMC8300137 DOI: 10.3390/ani11071953] [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] [Received: 05/10/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 11/17/2022] Open
Abstract
The aims of the study were to describe the ultrasonographic-guided lateral TAP block in rabbit cadavers and evaluate the spread of a lidocaine/methylene blue solution through a single fascial infiltration. The US-guided block and anatomical dissections were performed in 17 New Zealand rabbit cadavers. The probe was placed perpendicular to the column, one centimetre ventrally to the transverse processes, halfway between the iliac crest and the costal margin. External oblique (EO), internal oblique (IO), and transversus abdominis (TA) muscles were visualised, and 1 mL/kg of lidocaine 2% plus methylene blue 1% was injected. After dissection, the branches of spinal nerves stained were measured. Moreover, the percentage of length and height of the area marked were calculated. A good visualisation of the TAP was obtained in all 34 hemiabdomens. T11 nerve eminence was successfully stained in 52% of cases. T12, L1, and L2 were stained in 75%, 95%, and 100% of cases, respectively. L3 and L4 were stained in 60% and 40% of cases, respectively. The lateral TAP block with a single point of injection can be easily performed in rabbits, but it is not sufficient to cover the nerve eminences of the cranial abdomen. The two-point TAP block (lateral and subcostal) could represent a better option, particularly when large surgical incisions are required.
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Harfoush M, Wilson D, Kim SY, Claude A. Open approach to the ventral transversus abdominis plane in the dog: evaluation and injectate dispersion in cadavers. Vet Anaesth Analg 2021; 48:767-774. [PMID: 34281772 DOI: 10.1016/j.vaa.2021.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate a direct intra-abdominal approach to injection of the ventral transversus abdominis plane (TAP) and compare the dispersion of two volumes of injectate. STUDY DESIGN Prospective anatomic and feasibility study. ANIMALS A total of 10 canine cadavers weighing 9 ± 4 kg. METHODS A ventral incision was made extending through the linea alba, from the umbilicus and extending 5 cm caudally. A single injection of an isovolumic mixture of iopamidol and new methylene blue was performed with a hypodermic needle placed within the TAP of each hemiabdomen, alternating between 0.5 mL kg-1 in low-volume group (LV) and 1 mL kg-1 in high-volume group (HV). Surgical staples marked the incision. Computed tomography and three-dimensional reconstruction of the tomographic images evaluated the dimensions, cranial and caudal spread beyond the incision and the total area of the injectate. Dissection determined the extent of nerve staining within the TAP adjacent to the abdominal incision. Wilcoxon signed rank (stain) or paired t test was used to compare variables between groups. Data are reported as mean ± standard deviation or median (range). RESULTS Injectate spread was within the ventral TAP. Length of spread was 2.5 ± 1.6 cm greater in group HV than in group LV. There was a strong positive correlation between the surface area (p = 0.02, r = 0.71) and cranial-caudal spread of injectate (p = 0.041, r = 0.65) with volume. All but two LV injections were associated with staining of all nerves adjacent to the incision. Additional nerves caudal to the incision were stained in group HV (p = 0.02). CONCLUSIONS This approach to the TAP was easily performed, with volume of injectate positively influencing distribution. CLINICAL RELEVANCE This technique is easily applied and future prospective studies are warranted to determine its analgesic efficacy.
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Affiliation(s)
- Muhammad Harfoush
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.
| | - Deborah Wilson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Sun Young Kim
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Andrew Claude
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
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Otero PE, Romano M, Zaccagnini AS, Fuensalida SE, Verdier N, Sanchez F, Portela DA. Transversus abdominis plane block in cat cadavers: anatomical description and comparison of injectate spread using two- and three-point approaches. Vet Anaesth Analg 2021; 48:432-441. [PMID: 33745824 DOI: 10.1016/j.vaa.2021.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/02/2021] [Accepted: 02/20/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To describe the sonoanatomy of the abdominal wall in live cats and to compare the distribution pattern of two versus three ultrasound-guided transversus abdominis plane (TAP) injections using clinically applicable volumes of lidocaine-dye solution in cat cadavers. STUDY DESIGN Prospective anatomical study. ANIMALS A total of eight client-owned healthy cats and eight cat cadavers. METHODS Ultrasound anatomy of the abdominal wall, landmarks and sites for needle access were determined in live cats. Ultrasound-guided TAP injections were performed in eight thawed cat cadavers. Volumes of 0.25 or 0.16 mL kg-1 per point of a lidocaine-dye solution were injected using either two [subcostal and preiliac (SP)] or three [subcostal, retrocostal and preiliac (SRP)] injection points, respectively. Each cadaver was then dissected to determine the injectate distribution and the number of thoracolumbar nerves stained with each approach. The target nerves were defined as the ventromedial branches of the thoracic nerves 10 (T10), T11, T12, T13 and lumbar nerves 1 (L1) and L2. RESULTS Sonoanatomy was consistent with anatomy upon dissection and the TAP was identified in all cadavers. A total of 16 subcostal, 16 preiliac and nine retrocostal TAP injections were performed. The overall staining success rate of the target nerves was 66.7% and 92.6% for the SP and SPR approaches, respectively (p = 0.02). The ventromedial branches of T10, T11, T12, T13, L1 and L2 were stained in 57.1%, 100.0%, 85.7%, 28.6%, 42.9% and 85.7%, and in 66.7%, 100.0%, 100.0%, 100.0%, 88.9% and 100.0% of the cases with the SP and SRP approaches, respectively. CONCLUSIONS AND CLINICAL RELEVANCE The SRP approach allowed a broader distribution around the target nerves, whereas a staining gap was observed at T13 and L1 with the SP approach. Further studies are necessary to investigate the analgesic effect of these approaches in a clinical setting.
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Affiliation(s)
- Pablo E Otero
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina.
| | - Marta Romano
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Andrea S Zaccagnini
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Santiago E Fuensalida
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Natali Verdier
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina; Department of Anesthesiology and Perioperative Intensive Care, University of Veterinary Medicine, Vienna, Austria
| | - Fernanda Sanchez
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
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