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Irving W, Annear M, Whittaker C, Caruso K, Reynolds B, McCarthy P, Smith J. Effect of dexmedetomidine added to retrobulbar blockade with lignocaine and bupivacaine in dogs undergoing enucleation surgery. Vet Ophthalmol 2024; 27:148-157. [PMID: 37418492 DOI: 10.1111/vop.13130] [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: 01/22/2023] [Revised: 06/12/2023] [Accepted: 06/29/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVE To investigate the effect of the addition of dexmedetomidine (BLD) to retrobulbar blockade with combined lignocaine and bupivacaine on nociception. ANIMALS A total of 17 eyes from 15 dogs. METHODS Prospective, randomized, masked clinical comparison study. Dogs undergoing unilateral enucleation were randomly assigned into two groups; a retrobulbar administration of lignocaine and bupivacaine in a 1:2 volume ratio combined with either BLD or 0.9% saline (BLS). The total volume of the intraconal injection was calculated at 0.1 mL/cm cranial length. Intraoperative parameters were recorded: heart rate (HR), respiratory rate (RR), end-tidal CO2 (EtCO2 ) arterial blood pressure (BP), and inspired isoflurane concentration (ISOinsp). Pain scores, heart rate and RR were recorded postoperatively. RESULTS Dogs receiving BLD (n = 8) had significantly lower intraoperative RR (p = 0.007), and significantly lower ISOinsp (p = 0.037) than dogs in the BLS group (n = 9). Postoperatively heart rate was significantly lower in the BLD group at 1 min (p = 0.025) and 1 h (p = 0.022). There were no other significant differences in intraoperative or postoperative parameters, or in postoperative pain scores (p = 0.354). Dogs receiving BLD had a higher rate of anesthetic events of bradycardia and hypertension (p = 0.027). Analgesic rescue was not needed in either group. CONCLUSIONS The addition of BLD to retrobulbar anesthesia did not result in a detectable difference in pain scores relative to blockade with lignocaine and bupivacaine alone. Dogs receiving retrobulbar BLD had a significantly lower intraoperative RR and isoflurane requirement and an increased incidence of intraoperative bradycardia and hypertension.
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Affiliation(s)
- William Irving
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - Matthew Annear
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | | | - Kelly Caruso
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | | | - Paul McCarthy
- Eye Clinic for Animals, Sydney, New South Wales, Australia
| | - Jeff Smith
- Eye Clinic for Animals, Sydney, New South Wales, Australia
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2
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Lenihan E, Baines SJ, Linn-Pearl RN, Grundon RA, Carrozza R, Stevens EJ, Heinrich CL, Walsh K. Estimation of the intraoperative blood loss in dogs undergoing enucleation. Vet Ophthalmol 2023; 26:19-30. [PMID: 36322454 DOI: 10.1111/vop.13035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/07/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To quantify the surgical blood loss during canine enucleation and to investigate the relationship between this and any patient, surgical, and anesthetic factors. METHODS A prospective observational analysis was conducted on 121 client-owned dogs (130 eyes) undergoing enucleation at a referral ophthalmology clinic. Blood loss was estimated by the gravimetric method (weight difference between dry and blood-containing surgical materials) to provide absolute blood loss (ABL) in milliliters, expressed as a percentage of circulating blood volume, to establish relative blood loss (RBL). RESULTS Median ABL was 12 ml (1.6-116 ml), and median RBL was 1.3% (0.1%-6.7%). A higher RBL was associated with the following: use of a bupivacaine splash block versus retrobulbar nerve block (1.9 vs. 1%; p < .001), transpalpebral versus subconjunctival approach (2.2 vs. 1.3%; p = .003), and small versus large breed dogs (1.7% vs. 1.1%; p = .001). Both ABL and RBL differed significantly between surgeons. There was no significant difference in hemorrhage associated with the presence of ocular hypertension, systemic illness, surgical time, administration of meloxicam or choice of pre-medicant (acepromazine vs medetomidine). No dog required supportive intervention in response to surgical hemorrhage. CONCLUSIONS This study has established a surgical blood loss estimate for dogs undergoing enucleation at an ophthalmology referral centre. Subconjunctival enucleation may be preferred for patients at greater risk of haemodynamic complications.
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Thieme K, Mesquita L, Lieberth S, Dancker C, Doherr MG, Eule JC. Safety and accuracy of blind vs. ultrasound‐guided dorsal retrobulbar nerve blocks in horses—A cadaveric study. Vet Ophthalmol 2022; 26:135-144. [PMID: 36536509 DOI: 10.1111/vop.13053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE There is limited knowledge regarding the safety and accuracy of ultrasound-guided retrobulbar nerve blocks in horses. The aim of this study was to compare these parameters between blind and ultrasound-guided injection techniques for the dorsal retrobulbar nerve block in horses. METHODS Equine cadaver heads were used to inject the retrobulbar space with contrast medium (CM). Injections were performed either blindly based on anatomic landmarks (blind group, n = 44) or under ultrasonographic guidance (US-group, n = 44), equally divided between an experienced and unexperienced operator. Needle position and distribution of CM were assessed with computed tomography imaging and evaluated by a board-certified veterinary diagnostic imager blinded to the technique. Safety and accuracy of both techniques were compared. RESULTS Ocular penetration was observed in two cases (n = 2/44) in the blind group but not in the US group (n = 0/44). No intrathecal, intraneural, or intravascular injections were seen in either group. Safety was significantly improved in the US group (p = .026). There was no statistically significant difference between the groups regarding the accuracy of the injection. Excellent accuracy was achieved more often with the ultrasound-guided technique (n = 11/22) than with the blind technique (n = 7/22) when performed by the unexperienced operator, but this difference was not statistically significant. CONCLUSION To prevent globe-threatening complications and improve the safety of the injection, we recommend using the ultrasound-guided injection technique for the dorsal retrobulbar nerve block.
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Affiliation(s)
- Katharina Thieme
- Small Animal Clinic Freie Universität Berlin Berlin Germany
- Equine Clinic, Surgery and Radiology Freie Universität Berlin Berlin Germany
| | - Luis Mesquita
- Radiology Department Willows Veterinary Centre and Referral Service Solihull UK
| | - Simona Lieberth
- Equine Clinic, Surgery and Radiology Freie Universität Berlin Berlin Germany
| | | | - Marcus Georg Doherr
- Institute for Veterinary Epidemiology and Biostatistics Freie Universität Berlin Berlin Germany
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Scott EM, Vallone LV, Olson NL, Han G, Loria Lepiz MA, Simon BT. Analgesic effects of a retrobulbar block with 0.75% ropivacaine in dogs undergoing enucleation. Vet Anaesth Analg 2021; 48:749-758. [PMID: 34144876 DOI: 10.1016/j.vaa.2021.04.006] [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: 09/07/2020] [Revised: 04/20/2021] [Accepted: 04/24/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the analgesic effects of a retrobulbar block with ropivacaine in dogs undergoing enucleation. STUDY DESIGN Prospective, randomized, masked placebo-controlled trial. ANIMALS A total of 23 client-owned dogs. METHODS Dogs were randomized to be administered a preoperative inferior-temporal palpebral retrobulbar injection of either ropivacaine 0.75% (1 mL 10 kg-1; group RG) or equivalent volume of 0.9% saline (control; group CG). Intraoperative variables recorded to detect a response to noxious stimuli included heart rate (HR) and mean arterial pressure (MAP). Three observers assessed and recorded pain using a numerical rating pain scale and visual analog scale (VAS) before anesthesia (baseline) and postoperatively at 0, 0.5, 1, 2, 3, 4, 5, 6 and 24 hours after extubation. Rescue analgesia was administered if intraoperative HR or MAP increased by ≥ 20% from the previously recorded surgical time point, average postoperative pain scores totaled ≥ 9/20, scored ≥ 3/4 in any one category with VAS ≥ 35/100, or if VAS was ≥ 35/100 with a palpation score > 0/4. RESULTS Intraoperatively, there was no significant difference in HR or MAP between groups. Rescue analgesia was administered intraoperatively to four and one dogs and postoperatively to five and seven dogs in groups CG and RG, respectively, with no significant difference between groups. VAS scores were significantly lower in ropivacaine dogs at extubation (p = 0.02), but not at other postoperative time points. Adverse events were not observed in either group. CONCLUSIONS AND CLINICAL RELEVANCE Preoperative retrobulbar 0.75% ropivacaine injection (1 mL 10 kg-1) provided analgesia in dogs following enucleation at extubation; however, intraoperative and postoperative pain control did not differ from a placebo injection with saline. Lack of differences between groups may have been influenced by sample size limitations.
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Affiliation(s)
- Erin M Scott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA.
| | - Lucien V Vallone
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Natalie L Olson
- Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Gang Han
- Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Mauricio A Loria Lepiz
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Bradley T Simon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
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Ali HM, Elbadawy AM. Comparative Study of Retrobulbar Block versus Ketamine Infusion during Eye Enucleation/Evisceration (Randomized Controlled Trial). Anesth Essays Res 2020; 14:92-99. [PMID: 32843800 PMCID: PMC7428106 DOI: 10.4103/aer.aer_146_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/02/2020] [Accepted: 01/07/2020] [Indexed: 11/04/2022] Open
Abstract
Background The aim of this study is to compare the safety and efficacy of retrobulbar block versus intraoperative ketamine infusion in eye enucleation or evisceration under general anesthesia. Materials and Methods Forty-five patients belonging to American Society of Anesthesiologists Physical Status I and II undergoing eye enucleation or evisceration were randomly allocated to three equal groups (15 patients each). General anesthesia was used as the standardized technique in all patients. Group R received a single retrobulbar injection, Group K received intravenous ketamine infusion, and Group C received normal saline with the same rate of ketamine infusion. Intraoperative heart rate and mean arterial pressure, recovery time, postoperative pain score, time to first rescue analgesic, number of patients who required rescue analgesia, and any adverse events were reported. Results Postoperative pain Visual Analog Scale was significantly lower in R and K groups in comparison to the C group and was significantly higher in K than R group at 3, 6, 12, and 24 h. In addition, the time to first rescue analgesic was significantly longer in R group (429 ± 54 min) than that in K group (272 ± 34 min), but compared to both groups, it was longer in C group (52 ± 7 min). In K group, the recovery time was longer with higher sedation score in comparison to the other two groups. Conclusions Single retrobulbar injection and low-dose ketamine infusion are safe and effective when used as adjuvants to general anesthesia, but retrobulbar block provides better control of postoperative pain with prolonged time to first rescue analgesic and reduced analgesic consumption.
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Affiliation(s)
- Hassan Mohamed Ali
- Department of Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt
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Zibura AE, Salmon JH, Belda Lopez B, X Lascelles BD, Westermeyer HD. Glaucoma-associated pain results in mechanical sensitivity changes in dogs: A pilot study. Vet Ophthalmol 2020; 24 Suppl 1:116-124. [PMID: 32608141 DOI: 10.1111/vop.12800] [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: 04/22/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To explore the effects of chronic, uncontrolled glaucoma on pressure sensitivity in dogs before and after enucleation of the painful globe. METHODS Client-owned dogs undergoing enucleation for chronic glaucoma with no other sources of pain were enrolled. Normal dogs of similar breeds and skull morphology were enrolled as controls. Craniofacial ratio (CFR) and relative palpebral fissure width (RPFW) were assessed in all patients. Serial mechanical quantitative sensory testing (QST) was performed the day before surgery, and 14, 30, 60, and 120 days after surgery. QST consisted of electronic Von Frey (eVF), and blunt algometry (BA) performed above and below the nonglaucomatous eye, the metacarpus, and metatarsus. Cochet-Bonnet esthesiometry (CB) was also performed on the remaining eye. RESULTS Twelve dogs (6 per group) were included. Compared to baseline values, sensitivity tended to decrease over time (increased thresholds) in treatment dogs while it stayed constant or increased slightly in control dogs. The difference in change from baseline sensitivity between control and treatment groups was significant at day 120 using BA at supraorbital (P = .0153), infraorbital (P = .0209), and metacarpal sites (P = .007) and overall (P = .0470). This divergence was also significant using CB (P = .0470) on the opposite cornea. As patient CFR and RPFWV increased, both eVF (P = .005-.023) and BA (P = .004-.041) increased. CONCLUSIONS Sensitivity to mechanical stimuli decreased both locally and at remote sites in dogs following enucleation for painful chronic glaucoma. Cranial conformation is associated with differences in sensitivity.
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Affiliation(s)
- Ashley E Zibura
- Comparative Ophthalmology, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Jacklyn H Salmon
- Comparative Ophthalmology, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Beatriz Belda Lopez
- Small Animal Surgery, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.,Translational Research in Pain Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - B Duncan X Lascelles
- Small Animal Surgery, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.,Translational Research in Pain Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.,Comparative Pain Research and Education Center, North Carolina State University, Raleigh, NC, USA
| | - Hans D Westermeyer
- Comparative Ophthalmology, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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Shilo-Benjamini Y, Slav SA, Kahane N, Kushnir Y, Sarfaty H, Ofri R. Analgesic effects of intraorbital insertion of an absorbable gelatin hemostatic sponge soaked with 1% ropivacaine solution following enucleation in dogs. J Am Vet Med Assoc 2020; 255:1255-1262. [PMID: 31730436 DOI: 10.2460/javma.255.11.1255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate analgesic effects and complications associated with intraorbital insertion of an absorbable gelatin hemostatic sponge (AGHS) soaked with 1% ropivacaine solution following enucleation in dogs. ANIMALS 20 client-owned dogs undergoing enucleation. PROCEDURES Dogs were randomly assigned to receive an AGHS soaked with 1% ropivacaine solution (n = 10) or saline (0.9% NaCl) solution (control group; 10) inserted intraorbitally prior to skin closure following enucleation. Carprofen (2 mg/kg [0.9 mg/lb]) was administered SC once after orotracheal extubation and then PO twice a day for 5 days. During the postoperative recovery period, apparent pain level was scored at various points with a modified short-form Glasgow Composite Pain Scale (score range, 0 to 19), and methadone was administered for rescue analgesia if any score was ≥ 5. After dogs returned home, owners recorded their behavior and apparent pain level for the first 3 days following enucleation. RESULTS At extubation, the median (range) pain score was significantly higher in the control group (8 [2 to 14]) versus the ropivacaine group (3 [1 to 7]). A greater proportion of dogs in the control group received methadone (7/10 vs 1/10) and had crying or attention-seeking behavior on the first day following enucleation (7/10 vs 1/10). No complications were observed in either group. CONCLUSIONS AND CLINICAL RELEVANCE Addition of intraorbital insertion of a ropivacaine-soaked AGHS to the analgesic protocol for dogs undergoing enucleation provided better analgesia than was achieved without this treatment as measured immediately and the first day after surgery, with no noted adverse effects.
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8
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Bartholomew KJ, Smith LJ, Bentley E, Lasarev MR. Retrospective analysis of complications associated with retrobulbar bupivacaine in dogs undergoing enucleation surgery. Vet Anaesth Analg 2020; 47:588-594. [PMID: 32653165 DOI: 10.1016/j.vaa.2020.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate complications associated with, and without, bupivacaine retrobulbar local anesthesia in dogs undergoing unilateral enucleation surgery. STUDY DESIGN Retrospective, observational study. ANIMALS A total of 167 dogs underwent unilateral enucleation surgery via a transpalpebral approach. METHODS Records from 167 dogs that underwent unilateral enucleation surgery that did (RB) or did not (NB) include retrobulbar bupivacaine anesthesia were reviewed, including anesthetic record, daily physical examination records, surgery report, patient discharge report and patient notes within 14 days of the surgery. Specific complications and severity were compared between RB and NB using the Wilcoxon rank-sum test. A 'complication burden' (0-5) comprising five prespecified complications was assigned and tested using rank-sum procedures. Statistical significance was set to 0.05. RESULTS Group RB included 97 dogs and group NB 70 dogs. Dogs in NB had a 17.0 percentage points (points) greater risk for a postoperative recovery complication (38.6% versus 21.6%; 95% confidence interval: 3.0-30.6 points; p = 0.017). There was inconclusive evidence that dogs in group RB had a lower risk of requiring perioperative anticholinergic administration (12.4% versus 22.9%; 10.5 points; p = 0.073). Other complications were similar between groups RB and NB with risks that differed by <10 points. The risk of hemorrhage was similar between groups RB (22.7%) and NB (20.0%) with no significant difference in the level of severity (p = 0.664). CONCLUSIONS AND CLINICAL RELEVANCE In this retrospective study, the use of retrobulbar bupivacaine for enucleation surgery in dogs was not associated with an increased risk of major or minor complications.
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Affiliation(s)
- Kyle J Bartholomew
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin - Madison, Madison, WI, USA
| | - Lesley J Smith
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin - Madison, Madison, WI, USA.
| | - Ellison Bentley
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin - Madison, Madison, WI, USA
| | - Michael R Lasarev
- Department of Biostatistics and Medical Informatics, University of Wisconsin - Madison, Madison, WI, USA
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Zibura AE, Posner LP, Ru H, Westermeyer HD. A preoperative bupivacaine retrobulbar block offers superior antinociception compared with an intraoperative splash block in dogs undergoing enucleation. Vet Ophthalmol 2019; 23:225-233. [PMID: 31566883 DOI: 10.1111/vop.12708] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Investigate nociception differences in dogs undergoing enucleation administered bupivacaine either via preoperative retrobulbar block (pRB) or intraoperative splash block (iSB). METHODS Prospective, randomized, double-masked, clinical comparison study. Dogs undergoing unilateral enucleation were randomized to two groups: one received bupivacaine pRB and saline iSB of the same volume, and the other received saline pRB and bupivacaine iSB. The following intraoperative parameters were recorded: heart rate (HR), respiratory rate (RR), end-tidal CO2 (EtCO2 ); systolic, mean, and diastolic arterial blood pressure (SAP, MAP, and DAP respectively); inspired end-tidal isoflurane concentration (EtISOIns), and expired end-tidal isoflurane concentration (EtISOExp). Pain scores were recorded pre- and postoperatively. Analgesic rescue was documented. Surgical hemorrhage and postoperative bruising and swelling were graded subjectively by the surgeon (HDW) and study coordinator (AEZ). RESULTS A significant (P = .0399) increase from baseline in overall mean heart rate was recorded in iSB bupivacaine patients (n = 11) compared with pRB bupivacaine patients (n = 11), with no significant differences in other intraoperative physiologic parameters, or pain scores. More analgesic rescue events occurred in iSB bupivacaine patients compared to pRB bupivacaine patients. A near-significant increase in intraoperative bleeding (P = .0519), and a significant increase in bruising (P = .0382) and swelling (P = .0223) was noted in the iSB bupivacaine group. CONCLUSIONS Preoperative retrobulbar block bupivacaine is more effective than an iSB bupivacaine at controlling both intraoperative and postoperative nociception in dogs undergoing enucleation. Additionally, iSB causes more postoperative bruising and swelling and may be associated with increased intraoperative hemorrhage.
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Affiliation(s)
- Ashley E Zibura
- Comparative Ophthalmology, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Lysa P Posner
- Anesthesiology, Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Hongyu Ru
- Department of Population Health and Pathobiology, College of Veterinary Medicine, Raleigh, NC, USA
| | - Hans D Westermeyer
- Comparative Ophthalmology, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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Castejón-González AC, Reiter AM. Locoregional Anesthesia of the Head. Vet Clin North Am Small Anim Pract 2019; 49:1041-1061. [PMID: 31521406 DOI: 10.1016/j.cvsm.2019.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Locoregional (local and regional) anesthesia is used routinely during surgical procedures of the head. The goal of this article is to provide a practical guide for the clinician to safely perform different techniques in dogs and cats and to minimize the risk of complications associated with locoregional anesthesia.
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Affiliation(s)
- Ana C Castejón-González
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
| | - Alexander M Reiter
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA
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Berggren K, Wallin Håkansson N. A surgical approach for extensive orbital exenteration in dogs; a description of technique and its application in 4 cases. Vet Ophthalmol 2019; 22:238-245. [PMID: 30701695 DOI: 10.1111/vop.12583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/06/2018] [Accepted: 05/07/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe a surgical approach for preplanned orbital exenteration. ANIMALS STUDIED Indications included intraconal orbital mass lesions. Four dogs were included, 3 with neoplasia and one with retro bulbar nodular fasciitis. PROCEDURE To facilitate complete removal of lesions, exenteration was performed by a new procedure for wide access. The frontalis and temporalis muscles were elevated and retracted through a single U-shaped skin incision. Zygomatic arch osteotomy was performed, followed by a 360-degree peritomy and zygomatic process osteotomy. The eyelids were divided from each other through the lateral cantus and then folded forward to expose the globe. The orbit was exenterated by blunt and sharp dissection. Osteotomies were closed with cerclage wires, soft tissues closed and the skin wound sutured in a T-shape. RESULTS The present exenteration procedure gave excellent access to remove orbital contents flush with the optic foramen and orbital fissure. Postoperative swelling and pain were limited and healing uneventful. Two of the 3 neoplasia cases experienced tumor recurrence involving the brain at 18 and 20 months postoperatively, respectively. Both of these had optic canal or intracranial tumor extension preoperatively. Long-term complications included mild concavity of the operated side of the face. CONCLUSIONS The present approach for preplanned exenteration offers excellent access for complete removal of orbital contents to the level of the optic foramen. Complications due to the surgical method are few and limited.
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Shilo-Benjamini Y. A review of ophthalmic local and regional anesthesia in dogs and cats. Vet Anaesth Analg 2019; 46:14-27. [DOI: 10.1016/j.vaa.2018.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 10/19/2018] [Accepted: 10/20/2018] [Indexed: 12/17/2022]
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Shilo-Benjamini Y, Pascoe PJ, Maggs DJ, Hollingsworth SR, Strom AR, Good KL, Thomasy SM, Kass PH, Wisner ER. Retrobulbar vs peribulbar regional anesthesia techniques using bupivacaine in dogs. Vet Ophthalmol 2018; 22:183-191. [DOI: 10.1111/vop.12579] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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
| | - Peter J. Pascoe
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - David J. Maggs
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Steven R. Hollingsworth
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Ann R. Strom
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Kathryn L. Good
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Sara M. Thomasy
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Philip H. Kass
- Department of Population Health and Reproduction; School of Veterinary Medicine; University of California; Davis CA USA
| | - Erik R. Wisner
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
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Martel-Arquette A, Chen S, Hempstead J, Pacheco R, Antinoff N, Teixeira L. Microsporidial Keratoconjunctivitis in a Pet Bearded Dragon ( Pogona vitticeps ). J Exot Pet Med 2017. [DOI: 10.1053/j.jepm.2017.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Shilo-Benjamini Y, Pascoe PJ, Wisner ER, Kahane N, Kass PH, Maggs DJ. A comparison of retrobulbar and two peribulbar regional anesthetic techniques in dog cadavers. Vet Anaesth Analg 2017; 44:925-932. [DOI: 10.1016/j.vaa.2017.02.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/11/2017] [Accepted: 02/13/2017] [Indexed: 10/19/2022]
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16
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Chiavaccini L, Micieli F, Meomartino L, Duffee LR, Vesce G. A novel supra-temporal approach to retrobulbar anaesthesia in dogs: Preliminary study in cadavers. Vet J 2017; 223:68-70. [DOI: 10.1016/j.tvjl.2017.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/20/2017] [Accepted: 04/23/2017] [Indexed: 11/26/2022]
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17
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Comparison of two bupivacaine delivery methods to control postoperative pain after enucleation in dogs. Vet Ophthalmol 2016; 19:90. [DOI: 10.1111/vop.12334] [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]
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