Comparison of Short‐Term Postoperative Analgesia by Epidural, Femoral Nerve Block, or Combination Femoral and Sciatic Nerve Block in Dogs Undergoing Tibial Plateau Leveling Osteotomy

McCally, Ryan E.; Bukoski, Alex; Branson, Keith; Fox, D. B.; Cook, James L.

doi:10.1111/vsu.12406

Cited by 18 publications

(13 citation statements)

References 16 publications

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“…Regardless of the particular technique that is used, the nerve blocks can be used as either the principal anesthetic or, more commonly, as adjuncts to general anesthesia [ 1 – 4 , 9 , 17 , 20 , 21 ]. If a local anesthetic of sufficient duration is selected, nerve conduction blockade has the potential to provide substantial post-operative pain relief as well [ 1 – 3 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Initial studies reported the anatomical considerations for blocking the two main nerves, the FN and the ScN, at different locations along their courses while subsequent studies described the volume of dye that is required to stain a desired length of target nerve in cadaver specimens and the technical aspects of using ultrasound and/or nerve stimulation to perform these peripheral nerve blocks [ 5 , 6 , 10 , 11 ]. Clinical studies have documented the effects of different FN and ScN blocks on intraoperative analgesia, recovery quality, and the incidence of side effects and complications related to their use for surgical procedures of the pelvic limb [ 1 , 2 , 3 , 4 , 9 , 17 , 20 , 21 ]. Based on these clinical studies in dogs, advantages of using PNBs over neuraxial or opioid-based methods of perioperative pain control include decreased inhaled anesthetic requirements, better maintenance of blood pressure during anesthesia, smoother recoveries from anesthesia, less post-operative urinary retention, and equivalent or superior postoperative analgesia.…”

Section: Introductionmentioning

confidence: 99%

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Blood concentration of bupivacaine and duration of sensory and motor block following ultrasound-guided femoral and sciatic nerve blocks in dogs

Cathasaigh¹,

Read²,

Atilla³

et al. 2018

PLoS ONE

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Peripheral nerve blocks are becoming increasingly popular for perioperative use as anesthetics and analgesics in small animals. This prospective study was performed to investigate the duration of motor and sensory blockade following use of bupivacaine for ultrasound-guided femoral and sciatic nerve blocks in dogs and to measure the plasma concentrations of bupivacaine that result from these procedures. Six dogs were anesthetized twice using a randomized cross-over design. At the first anesthetic, dogs were assigned to receive either an ultrasound-guided femoral nerve block or sciatic nerve block with 0.15 mL kg-1 of bupivacaine 0.5%. Two months later, the other nerve block was performed during a second anesthetic. At 5, 10, 15, 20, 30 and 60 minutes after injection, arterial blood samples were collected for laboratory measurement of bupivacaine. After 60 minutes, dogs were recovered from anesthesia. Starting at two hours post-injection, video-recordings of the dogs were made every two hours for 24 hours. The videos were randomized and the degree of motor and sensory blockade was evaluated using a three-point scoring system (0 = no effect, 1 = mild effect, 2 = complete blockade) by two blinded assessors. The median (range) times to full recovery from motor blockade were 11 (6–14) hours (femoral) and 12 (4–18) hours (sciatic), and 15 (10–18) hours (femoral) and 10 (4–12) hours (sciatic) for sensory blockade. There were no differences in the median times to functional recovery for the two techniques. Plasma concentrations of bupivacaine were no different following the blocks and were less than 0.78 μg mL-1 at all times. These results suggest that these ultrasound-guided nerve blocks do not result in potentially toxic systemic levels of local anesthetic and that their duration of action is useful for providing anesthesia and analgesia for pelvic limb procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Blood concentration of bupivacaine and duration of sensory and motor block following ultrasound-guided femoral and sciatic nerve blocks in dogs

Cathasaigh¹,

Read²,

Atilla³

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

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“…Perineural sciatic-femoral block and spinal or epidural injection are widely used preemptive analgesia methods in canine stifle surgery and human knee arthroplasty. 11,[35][36][37][38][39] Both methods are seen as equivalently good in preventing perioperative pain. 36,38 We did not find any of these perioperative analgesia methods superior to another.…”

Section: Discussionmentioning

confidence: 99%

“…11,[35][36][37][38][39] Both methods are seen as equivalently good in preventing perioperative pain. 36,38 We did not find any of these perioperative analgesia methods superior to another. Previous authors reported that fentanyl rescue analgesia was administered in 13.3% and 6.7% of TPLO cases after a sciatic-femoral and spinal or epidural injection, respectively.…”

Section: Discussionmentioning

confidence: 99%

The influence of the choice of preemptive analgesia on long‐term postsurgical pain after tibial plateau leveling osteotomy in dogs

et al. 2020

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Objective: To evaluate the prevalence of chronic postsurgical pain (CPSP) after tibial plateau leveling osteotomy (TPLO) in dogs and to determine the influence of preemptive locoregional analgesia on CPSP. Study design: Retrospective study. Animals: One hundred twenty client-owned dogs. Methods: Medical records of dogs that underwent TPLO between 2012 and 2016 were reviewed for demographic information and type of preemptive analgesia. Owners were contacted to retrospectively assess the quality of life of their dogs by using the Helsinki Chronic Pain Index (HCPI) before and 6 months after surgery and at the time of questioning. An HCPI score > 12 was considered indicative of CPSP. Medical records were reviewed for demographic information and type of preemptive analgesia. A cumulative logit model was used to assess correlation of type of perioperative analgesia, HCPI, and demographic data. Results: The HCPI score was consistent with CPSP in 41 of 101 dogs with long-term follow-up (2.9 ± 1.5 years after surgery). Chronic postsurgical pain was documented in 11 of 32 and 13 of 28 dogs that received a spinal or epidural injection, respectively, or in 28 of 80 and 25 of 67 dogs with sciatic-femoral block at 6 months or with long-term follow-up after TPLO, respectively (P > .05). A negative correlation was found between HCPI and both weight and age 6 months after surgery. Only weight remained negatively correlated 2.9 years after surgery. Conclusion: Forty-one percent of dogs that were evaluated exhibited HCPI values compatible with CPSP long-term after TPLO, regardless of the type of preemptive analgesia. Increased body weight was a negative prognostic factor for CPSP development. Clinical significance: Additional studies are required to evaluate CPSP development after TPLO.

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“…Sciatic/femoral block (McCally, Bukoski, Branson, Fox, & Cook, 2015;Caniglia et al, 2012;Campoy, Martin-Flores, Ludders, Erb, & Gleed, 2012;Gurney & Leece, 2014) Box 22 and Figure 11. Tissues/area desensitized: Used together, these blocks will desensitize structures of the rear limb from the distal femur through the digits.…”

Section: Other Blocks Of the Pelvic Limbsmentioning

confidence: 99%

Local and regional anaesthesia in dogs and cats: Descriptions of specific local and regional techniques (Part 2)

Grubb

Lobprise

2020

Veterinary Medicine & Sci

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Pain management in veterinary patients is a crucial component of appropriate patient care. Local anaesthetic drugs used in local and regional blockade can completely block the transmission of nociceptive impulses, decreasing both intra-operative nociception and postoperative pain, while decreasing the potential incidence of adverse effects that can be associated with systemic boluses of drugs. For efficacy and safety, this class of drugs is recommended as part of the analgesic protocol in the majority of surgical procedures and traumatic injuries. Numerous local and regional blocks are proven effective in dogs and cats, thus providing the clinician with ample opportunity to include these blocks in practice. This manuscript, Part 2 of a two-part instalment, focuses on brief descriptions of select commonly used local/regional anaesthesia techniques for dogs and cats that cover a multitude of painful surgeries/injuries and that can be implemented in any practice. In Part 1 of this topic, detailed information on local anaesthetic drugs commonly used in small animal practice was reviewed . K E Y W O R D Sanalgesia, bupivacaine, liposome-encapsulated, local anaesthetics, local block This article is linked to "Local and regio nal anaes thesi a in dogs and cats: Overv iew of conce pts and drugs (Part 1)."

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Comparison of Short‐Term Postoperative Analgesia by Epidural, Femoral Nerve Block, or Combination Femoral and Sciatic Nerve Block in Dogs Undergoing Tibial Plateau Leveling Osteotomy

Abstract: In dogs undergoing unilateral TPLO, bupivacaine administered via FNB, alone or in combination with sciatic nerve block, can provide short-term postoperative analgesia not different to that with administration via lumbosacral epidural.

Cited by 18 publications

References 16 publications

Blood concentration of bupivacaine and duration of sensory and motor block following ultrasound-guided femoral and sciatic nerve blocks in dogs

Blood concentration of bupivacaine and duration of sensory and motor block following ultrasound-guided femoral and sciatic nerve blocks in dogs

The influence of the choice of preemptive analgesia on long‐term postsurgical pain after tibial plateau leveling osteotomy in dogs

Local and regional anaesthesia in dogs and cats: Descriptions of specific local and regional techniques (Part 2)

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