Evaluation of a Midhumeral Block of the Radial, Ulnar, Musculocutaneous and Median (RUMM Block) Nerves for Analgesia of the Distal Aspect of the Thoracic Limb in Dogs

Trumpatori, Brian J.; Carter, Jennifer E.; Hash, Jon; Davidson, Gigi; Mathews, Kyle G.; Roe, Simon C.; Lascelles, B. Duncan X.

doi:10.1111/j.1532-950x.2010.00712.x

Cited by 46 publications

(45 citation statements)

References 36 publications

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“…These two techniques are usually referred to as axillary BPB (ABPB). A more distal technique has been described to desensitize the individual nerves that innervate the thoracic limb (radial, ulnar, median and musculocutaneous nerves) at the level of the mid-humerus, called RUMM block (Trumpatori et al 2010). Another technique blocks the spinal nerves that form the brachial plexus as they emerge from the spinal cord at the level of the intervertebral foramina (IVF), which is called paravertebral BPB (PBPB) (Lemke & Dawson 2000).…”

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confidence: 99%

Comparison of three techniques for paravertebral brachial plexus blockade in dogs

Rioja

Sinclair

Chalmers

et al. 2012

Veterinary Anaesthesia and Analgesia

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Objective To compare success and complication rates, based on staining of nerves and other structures, among three techniques of paravertebral brachial plexus blockade (PBPB) in dogs. Study design Prospective randomized design.Animals A total of 68 thoracic limbs from 34 dogs. Methods ResultsThe median (range) number of nerves stained was 2 (0-4) with BL, 1 (0-3) with NS and 1 (0-4) with US guided technique. No significant differences in staining of C6, C8 and T1 or other structures were found among techniques. Nerve C7 was more likely to be stained by BL (p=0.05). Time to perform the blocks was significantly different among techniques, with mean ± SD duration in minutes of 3.6 ± 1.8 with BL, 6.3 ± 2.7 with US and 12.2 ± 5 with NS. The most common complication was staining of the spinal cord (29%, 38% and 39% with BL, NS and US, respectively).Conclusions Success rates were low and complication rates were relatively high, based on staining, with the three techniques.Clinical relevance The use of more advanced techniques for PBPB in dogs is not justified according to this study. Clinical significance of the complications encountered in this study should be evaluated.

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confidence: 99%

Comparison of three techniques for paravertebral brachial plexus blockade in dogs

Rioja

Sinclair

Chalmers

et al. 2012

Veterinary Anaesthesia and Analgesia

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“…In our study, mechanical testing was performed using specialized calibrated hemostatic forceps used in our laboratory previously 24. These forceps were developed to evaluate skin sensation after the administration of peripheral nerve blocks 30. This method was chosen based on ease of use at novel testing sites in the neck.…”

Section: Discussionmentioning

confidence: 99%

Investigation of sensory thresholds in Cavalier King Charles Spaniels with and without Chiari‐like malformations and syringomyelia

Sparks

Gorney

Williams

et al. 2018

Veterinary Internal Medicne

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BackgroundCavalier King Charles Spaniels (CKCS) suffer pain associated with Chiari‐like malformation and syringomyelia (CMSM). People suffer from a similar condition and describe numerous sensory abnormalities. Sensory changes have not been quantified in affected CKCS.ObjectivesTo use quantitative sensory testing (QST) to quantify thermal and mechanical thresholds in CKCS and to compare QST in dogs with and without syringomyelia (SM).AnimalsForty‐four CKCS.MethodsProspective study. Dogs underwent neurological examinations and craniocervical magnetic resonance imaging (MRI). Thermal testing was performed over the humerus and thorax (n = 32); mechanical testing was performed on the paw and neck (n = 44). Latencies, thresholds, and response rates were compared with presence and severity of SM on MRI, presence of pain reported by the owner and pain identified on examination.ResultsThirty dogs had SM, 30 were painful on examination, 29 were owner‐reported symptomatic. Thermal and mechanical variables were not significantly different based on presence or severity of SM. Dogs with pain on examination had decreased mechanical thresholds on the paw (0.38 kg, SD = 0.18) and neck (2.05 kg, SD = 0.74) compared to thresholds of dogs without pain on examination on the paw (0.60 kg, SD = 0.30) and neck (2.72 kg, SD = 0.57; P = .021).Conclusions and Clinical ImportanceMechanical and thermal sensitivity does not appear to be related to the presence of SM, but mechanical sensitivity appears to be related to the presence of pain and clinical signs. Mechanical testing may be useful for assessing sensory abnormalities during clinical trials.

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“…Our testing protocols were adapted from QST protocols described previously to assess sensory thresholds in dogs with chronic pain (eg, osteoarthritis)11 and to assess efficacy of analgesics or nerve blocks 16. Protocols were adapted with a focus on decreased sensation rather than increased sensitivity and to be practical in animals that are unable to move their hindlimbs voluntarily.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, we chose to investigate the use of calibrated forceps to apply force in a fashion similar to the clinical testing performed routinely in evaluation of paralyzed dogs with the intent of being able to apply a strong stimulus to dogs with blunted sensory function. These forceps were developed to assess cutaneous sensation after nerve blocks 16. Because of the potential to cause tissue damage, the maximum force to be applied was defined ahead of time, and only one testing session was used per limb.…”

Section: Discussionmentioning

confidence: 99%

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Mechanical and Thermal Sensory Testing in Normal Chondrodystrophoid Dogs and Dogs with Spinal Cord Injury caused by Thoracolumbar Intervertebral Disc Herniations

Gorney

Blau

Dohse

et al. 2016

Veterinary Internal Medicne

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BackgroundIntervertebral disc herniation is a common cause of spinal cord injury (SCI) causing paralysis and sensory loss. Little quantitative information is available on the loss and recovery of sensation in dogs with SCI.ObjectivesTo determine whether quantitative sensory testing (QST) can be used to establish thermal and mechanical sensory thresholds in chrondrodystrophoid dogs and compare thresholds among normal dogs and dogs with different grades of SCI.AnimalsThirty‐three client‐owned chondrodystrophoid dogs: 15 normal and 18 SCI dogs.MethodsThermal testing was performed by placing a hot (49°C) and cold (5°C) probe on the dorsal metatarsus and mechanical thresholds were tested using calibrated forceps to apply force to the lateral digit. Stimuli were applied until acknowledged, and response rate, latency, and force applied to response were recorded. Test‐retest repeatability was determined by calculating intraclass correlation coefficients. Response rates were compared using logistic regression and thresholds were compared using Kaplan–Meier Survival curves.ResultsTesting was feasible with moderate repeatability. Thresholds and response rates were significantly different between normal and SCI dogs for all modalities (P < .001). When dogs were grouped by their clinical grade, each grade was significantly different from normal dogs, and cold stimuli differentiated among all grades.Conclusion and clinical importanceSensory thresholds can be measured reliably in chondrodystrophoid dogs and are altered by SCI. The differences in sensation among neurologic grades indicate that these techniques can be used to further characterize recovery of SCI dogs.

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Evaluation of a Midhumeral Block of the Radial, Ulnar, Musculocutaneous and Median (RUMM Block) Nerves for Analgesia of the Distal Aspect of the Thoracic Limb in Dogs

Abstract: RUMM block may be an effective technique to provide adjunctive analgesia for dogs undergoing surgery of the distal aspect of the thoracic limb.

Cited by 46 publications

References 36 publications

Comparison of three techniques for paravertebral brachial plexus blockade in dogs

Comparison of three techniques for paravertebral brachial plexus blockade in dogs

Investigation of sensory thresholds in Cavalier King Charles Spaniels with and without Chiari‐like malformations and syringomyelia

Mechanical and Thermal Sensory Testing in Normal Chondrodystrophoid Dogs and Dogs with Spinal Cord Injury caused by Thoracolumbar Intervertebral Disc Herniations

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