Ultrasound-guided erector spinae plane block in horses: a cadaver study

Delgado, Oscar Bautista Díaz; Louro, Luís Filipe; Rocchigiani, Guido; Verin, Ranieri; Humphreys, William; Senior, Mark; Campagna, Ivo

doi:10.1016/j.vaa.2020.11.009

Cited by 18 publications

(25 citation statements)

References 22 publications

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“…25,40 There are no publications on the ESP block for lateral thoracotomy in veterinary patients, presumably due to the weak evidence in veterinary medicine on the spread of the local anaesthetic to the paravertebral canal in cadavers. 17,19,20,23,24 Some cadaveric studies in humans have reported the same findings. [41][42][43] However, others have reported that the spread of the local anaesthetic into the paravertebral, epidural and the intercostal space is one of the potential mechanisms of action by which the ESP block may produce its local anaesthetic effect in humans.…”

Section: Discussionsupporting

confidence: 61%

“…26,39,44,45 Although there is very little evidence of epidural spread in veterinary species, a recent paper describing the ESP block in horse cadavers detected some epidural migration. 24 If epidural spread of the local anaesthetic is at least partially responsible for the intraoperative analgesia provided by the ESP block, it could explain the mild hypotension detected in cases 4, 5 and 6. It is also noteworthy that the lack of spread towards the ventral branches in cadaver studies may be due to the less dynamic and less extensive spread along tissue planes in cadavers compared with living subjects, 16 and could explain why the ESP block has been able to provide thoracic postoperative analgesia in humans despite the absence of cadaveric evidence.…”

Section: Discussionmentioning

confidence: 99%

“…Local anaesthetics, after an ultrasound‐guided ESP block, have been reported to spread to the ventromedial, lateral and craniocaudal direction, effectively bathing the dorsomedial and dorsolateral branches of the spinal nerves, 25 leading to profound analgesia of the ipsilateral hemithorax and lumbar region 25,40 . There are no publications on the ESP block for lateral thoracotomy in veterinary patients, presumably due to the weak evidence in veterinary medicine on the spread of the local anaesthetic to the paravertebral canal in cadavers 17,19,20,23,24 . Some cadaveric studies in humans have reported the same findings 41–43 .…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound‐guided erector spinae plane (ESP) block was first described in humans in 2016 16 . Since then, it has also been described in dogs, pigs and horses 17–24 . This technique consists of infiltration of local anaesthetic solution in the interfascial plane between the transverse processes of the thoracic vertebrae and the erector spinae muscle group 25 .…”

Section: Introductionmentioning

confidence: 99%

“…16 Since then, it has also been described in dogs, pigs and horses. [17][18][19][20][21][22][23][24] This technique consists of infiltration of local anaesthetic solution in the interfascial plane between the transverse processes of the thoracic vertebrae and the erector spinae muscle group. 25 The erector spinae muscles include the iliocostalis, spinalis and longissimus muscles, all covered by a common fascia.…”

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confidence: 99%

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The combination of an ultrasound‐guided erector spinae plane (ESP) block and epidural morphine as effective intra‐operative adjuncts to opioid premedication in six dogs undergoing lateral thoracotomy

Fernández

Huuskonen

Potter

2021

Vet Record Case Reports

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Six dogs were presented to the University College Dublin Veterinary Hospital for either left or right lateral thoracotomy. After opioid premedication and induction of general anaesthesia, ultrasound-guided erector spinae plane (ESP) block with bupivacaine 0.5% (0.5 mL/kg) or bupivacaine 0.25% (1 mL/kg) was performed in all cases before the surgical procedure along with morphine (0.2 mg/kg) administered epidurally. This combination of local techniques was a successful adjunct to systemic analgesia in these six dogs undergoing lateral thoracotomy, reducing considerably the need for systemic opioids intra-and post-operatively. Ultrasound-guided ESP block with bupivacaine and epidurally administered morphine provided good multimodal intra-operative analgesia for dogs undergoing lateral thoracotomy. BACKGROUNDLateral thoracotomy is one of the most painful but commonly performed surgical procedure to manage diseases within the thoracic cavity in small animals. 1,2 In humans it is known that adequate intra-and post-operative analgesia is essential to allow for early mobilization and discharge and also to reduce the incidence of chronic neuropathic pain development. [3][4][5][6] In human and veterinary medicine, both systemic administration of opioids and locoregional anaesthesia have been used to manage intra-and post-operative pain after lateral thoracotomy. 3,7,8 The use of locoregional anaesthesia reduces systemic opioid requirement and provides analgesia without central respiratory depression or sedation, thus improving ventilation and allowing a more accurate clinical assessment of the patient. 9,10 Thoracic epidural catheter is the "gold standard" analgesic technique in humans, 11 and its effectiveness in providing analgesia in lateral thoracotomies has also been reported in veterinary medicine. 12,13 However, the technique itself and the epidural administration of local anaesthetics may have certain complications and contraindications. 12,14,15 In dogs, these can include mechanical or chemical injury of the spinal cord, motor function impairment, and sympathetic blockade leading to hypotension. 12 Vomiting has also beenThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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The combination of an ultrasound‐guided erector spinae plane (ESP) block and epidural morphine as effective intra‐operative adjuncts to opioid premedication in six dogs undergoing lateral thoracotomy

Fernández

Huuskonen

Potter

2021

Vet Record Case Reports

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Ultrasound‐Guided Erector Spinae Plane Block

Ferreira

2024

Small Animal Regional Anesthesia and Analgesia

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International survey of equine orthopaedic specialists reveals diverse treatment strategies for horses with overriding spinous processes

Treß,

Lischer,

Merle

et al. 2024

Veterinary Record

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BackgroundOverriding spinous processes, also known as ‘kissing spines’, are one of the most common causes of back pain in horses. The aim of this study was to investigate which options for diagnosis and treatment are preferred by equine orthopaedic specialists and assess which techniques are used for local injection.MethodsAn online survey was distributed among members of the European/American College of Veterinary Surgeons, the European/American College of Veterinary Sports Medicine and Rehabilitation, the International Society of Equine Locomotor Pathology and nationally recognised advanced equine orthopaedic practitioners.ResultsThe survey was completed by 353 respondents. The injection techniques most commonly used involve placing two needles abaxial to the interspinous space (42%) under ultrasonographic guidance (32%) or one needle in the midline (35%) between two spinous processes. The most popular combination for overriding dorsal spinous process therapy was local injection (26.7%) combined with controlled exercise (25.5%). Manual therapy was considered by 42% of European and 25% of American specialists (p = 0.01). Surgical intervention as a first‐line treatment was recommended mainly by specialists working in the United States, the UK or Ireland (p = 0.001). Overall, most equine orthopaedic veterinarians (71%; n = 201) preferred conservative management and recommended surgery only for horses that did not respond to conservative therapy.LimitationsRespondents’ personal bias may have skewed the findings.ConclusionsDespite a growing body of evidence, the therapeutic approach to ‘kissing spines’ in horses is influenced by professional specialisation and regional preferences. Variations in injection techniques and differing criteria for surgical intervention warrant further investigation.

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Ultrasound-guided erector spinae plane block in horses: a cadaver study

Cited by 18 publications

References 22 publications

The combination of an ultrasound‐guided erector spinae plane (ESP) block and epidural morphine as effective intra‐operative adjuncts to opioid premedication in six dogs undergoing lateral thoracotomy

The combination of an ultrasound‐guided erector spinae plane (ESP) block and epidural morphine as effective intra‐operative adjuncts to opioid premedication in six dogs undergoing lateral thoracotomy

Ultrasound‐Guided Erector Spinae Plane Block

International survey of equine orthopaedic specialists reveals diverse treatment strategies for horses with overriding spinous processes

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