Lumbar paravertebral block in a rabbit (Oryctolagus cuniculus) submitted to pelvic limb amputation: case report / Bloqueio paravertebral lombar em coelho (Oryctolagus cuniculus) submetido à amputação de membro pélvico: relato de caso

The concern about pain management in exotic mammals is increasing. However, only a few studies describe locoregional anesthesia techniques in rabbits. Thus, this report aims to describe the lumbar paravertebral block, guided by peripheral nerve stimulation, in a rabbit undergoing mid-femoral amputation. We received a one-year-old rabbit weighing 1.27kg with a history of non-union of the right femur and osteomyelitis. The animal came to us for high pelvic limb amputation. After premedication with ketamine, midazolam, and morphine, the patient was maintained under general anesthesia in a non-rebreathing circuit under spontaneous ventilation with isoflurane vaporized in 0.6 oxygen. Using a peripheral nerve stimulator, we performed the lumbar paravertebral block, positioning the needle between the L5 and L6 vertebrae and injecting 0.2mL/kg bupivacaine. The patient remained stable throughout the procedure, without the need for analgesic rescue with opioids during surgery and postoperatively. The discharge occurred after 24 hours. The lumbar paravertebral block proved efficient for trans and postoperative analgesia for high pelvic limbic amputation in rabbits.

A preocupação quanto ao manejo da dor em mamíferos exóticos é crescente, entretanto existem poucos estudos que descrevem o uso de técnicas de anestesia locorregional em coelhos. Assim, este relato tem por objetivo descrever o bloqueio paravertebral lombar guiado por neurolocalizador em um coelho submetido à amputação mediofemoral. Um coelho de um ano de idade e 1,27kg foi atendido com histórico de não união de fêmur direito e osteomielite, sendo encaminhado para amputação alta do membro pélvico. Após pré-medicação com cetamina, midazolam e morfina, o paciente foi mantido sob anestesia geral em circuito sem reinalação de gases, sob ventilação espontânea com isoflurano vaporizado em 0,6 de oxigênio. O bloqueio do plexo lombar foi realizado pela abordagem paravertebral, com o auxílio de neurolocalizador, sendo a agulha posicionada entre as vértebras L5 e L6 e injeção de 0,2mL/kg de bupivacaína 0,5%. O paciente manteve-se estável durante todo o procedimento, sem a necessidade de resgate analgésico com opioides no trans e no pós-operatório. O paciente recebeu alta médica após 24 horas. O bloqueio lombar paravertebral demonstrou-se eficiente para analgesia trans e pós-operatória no procedimento de amputação alta de membro pélvico de coelho.

Bloqueio do plexo braquial com uso de neuroestimulador em coruja-orelhuda (Asio clamator) submetida à amputação de asa / Brachial plexus block with use of a neurostimulator in a striped owl (Asio clamator) undergoing wing amputation

Background: The use of distinct drugs and techniques for establishing balanced anesthesia protocols has shown promisingresults in birds. The techniques of locoregional block can be incorporated to these protocols, thereby providing intra- andpost-operative analgesia and reducing the requirement for general anesthesia. Additionally, the use of neurostimulatorsincreases the chances of success and reduces the risk of toxicity; however, there are limited reports in the literature of itsapplicability in wild birds. Therefore, the aim of this study was to describe the brachial plexus block technique guidedusing a neurolocalizer in a striped owl (Asio clamator) submitted for right wing amputation.Case: A striped owl weighing 400 g with a history of exposed fracture of the right wing was supplied by the clinical sectorat the Veterinarian Hospital of the Federal University of Bahia. Following hydration and stabilization of vital signs, theanimal was referred to the surgical center for amputation of the limb. Dexmedetomidine (10 µg.kg−1 IM) was administeredas premedication, and after 20 min, anesthetic induction was performed using sevoflurane (FiO2 = 100%) via a mask followed by maintenance using the same drug. The animal was positioned in a left lateral decubitus position with access to thebrachial plexus determined by palpation and identification of the border of the following muscles: pectoral, cranial branchof the brachial biceps, and dorsal branch of the ventral serratus. The brachial plexus nerves are situated in the subcutaneous site craniodorsal to the axillary depression. For the block, a neurolocalizer was used, fixing the positive electrode toapproximately 5 cm from the needle insertion site (21G × 2’”) in the axillary depression, which remained connected to theneurostimulator by the second electrode. At first, the needle was attached to the peripheral nerve stimulator using a pulsefrequency of 1 Hz with an...

Bloqueios dos nervos ciático e femoral guiado por neuroestimulador em Chinchilla lanigera submetida a osteossíntese de tíbia / Nerve stimulator-guided ciatic and femoral nerve block during tibial osteosynthesis in Chinchilla lanigera

Background: Nociceptive stimulation in orthopedic surgery requires effective pain management to ensure trans andpostoperative patient comfort. Several techniques can be used for this, and multimodal analgesia protocols such as guidedlocoregional blocks provide a balanced effect, as they enable the use of low-dose anesthetics and offer rapid recovery. Thebenefits of specific nerve blocks in domestic animals are well known; however, there are few reports that have ascertainedtheir safety in wild species. This report is aimed at describing the successful use of neurolocalizer-guided sciatic andfemoral nerve blocks during tibial osteosyntheses in a chinchilla.Case: A 9-month-old chinchilla weighing 0.56 kg was referred for surgery for proximal and mid-diaphyseal tibia fracturesresulting from trauma. Following preanesthetic evaluation, the animal received intramuscular dexmedetomidine (15 µgkg1) as preanesthetic medication. Sedation was apparent after 15 min and was verified by a decreased activity, the animalallowing manipulation, absence of the eyelid and righting reflexes, and limb movement after clamping removal of limbafter clamping. After achieving sedation, anesthesia was induced and maintained with sevoflurane (FiO2 = 1.0), suppliedthrough a nasoral mask. Sciatic and femoral nerve blocks were performed with the aid of a neurostimulator. A needle wasinserted into the femoral triangle, cranial to the femoral artery, and into the depression between the sciatic tuberosity andthe greater femoral trochanter. The neurostimulator was set at a pulse frequency of 1 Hz, pulse duration of 0.1 ms andinitial current of 0.6 mA. The needle was advanced toward the nerves until muscle contractions were observed, and thecurrent was gradually reduced until contractions were manifested at a minimum current...

Bloqueios dos nervos ciático e femoral guiado por neuroestimulador em Chinchilla lanigera submetida a osteossíntese de tíbia / Nerve stimulator-guided ciatic and femoral nerve block during tibial osteosynthesis in Chinchilla lanigera

Background: Nociceptive stimulation in orthopedic surgery requires effective pain management to ensure trans andpostoperative patient comfort. Several techniques can be used for this, and multimodal analgesia protocols such as guidedlocoregional blocks provide a balanced effect, as they enable the use of low-dose anesthetics and offer rapid recovery. Thebenefits of specific nerve blocks in domestic animals are well known; however, there are few reports that have ascertainedtheir safety in wild species. This report is aimed at describing the successful use of neurolocalizer-guided sciatic andfemoral nerve blocks during tibial osteosyntheses in a chinchilla.Case: A 9-month-old chinchilla weighing 0.56 kg was referred for surgery for proximal and mid-diaphyseal tibia fracturesresulting from trauma. Following preanesthetic evaluation, the animal received intramuscular dexmedetomidine (15 µgkg1) as preanesthetic medication. Sedation was apparent after 15 min and was verified by a decreased activity, the animalallowing manipulation, absence of the eyelid and righting reflexes, and limb movement after clamping removal of limbafter clamping. After achieving sedation, anesthesia was induced and maintained with sevoflurane (FiO2 = 1.0), suppliedthrough a nasoral mask. Sciatic and femoral nerve blocks were performed with the aid of a neurostimulator. A needle wasinserted into the femoral triangle, cranial to the femoral artery, and into the depression between the sciatic tuberosity andthe greater femoral trochanter. The neurostimulator was set at a pulse frequency of 1 Hz, pulse duration of 0.1 ms andinitial current of 0.6 mA. The needle was advanced toward the nerves until muscle contractions were observed, and thecurrent was gradually reduced until contractions were manifested at a minimum current...(AU)

Bloqueio do plexo braquial com uso de neuroestimulador em coruja-orelhuda (Asio clamator) submetida à amputação de asa / Brachial plexus block with use of a neurostimulator in a striped owl (Asio clamator) undergoing wing amputation

Background: The use of distinct drugs and techniques for establishing balanced anesthesia protocols has shown promisingresults in birds. The techniques of locoregional block can be incorporated to these protocols, thereby providing intra- andpost-operative analgesia and reducing the requirement for general anesthesia. Additionally, the use of neurostimulatorsincreases the chances of success and reduces the risk of toxicity; however, there are limited reports in the literature of itsapplicability in wild birds. Therefore, the aim of this study was to describe the brachial plexus block technique guidedusing a neurolocalizer in a striped owl (Asio clamator) submitted for right wing amputation.Case: A striped owl weighing 400 g with a history of exposed fracture of the right wing was supplied by the clinical sectorat the Veterinarian Hospital of the Federal University of Bahia. Following hydration and stabilization of vital signs, theanimal was referred to the surgical center for amputation of the limb. Dexmedetomidine (10 µg.kg−1 IM) was administeredas premedication, and after 20 min, anesthetic induction was performed using sevoflurane (FiO2 = 100%) via a mask followed by maintenance using the same drug. The animal was positioned in a left lateral decubitus position with access to thebrachial plexus determined by palpation and identification of the border of the following muscles: pectoral, cranial branchof the brachial biceps, and dorsal branch of the ventral serratus. The brachial plexus nerves are situated in the subcutaneous site craniodorsal to the axillary depression. For the block, a neurolocalizer was used, fixing the positive electrode toapproximately 5 cm from the needle insertion site (21G × 2”) in the axillary depression, which remained connected to theneurostimulator by the second electrode. At first, the needle was attached to the peripheral nerve stimulator using a pulsefrequency of 1 Hz with an... (AU)

BLOQUEIO DOS NERVOS FEMORAL E ISQUIÁTICO COM AUXÍLIO DE NEUROELETROESTIMULAÇÃO EM GALINHAS (GALLUS GALLUS DOMESTICUS)

Objetivou-se avaliar os efeitos dos bloqueios perineurais dos nervos femoral e isquiático com auxílio de neuroeletroestimulação em galinhas clinicamente saudáveis. Após determinados os pontos de referência anatômicos para o bloqueio de cada nervo, foram utilizadas 10 galinhas jovens, 4 meses de idade, pesando em média 1,22 ± 0,25 kg. Após a indução anestésica com sevoflurano, foram realizados os bloqueios nos nervos femoral e isquiático, sempre nesta ordem, com 10 mg/kg de lidocaína 2% com vasoconstritor em cada nervo. As variáveis frequência cardíaca, frequência respiratória e temperatura [FC, f e Tº(C)] foram avaliadas antes da indução anestésica e a cada 10 minutos após o último bloqueio durante 120 minutos (M10, M20, M30, M40, M50, M60, M70, M80, M90, M100, M110, M120), juntamente com as avaliações para bloqueio sensitivo e motor. Os bloqueios perineurais foram avaliados com classificação em escores, por meio de pinçamento nas regiões de fêmur, tibiotarso proximal, tibiotarso distal, tarsometatarso, dígitos (F, TTP, TTD, TM, D) para bloqueio sensorial, e observação de relaxamento muscular (RM) por correção proprioceptiva para bloqueio motor. Foi notada ausência de reação ou de mudança comportamental durante os pinçamentos e dificuldade de reposicionamento da região do joelho aos dígitos. Observando os resultados obtidos, pode-se concluir que os bloqueios perineurais dos nervos femoral e isquiático proporcionaram analgesia e ataxia nas regiões avaliadas do membro pélvico em galinhas.

The aim of the study was to evaluate the effects of perineural blocks of the femoral and sciatic nerves with electrical nerve stimulation aid in clinically healthy chickens. After defined anatomical landmarks for each nerve block, ten young chickens, 4 months old, weighing 1,22 ± 0,25 kg were used. After anesthetic induction with sevoflurane, femoral and sciatic nerve blocks were performed, always in this order, with 10 mg/kg of 2% lidocaine with vasoconstrictor on each nerve. The heart rate, respiratory rate and temperature variables [HR, RR and T(ºC)] were assessed before anesthetic induction and every 10 minutes after the last blockade for 120 minutes (M10, M20, M30, M40, M50, M60, M70, M80, M90, M100, M110, M120) together with evaluations for sensory and motor blocks. Perineural blocks were assessed with score classification, by clamping the regions of the femur, proximal tibiotarsus, distal tibiotarsus, tarsometatarsus, digits (F, PTT, DTT, TM, D) for sensory block, and observation of muscle relaxation (RM) by repositioning of the limb or withdrawal reflex for motor block. There was an absence of reaction or behavioral change during the clamping and difficulty in repositioning of the knee region all the way to the digits. Observing the results, it can be concluded that the perineural blocks of the femoral and sciatic nerves provided analgesia and ataxia in the evaluated areas of the pelvic limb in chickens.

Nova técnica de bloqueio do plexo braquial em cães

The aim of this study was to evaluate the viability and efficacy of a new technique of brachial plexus block in dogs. Eleven mongrel dogs of different ages and weight, both male and female were used. Animals were pre-medicated with acepromazine and induction of anesthesia was performed with propofol. The brachial plexus block was achieved with the combination of the following techniques: multiple injections, nerve stimulator and the axilary artery pulse to locate the nerves. Bupivacaine was the local anesthetic employed at a total dose of 4mg/kg. This dose was divided in 4, that were administered in 30 seconds each, to achieve more nerves as possible. The time spent to perform the whole procedure was 11.30 ± 4.54 minutes; onset time for motor and sensitive block were 9.70 ± 5.52 and 26.20 ± 8.86 respectively. Duration of analgesia was 11.0 ± 0.45 hours. The block was effective in 90% of animals what was assessed through complete anesthesia of the front limb distally to the shoulder joint. Hypotension in one animal was the sole complication observed. With the results obtained we can suggest the use of this technique for front limb surgery performed distally to the shoulder joint as well as a pos-operative analgesic approach in dogs.

O objetivo do presente estudo foi analisar a viabilidade e a eficácia de uma nova técnica para o bloqueio do plexo braquial em cães. Para tanto, foram utilizados 11 cães, machos e fêmeas, idade e peso variáveis e mestiços. Os animais foram pré-tratados com acepromazina e a indução da anestesia foi realizada com propofol. Posteriormente, os animais foram submetidos ao bloqueio do plexo braquial que constou da associação da técnica de múltiplas injeções com o emprego do estimulador de nervos e a técnica da palpação arterial como ponto de referência para a localização dos nervos. Utilizou-se como anestésico local, a bupivacaína com vasoconstritor administrado na dose total de 4mg/kg a 0,375% . O volume total foi dividido em 4 partes iguais, administradas na velocidade de 30 segundos cada, com o objetivo de se atingir a maior quantidade de nervos. O tempo necessário para realização da técnica foi de 11,30 ± 4,54 minutos; o período de latência para o bloqueio motor foi de 9,70 ± 5,52 minutos e para o bloqueio sensitivo foi de 26,20 ± 8,86 min. , sendo a duração da analgesia de 11:00 ± 0:45 horas. Em 90% dos animais, o bloqueio foi efetivo, constatado através da anestesia de todo membro torácico distal à articulação escápulo-umeral. A única complicação observada foi a hipotensão arterial desenvolvida em um animal. Mediante os resultados obtidos, pode-se pressupor que as cirurgias envolvendo o membro torácico distal à articulação escápulo-umeral poderão ser utilizadas com auxílio desta nova técnica do bloqueio do plexo braquial, bem como na analgesia pós-operatória de longa duração.

Nova técnica de bloqueio do plexo braquial em cães

The aim of this study was to evaluate the viability and efficacy of a new technique of brachial plexus block in dogs. Eleven mongrel dogs of different ages and weight, both male and female were used. Animals were pre-medicated with acepromazine and induction of anesthesia was performed with propofol. The brachial plexus block was achieved with the combination of the following techniques: multiple injections, nerve stimulator and the axilary artery pulse to locate the nerves. Bupivacaine was the local anesthetic employed at a total dose of 4mg/kg. This dose was divided in 4, that were administered in 30 seconds each, to achieve more nerves as possible. The time spent to perform the whole procedure was 11.30 ± 4.54 minutes; onset time for motor and sensitive block were 9.70 ± 5.52 and 26.20 ± 8.86 respectively. Duration of analgesia was 11.0 ± 0.45 hours. The block was effective in 90% of animals what was assessed through complete anesthesia of the front limb distally to the shoulder joint. Hypotension in one animal was the sole complication observed. With the results obtained we can suggest the use of this technique for front limb surgery performed distally to the shoulder joint as well as a pos-operative analgesic approach in dogs.

O objetivo do presente estudo foi analisar a viabilidade e a eficácia de uma nova técnica para o bloqueio do plexo braquial em cães. Para tanto, foram utilizados 11 cães, machos e fêmeas, idade e peso variáveis e mestiços. Os animais foram pré-tratados com acepromazina e a indução da anestesia foi realizada com propofol. Posteriormente, os animais foram submetidos ao bloqueio do plexo braquial que constou da associação da técnica de múltiplas injeções com o emprego do estimulador de nervos e a técnica da palpação arterial como ponto de referência para a localização dos nervos. Utilizou-se como anestésico local, a bupivacaína com vasoconstritor administrado na dose total de 4mg/kg a 0,375% . O volume total foi dividido em 4 partes iguais, administradas na velocidade de 30 segundos cada, com o objetivo de se atingir a maior quantidade de nervos. O tempo necessário para realização da técnica foi de 11,30 ± 4,54 minutos; o período de latência para o bloqueio motor foi de 9,70 ± 5,52 minutos e para o bloqueio sensitivo foi de 26,20 ± 8,86 min. , sendo a duração da analgesia de 11:00 ± 0:45 horas. Em 90% dos animais, o bloqueio foi efetivo, constatado através da anestesia de todo membro torácico distal à articulação escápulo-umeral. A única complicação observada foi a hipotensão arterial desenvolvida em um animal. Mediante os resultados obtidos, pode-se pressupor que as cirurgias envolvendo o membro torácico distal à articulação escápulo-umeral poderão ser utilizadas com auxílio desta nova técnica do bloqueio do plexo braquial, bem como na analgesia pós-operatória de longa duração.