RESUMO
OBJECTIVE: To investigate the feasibility of an ultrasound-guided sciatic nerve block by describing the sonoanatomy and comparing the distribution of two volumes of bupivacaine dye solution for nerve staining. STUDY DESIGN: Randomized, experimental, assessor-blinded cadaveric study. ANIMALS: A total of 40 adult female Wistar rat cadavers. METHODS: After studying the sonoanatomy of the sciatic nerve and adjacent structures using a high-resolution linear transducer (19-5 MHz), rat cadavers were randomly divided into two groups that were administered either 0.1 mL (group 0.1) or 0.2 mL (group 0.2) of bupivacaine dye solution per nerve, delivered via an in-plane technique. The extent of nerve staining was subsequently evaluated following dissection. Statistical analysis consisted of assessing data distribution using the Shapiro-Wilk test, followed by paired t-tests for continuous data, Mann-Whitney U test and McNemar's test for categorical data. Statistical significance was defined as p < 0.05. RESULTS: The sciatic nerve was identified bilaterally as a double ellipsoid-shaped image, surrounded by a hyperechoic fascia separating the biceps femoris from the adductor muscle. The hypoechoic structure formed by the bupivacaine dye solution around the nerve was effectively visualized using ultrasound imaging. Sciatic nerve staining was successfully achieved in all pelvic limbs, with dye spread of 4.82 ± 1.55 mm and 5.47 ± 2.18 mm in groups 0.1 and 0.2, respectively (p = 0.128). CONCLUSIONS AND CLINICAL RELEVANCE: This study achieved a detailed understanding of the sonoanatomy of the sciatic nerve and its adjacent structures, highlighting the feasibility of the ultrasound-guided technique for injection in Wistar rats. Furthermore, the results show a comparable distribution of dye solution in both groups. Use of the ultrasound-guided sciatic nerve block technique in rats not only exhibits substantial potential for regional anesthesia but also opens avenues for translational studies.
Assuntos
Anestesia por Condução , Bloqueio Nervoso , Doenças dos Roedores , Animais , Feminino , Ratos , Anestesia por Condução/veterinária , Bupivacaína/farmacologia , Cadáver , Bloqueio Nervoso/veterinária , Bloqueio Nervoso/métodos , Ratos Wistar , Nervo Isquiático , Ultrassonografia , Ultrassonografia de Intervenção/veterinária , Ultrassonografia de Intervenção/métodosRESUMO
OBJECTIVES: To compare the duration of regional anesthesia of the pelvic limb using bupivacaine with and without a temperature-responsive hydrogel (TRH) in dogs. METHODS: Under anesthesia using medetomidine (10 µg·kg-1 ), alfaxalone (2 mg·kg-1 ), and isoflurane, seven healthy male Beagles received four injections of 0.5% bupivacaine (1 mg·kg-1 with 5 µg·ml-1 epinephrine) to block the femoral and sciatic nerves bilaterally via ultrasound with nerve stimulation guidance. Bupivacaine was used on one pelvic limb (Bup treatment), and bupivacaine with TRH was used on the contralateral limb (Bup-TRH treatment). The nerve block was considered successful upon the absence of responses to pinching the digital pads and mid-tibial skin of both pelvic limbs with mosquito forceps; the pinch, proprioception, and locomotion tests were performed before (baseline) and at each hour after the nerve block until sensory and motor functions returned to baseline. The effect of TRH on nerve blocks was analyzed using a linear mixed model. RESULTS: The duration of the sensory nerve block at the digital pads and mid-tibial skin was longer with Bup-TRH (8.0 ± 1.6 h and 10.9 ± 1.6 h, respectively) than with Bup treatment (3.7 ± 2.0 h and 8.0 ± 1.6 h, respectively). Motor block times of proprioception and locomotion were longer with Bup-TRH (9.3 ± 1.6 and 12.7 ± 1.5 h, respectively) than with Bup treatment (4.6 ± 1.9 and 9.6 ± 1.5 h, respectively). No complications were observed. CLINICAL SIGNIFICANCE: TRH extended the duration of regional anesthesia of the pelvic limb using bupivacaine.
Assuntos
Anestesia por Condução , Bupivacaína , Animais , Cães , Masculino , Bupivacaína/farmacologia , Anestésicos Locais/farmacologia , Hidrogéis/farmacologia , Temperatura , Anestesia por Condução/veterinária , Nervo IsquiáticoRESUMO
Local anaesthesia techniques are now essential parts of the multimodal analgesic approach applied in the care of small animals. The sensory innervation of the nose is provided by the maxillary division of the trigeminal nerve, so nasal pain can be prevented or alleviated by blocking branches of this nerve. Maxillary or infraorbital nerve block can be used if invasive procedures are performed on the nose of the canine and feline patients. Clear anatomical landmarks facilitate the placements of these blocks, which impose relatively low risk to the patients. These blocks do not require any advanced equipment and all necessary material is widely available in small animal veterinary practices. The total dose of the local anaesthetic agents should be calculated precisely to avoid toxicity.
Les techniques d'anesthésie locale sont aujourd'hui une part essentielle de l'approche analgésique multimodale appliquée aux soins des petits animaux. L'innervation sensorielle du nez est assurée par la division maxillaire du nerf trijumeau, de sorte que la douleur nasale peut être prévenue ou soulagée en bloquant les branches de ce nerf. Un bloc nerveux maxillaire ou sous-orbitaire peut être utilisé si des procédures invasives sont effectuées sur le nez des patients canins et félins. Des repères anatomiques clairs facilitent la mise en place de ces blocs, qui présentent un risque relativement faible pour les patients. Ces blocs ne nécessitent aucun équipement de pointe et tout le matériel nécessaire est largement disponible dans les cabinets vétérinaires pour petits animaux. La dose totale des agents anesthésiques locaux doit être calculée avec précision pour éviter toute toxicité.
Las técnicas de anestesia local son ahora partes esenciales en la estrategia analgésica multimodal aplicado para el cuidado de animales pequeños. La inervación sensorial de la nariz la proporciona la división maxilar del nervio trigémino, por lo que el dolor nasal se puede prevenir o aliviar bloqueando las ramas de este nervio. El bloqueo del nervio maxilar o infraorbitario se puede utilizar si se realizan procedimientos invasivos en la nariz de los pacientes caninos y felinos. Los puntos de referencia anatómicos claros facilitan la colocación de estos bloqueos, que suponen un riesgo relativamente bajo para los pacientes. Estos bloqueos no requieren ningún equipo avanzado y todo el material necesario está ampliamente disponible en las prácticas veterinarias de pequeños animales. La dosis total de los agentes anestésicos locales debe calcularse con precisión para evitar la toxicidad.
As técnicas de anestesia local são partes essenciais da abordagem anestésica multimodal aplicada na assistência de pequenos animais. A inervação sensorial do nariz é fornecida pela a divisão maxilar do nervo trigêmeo, assim, a dor nasal por ser prevenida ou aliviada pelo bloqueio dos ramos deste nervo. O bloqueio do nervo maxilar ou infraorbital pode ser utilizado em procedimentos invasivos realizados no nariz de cães e gatos. Marcadores anatômicos claros facilitam o posicionamento desses bloqueios, submetendo os pacientes a um risco relativamente baixo. Esses bloqueios não necessitam de nenhum equipamento avançado e todo o material necessário é amplamente disponível em clínicas e hospitais veterinários. A dose total dos anestésicos locais deve ser calculada com precisão para evitar toxicidade.
Assuntos
Anestesia por Condução , Doenças do Gato , Dermatologia , Doenças do Cão , Bloqueio Nervoso , Anestesia por Condução/veterinária , Animais , Gatos , Dermatologia/métodos , Cães , Bloqueio Nervoso/veterináriaRESUMO
Local anesthetics provide analgesia and can be incorporated into multimodal anesthetic protocols. They work by blocking the voltage-dependent sodium ion channels along neurons that mediate nociception. Systemically, these drugs can be cardiotoxic in a dose-dependent manner. Lidocaine and bupivacaine are the most commonly used local anesthetics and their use has been reported in all classes of vertebrates. Despite anecdotal reports to the contrary, zoologic companion animals are unlikely to be more susceptible to the cardiotoxic effects of local anesthetics than domestic small animals. Local anesthetics can be clinically useful for analgesia and anesthesia in zoologic companion animal practice.
Assuntos
Anestesia por Condução , Animais de Estimação , Anestesia por Condução/veterinária , Anestésicos Locais/efeitos adversos , Animais , Bupivacaína , Lidocaína/efeitos adversosRESUMO
The present study was designed to compare the effects of lidocaine and ropivacaine in intravenous regional anaesthesia (IVRA) in dogs. Twelve adult male dogs were used. Under isoflurane anaesthesia, exsanguination was performed in the target forelimb. Then, a blood pressure cuff was encircled around the limb proximal to the elbow joint with a pressure of approximately 150 mmHg above the mean arterial blood pressure. The animals then received one of the two treatments of lidocaine (3 mg/kg) or ropivacaine (1.5 mg/kg) with a final volume of 0.6 mL/kg into the cephalic vein. After 60 min, the anaesthesia was disrupted and the tourniquet was removed using intermittent opening (30 s) and closing (5 min) manner for three times. The results revealed that at 20 and 30 min after the initiation of IVRA, the dogs in ROP showed higher analgesia than LID. A leakage under the tourniquet during IVRA was detected. Tremor and hypersalivation were observed after tourniquet removal in some dogs. It was concluded that ropivacaine might provide a higher quality of anaesthesia than lidocaine in IVRA in dogs. The development of local anaesthetic toxicity is a major concern and should be considered at the time of tourniquet removal.
Assuntos
Anestesia por Condução , Lidocaína , Anestesia por Condução/veterinária , Anestesia Intravenosa/métodos , Anestesia Intravenosa/veterinária , Anestésicos Locais/efeitos adversos , Animais , Cães , Lidocaína/efeitos adversos , Masculino , RopivacainaAssuntos
Anestesia por Condução , Bloqueio Nervoso , Anestesia por Condução/veterinária , Animais , Cães , Úmero/diagnóstico por imagem , Úmero/cirurgia , Nervo Mediano , Nervo Musculocutâneo/cirurgia , Bloqueio Nervoso/veterinária , Nervo Radial , Nervo Ulnar , Ultrassonografia de Intervenção/veterináriaRESUMO
OBJECTIVE: To compare the quality of postoperative analgesia and sedation after preoperative saphenous and sciatic nerve blockade, preoperative lumbosacral epidural injection and perioperative intravenous (IV) morphine, lidocaine and ketamine infusions in dogs undergoing stifle arthroscopy and tibial plateau leveling osteotomy (TPLO) under general anesthesia. STUDY DESIGN: Prospective, blinded, randomized, clinical comparison study. ANIMALS: A total of 45 dogs weighing 33.9 (15.9-56.7) kg and aged 5.2 (1.0-12.0) years, mean (range), undergoing elective unilateral TPLO for spontaneous cranial cruciate ligament rupture. METHODS: Client-owned dogs were enrolled. Dogs were randomly assigned to one of three groups: group MLK, perioperative IV morphine, lidocaine and ketamine infusion; group EPID, lumbosacral epidural with ropivacaine and morphine; or group SSNB, saphenous and sciatic nerve blockade with ropivacaine. Routine stifle arthroscopy followed by TPLO surgery was performed. Sedation and pain scores were assessed at 0, 2, 4, 8 and 24 hours following extubation. Rescue analgesia was administered as prescribed by Glasgow composite pain score-short form score >5. RESULTS: Sedation scores for MLK were higher than EPID and SSNB. Pain scores for SSNB were lower than those for EPID and MLK. No significant differences were found in anesthesia duration or surgery duration among groups. No dogs required rescue analgesia. CONCLUSIONS AND CLINICAL RELEVANCE: Although analgesia was adequate in all groups, the best combination of analgesia without increased sedation was recorded for SSNB.
Assuntos
Anestesia por Condução , Doenças do Cão , Ketamina , Anestesia por Condução/veterinária , Animais , Doenças do Cão/cirurgia , Cães , Lidocaína , Morfina , Osteotomia/veterinária , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/veterinária , Estudos Prospectivos , Nervo IsquiáticoRESUMO
OBJECTIVE: To compare the peribulbar injectate distribution and probability of regional anaesthesia of four peribulbar anaesthetic techniques in equine cadavers. STUDY DESIGN: Prospective experimental cadaver study. ANIMALS: A total of 12 isolated equine cadaver heads and 24 eyes. METHODS: The 24 orbits underwent one of four injection techniques (six orbits each) with a mixture (1:4) of contrast medium and saline (CM): 20 mL ventrolateral peribulbar injection (V-20), 20 mL dorsolateral peribulbar injection (D-20), combined ventrolateral and dorsolateral peribulbar injections 10 mL each (VD-20) or 20 mL each (VD-40). To evaluate and score CM distribution at the base of, within the extraocular muscle cone (EOMC), and around the optic nerve (before and after pressure application to the periorbital area), computed tomography was performed. To assess the probability of achieving locoregional anaesthesia, two criteria were applied and both scored as 'likely', 'possible' or 'unlikely'. To compare CM distribution scores between injection techniques, Kruskal-Wallis analysis of variance was used. Mann-Whitney U test was used for post hoc comparisons between groups when needed. A p value < 0.05 was considered significant. RESULTS: The CM distribution within the EOMC and around the optic nerve circumference was detected as 'possible' only after pressure application in seven out of 24 orbits (V-20, 3; D-20, 1; VD-40, 3). It was never considered 'likely' either before or after pressure application. The CM distribution at the EOMC base was considered 'likely' to provide regional anaesthesia in 50% (V-20), 0% (D-20), 33% (VD-20), 100% (VD-40) and in 66% (V-20), 16% (D-20), 50% (VD-20), 100% (VD-40) before and after applying pressure, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Complete regional anaesthesia seems more likely using the VD-40 technique, although the authors advise caution due to the risk of potential complications. Future studies are necessary to evaluate the efficacy of the technique in vivo.
Assuntos
Anestesia por Condução , Anestésicos , Doenças dos Cavalos , Anestesia por Condução/veterinária , Anestesia Local/veterinária , Anestésicos Locais , Animais , Cadáver , Cavalos , Injeções/veterinária , Estudos ProspectivosRESUMO
BACKGROUND: Local anaesthesia for procedures involving the distal limb are a useful component of balanced protocols to achieve effective procedural analgesia for patients. A ring block is an effective and straightforward technique. HYPOTHESIS/OBJECTIVE: To review and describe the ring block technique for local anaesthesia of the canine and feline distal limb. ANIMALS: Images of hospitalized patients were used. These photographs were obtained with owner permission. RESULTS: The clinical technique for the ring block of the canine or feline distal limb is described. CONCLUSIONS AND CLINICAL IMPORTANCE: The ring block can be implemented simply and successfully for a variety of procedures involving the distal limb to provide effective analgesia.
Assuntos
Anestesia por Condução , Gatos , Dermatologia , Cães , Medicina Veterinária , Anestesia por Condução/veterinária , Animais , Dermatologia/métodos , Bloqueio Nervoso/veterinária , Medicina Veterinária/métodosRESUMO
Impinging/overriding dorsal spinous processes (DSPs) of the thoracolumbar vertebrae are a common cause of poor performance in horses. In the last five decades, numerous surgical treatments have been reported on, from transverse transection of the affected DSPs, and endoscopic resection of the affected DSPs, to transection of the interspinous ligament. Until recently, cosmetic outcomes have been reported as good to excellent in studies. However, a previously unreported complication of neurogenic atrophy of the contralateral epaxial muscle following desmotomy of the interspinous ligament has been recently reported. The authors hypothesised that this was because of a more lateral approach than previously described, resulting in the scissors being too far across midline and transecting a nerve in the region. Considering this finding, we have reviewed the literature on the neuroanatomy of the thoracolumbar region in the horse. Literature on the neuroanatomy of the horse is lacking when compared with that of humans and companion animals, with most of the work extrapolated from companion animals. Based on the current literature, we hypothesise that transection of an intermediate branch of the dorsal spinal nerve supplying the m. longissimus is potentially the cause of the post-operative neurogenic atrophy. The lack of detailed knowledge of the neural anatomy of the equine back has resulted in the role of local anaesthesia in localising pain in the equine back being poorly understood. The wide variation in techniques used for localising back pain may explain why some horses suffering from poor performance or an abnormal gait because of back pain improve to local anaesthesia of the back while others do not. This review article highlights a lack of anatomical knowledge regarding the equine thoracolumbar region in the literature despite diagnostic local anaesthesia, medication, and surgery in this area being relatively common.
Assuntos
Anestesia por Condução , Doenças dos Cavalos , Anestesia por Condução/veterinária , Animais , Dor nas Costas/veterinária , Doenças dos Cavalos/etiologia , Doenças dos Cavalos/cirurgia , Cavalos , Ligamentos Articulares , Vértebras Lombares/cirurgia , Neuroanatomia , Vértebras Torácicas/cirurgiaRESUMO
Background: Loco-regional anesthetic techniques are considered important in the multimodal approach to analgesia in both human and veterinary medicine. No such techniques are described in the alpaca, bar the use of epidural. This is in part due to the lack of anatomical description for this species. While this limitation exists, the use of ultrasound guidance makes peripheral nerve blocks a viable possibility in the alpaca. Case description: A 12-month-old alpaca was referred for the treatment of a septic left tarso-crural joint. Due to a poor prognosis, amputation of the limb under general anesthesia was performed. Sciatic and psoas compartment blocks were attempted with the ultrasound-guided injection of ropivacaine prior to the start of the procedure. While the femoral nerve was possible to visualize, no obturator nerve was identified. A 5-year old alpaca was also referred for a left hind lateral claw removal, due to a squamous cell carcinoma. The sciatic nerve block was performed prior to the claw amputation under general anesthesia. No changes in heart and respiratory rate, or blood pressure suggestive of nociception, were observed in either of these cases. At the end of both the procedures, the patients experienced uneventful recoveries characterized by the ability to maintain the standing position, interest in food, and normal behavior. Conclusion: This report identifies the ease of performance and the challenges encountered using the ultrasound-guided psoas compartment and sciatic nerve blocks in the alpaca. It is our hope that this report encourages the use of ultrasound-guided loco-regional techniques in this species.
Assuntos
Anestésicos Locais/administração & dosagem , Camelídeos Americanos/cirurgia , Manejo da Dor/veterinária , Ropivacaina/administração & dosagem , Amputação Cirúrgica/veterinária , Analgesia/veterinária , Anestesia por Condução/veterinária , Anestesia Geral/veterinária , Animais , Feminino , Nervo Femoral/diagnóstico por imagem , Membro Posterior/cirurgia , Bloqueio Nervoso/veterinária , Nervo Obturador/diagnóstico por imagem , Nervos Periféricos/diagnóstico por imagem , Nervo Isquiático/diagnóstico por imagem , Ultrassonografia/veterináriaRESUMO
Atropelamentos de animais silvestres são frequentes e muitas vezes causam fraturas ósseas que, se não tratadas adequadamente, levam à morte do animal por complicações ou por inabilidade de sobrevivência no seu habitat natural. O objetivo do presente trabalho foi relatar o uso de placa associada ao pino intramedular e ao biovidro 60S (BV60S) para o tratamento de fratura de fêmur em tamanduá-bandeira. O animal foi resgatado pela polícia ambiental com suspeita de atropelamento. Foi sedado para avaliação clínica e radiográfica, que revelou fratura em fêmur direito. Utilizou-se dexmedetomidina como medicação pré-anestésica, midazolam e cetamina para indução, e isoflurano para manutenção. Também foi realizado bloqueio peridural com bupivacaína e morfina. A osteossíntese foi feita com placa bloqueada 2,7 e pino intramedular 2,5. Colocaram-se 4g de BV60S no foco de fratura para favorecer a osteogênese. O paciente teve recuperação funcional imediata do membro acometido. A reparação óssea ocorreu por segunda intenção, observando-se ossificação completa do calo com consolidação clínica, aos 30 dias, e remodelação quase completa, aos 180 dias. Conclui-se que o uso de placa e pino associado ao BV60S é eficiente no tratamento de fratura de fêmur em tamanduá, permitindo a rápida recuperação e a reintrodução do animal na natureza.(AU)
Roadblocks of wild animals are frequent and often cause bone fractures that if not properly treated lead to the death of the animal due to complications or inability to survive in its natural habitat. The objective of the present study was to report the use of plate rod and bioglass 60S (BG60S) for the treatment of femoral fracture in anteater. The animal was rescued by environmental police on suspicion of being hit. It was sedated for clinical and radiographic evaluation, which revealed a fracture in the right femur. Dexmedetomidine was used as preanesthetic medication, midazolam and ketamine for induction, and isoflurane for maintenance. Epidural blockade with bupivacaine and morphine was also performed. Osteosynthesis was done with a locking plate 2.7 and 2.5 intramedullary pin. 4G of BG60S was placed in the focus of fracture to favor osteogenesis. The patient had immediate functional recovery of the affected limb. The bone repair occurred by second intention, with complete ossification of the callus with clinical consolidation at 30 days, and near complete remodeling at 180 days. It is concluded that the use of plate rod to the BG60S is efficient in the treatment of femur fracture in anteater, allowing the rapid recovery and reintroduction of the animal in the wild.(AU)
Assuntos
Animais , Xenarthra/cirurgia , Fraturas do Fêmur/veterinária , Fixação Interna de Fraturas/métodos , Fixação Interna de Fraturas/veterinária , Osteogênese/fisiologia , Materiais Biocompatíveis/uso terapêutico , Fraturas Ósseas , Anestesia por Condução/veterináriaRESUMO
OBJECTIVE: To evaluate the efficacy, duration and safety of greater auricular and auriculotemporal nerve blocks in rabbits. STUDY DESIGN: Prospective, randomized, crossover, experimental study. ANIMALS: A total of 11 healthy adult Dutch-belted rabbits. METHODS: The rabbits underwent general anesthesia and injections of the greater auricular and auriculotemporal nerves using either bupivacaine (0.3 mL kg-1, 0.5%) or the same volume of saline. After anesthesia, the efficacy and duration of nerve blocks were assessed using analgesiometry forceps on the pinna and cotton-tipped applicators within the vertical ear canal. Rabbits were monitored for abnormal carriage of the ear and auriculopalpebral nerve block of the ipsilateral eye. Body weight, food intake, fecal output and fecal pellet diameter were measured daily for 6 days after the nerve blocks were performed and compared with baseline to assess short-term effects. RESULTS: The greater auricular nerve was successfully blocked in 12/16 (75%) ears for mean ± standard deviation duration of 88 ± 52 minutes. In successfully blocked ears, altered ear position was noted in five/16 (31%) cases. The auriculotemporal nerve was blocked in one/16 ears for 120 minutes. The auriculopalpebral nerve was inadvertently blocked in three/16 ears. Food intake and fecal output decreased significantly during the treatment day but returned to pretreatment values after 24 hours. There was no change in body weight or fecal pellet diameter for either treatment. CONCLUSIONS AND CLINICAL RELEVANCE: The results suggest that duration of the greater auricular nerve block with 0.5% bupivacaine was short-lived in the live rabbit. Auriculotemporal nerve block was only achieved in one ear; therefore, further studies are warranted to evaluate the contribution of these blocks in the pain management of rabbits undergoing auricular surgery.
Assuntos
Nervo Mandibular/efeitos dos fármacos , Bloqueio Nervoso/veterinária , Anestesia por Condução/veterinária , Anestésicos Locais , Animais , Bupivacaína , Estudos Cross-Over , Bloqueio Nervoso/métodos , Projetos Piloto , Estudos Prospectivos , Coelhos , Fatores de TempoRESUMO
Pain management in veterinary patients is a crucial component of appropriate patient care. Multimodal analgesia that includes both systemically and locally/regionally administered drugs is generally the most effective approach to providing pain relief. Local anaesthetic drugs used in local and regional blockade are unique in that they can completely block the transmission of pain (in conscious patients) or nociceptive (in anaesthetized patients) signals, thereby providing profound analgesia. In addition, local and regional administration of drugs, when compared with systemic bolus administration, generally results in a lower incidence of dose-related adverse effects. Due to the potential to provide profound analgesia and the high safety margin (when used correctly) of this drug class, local anaesthetics are recommended as part of the analgesic protocol in the majority of patients undergoing surgical procedures or suffering traumatic injuries. This manuscript, Part 1 of a two-part instalment, emphasizes the importance of using local and regional anaesthesia as a component of multimodal analgesia, provides a review of the basic pharmacokinetics/pharmacodynamics of local anaesthetic drugs in general, lists information on commonly used local anaesthetic drugs for local and regional blockade in dogs and cats, and briefly introduces the novel liposome-encapsulated bupivacaine (NOCITA®). Part 2 is a review of local and regional anaesthetic techniques used in dogs and cats (Grubb & Lobprise, 2020).
Assuntos
Anestesia por Condução/veterinária , Anestesia Local/veterinária , Anestésicos Locais/farmacologia , Gatos/fisiologia , Cães/fisiologia , Manejo da Dor/veterinária , Anestésicos Locais/farmacocinética , Animais , Bupivacaína/farmacocinética , Bupivacaína/farmacologiaRESUMO
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 (Grubb & Lobprise, 2020).
Assuntos
Anestesia por Condução/veterinária , Doenças do Gato , Doenças do Cão , Anestésicos Locais , Animais , Gatos , Cães , Dor Pós-Operatória/veterináriaRESUMO
BACKGROUND: Local anaesthetics are being combined clinically with amikacin in intravenous regional limb perfusion (IVRLP), with limited knowledge on the analgesia provided and its onset and duration of action after tourniquet application and release. OBJECTIVE: To evaluate the systemic clinical effect, limb withdrawal to nociceptive stimulation, and plasma and synovial fluid concentrations after IVRLP with lidocaine or mepivacaine in standing sedated horses. STUDY DESIGN: Prospective, controlled, randomised, cross-over study. METHODS: Six healthy adult horses were sedated and received IVRLP with lidocaine, mepivacaine or saline (negative control), or perineural anaesthesia of the medial and lateral palmar and palmar metacarpal nerves (positive control) in one forelimb with a 3-week washout period between trials. Electrical and mechanical stimuli were used to test nociceptive threshold of the limb before and after IVRLP/perineural anaesthesia. For lidocaine and mepivacaine trials, blood was collected from the jugular vein and synovial fluid from the radiocarpal joint before, during and out to 24 hours after IVRLP. Drug concentrations were measured using high-performance liquid chromatography. RESULTS: Nociceptive thresholds for lidocaine, mepivacaine and perineural anaesthesia trials were significantly increased compared with saline and baseline values at 10, 20 and 30 minutes, with no differences between anaesthetic trials. During this time, horses had lower heart rates than IVRLP with saline. After tourniquet release at 30 minutes, nociceptive thresholds for lidocaine and mepivacaine trials gradually returned to baselines, whereas perineural anaesthesia trial remained unchanged out to an hour. Plasma lidocaine and mepivacaine concentrations were ≤50 ng/mL while the tourniquet was in place, significantly increasing 10 minutes after tourniquet release. Maximal lidocaine and mepivacaine concentrations in synovial fluid were reached 25 minutes after IVRLP injection. MAIN LIMITATIONS: Amikacin was not included in the perfusate. CONCLUSION: Similar to perineural anaesthesia, IVRLP with lidocaine or mepivacaine provides anti-nociception to the distal limb in standing sedated horses while a tourniquet is applied with concentrations remaining below toxic levels in plasma and synovial fluid.
Assuntos
Anestesia por Condução/veterinária , Mepivacaína , Anestésicos Locais , Animais , Antibacterianos , Estudos Cross-Over , Membro Anterior , Cavalos , Lidocaína , Estudos Prospectivos , Líquido SinovialRESUMO
The field of locoregional anesthesia is showing good and promising results for intraoperative and postoperative analgesia, reducing opioid requirements and improving early postoperative recovery. Peripheral nerve blocks are being reinvigorated as a viable option to decrease the administration of opioids and some of the consequences of their use and yet provide high-quality analgesia. In this article, techniques to block the pelvic limb are discussed.
Assuntos
Anestesia por Condução/veterinária , Anestesia Local/veterinária , Membro Posterior/inervação , Bloqueio Nervoso/veterinária , Animais , Bloqueio Nervoso/métodosRESUMO
BACKGROUND: Video otoscopy is a valuable tool for the diagnosis and treatment of otitis externa (OE) and otitis media (OM) in dogs. Procedures performed by video otoscopy often are painful and it can be challenging to maintain steady anaesthetic depth and provide smooth anaesthetic recovery. A multimodal approach to analgesia and anaesthesia is ideal to minimize complications associated with high doses of anaesthetic drugs while providing the patient with adequate analgesia. HYPOTHESIS/OBJECTIVE: To describe a technique for regional anaesthesia of the canine ear. ANIMALS: One canine cadaver, obtained as part of a teaching laboratory class for other clinical techniques, with institutional approval, was used for illustration purposes. RESULTS: Clinical technique for regional anaesthesia of the canine ear. CONCLUSIONS AND CLINICAL IMPORTANCE: Nerve blocks for regional anaesthesia are an important aspect of a multimodal anaesthetic approach. A technique for blocking the two major sensory nerves to the canine ear is described.
Assuntos
Anestesia por Condução/veterinária , Dermatologia/métodos , Doenças do Cão/diagnóstico por imagem , Otoscopia/veterinária , Animais , Cães , Orelha/diagnóstico por imagem , Orelha/patologia , Otite Externa/diagnóstico por imagem , Otite Externa/veterinária , Otite Média/diagnóstico por imagem , Otite Média/veterinária , Otoscopia/métodosRESUMO
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.