1. Description and Outcomes of an Ultrasound-Guided Technique for Catheter Placement in the Canine Quadratus Lumborum Plane: A Cadaveric Tomographic Study and Clinical Case Series.
- Author
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Degani, Massimiliano, Bolen, Géraldine, Talarico, Chiara, Noël, Stéphanie, Gommeren, Kris, Di Franco, Chiara, and Sandersen, Charlotte
- Subjects
POSTOPERATIVE pain treatment ,CATHETERIZATION ,ADMINISTRATION of anesthetics ,ABDOMINAL surgery ,CONTRAST media ,PSOAS muscles - Abstract
Simple Summary: In human medicine, catheter implantation for local anesthetic administration in the quadratus lumborum (QL) inter-fascial plane (IFP) has been reported to extend the duration of a single-shot block's effect in the postoperative period of patients undergoing abdominal surgeries. In the first phase of this study, we described an ultrasound-guided technique for placing catheters in the QL IFP in canine cadavers and assessed the spread of 0.3 versus 0.6 mL kg
−1 per side of contrast media solution injected through the catheters using computed tomography (CT). The second phase described the outcomes of five dogs undergoing open cholecystectomy or adrenalectomy, in which QL catheters were used for postoperative pain management. CT scan images showed that using a higher volume of injectate resulted in a significantly higher number of vertebral bodies stained by the contrast solution between the QL and psoas minor muscles. Results of the second phase of the study suggest that ropivacaine 0.5% injected uni- or bilaterally every eight hours through QL catheters could be safely implemented in a multimodal analgesic approach during the postoperative period in dogs subjected to abdominal surgeries. This study aimed to describe an ultrasound-guided technique for implanting catheters for local anesthetic administration into the quadratus lumborum (QL) inter-fascial plane in canine cadavers and assessing the spread along the vertebral bodies (VBs) by computed tomography (CT). Phase 1: eight canine cadavers received one catheter per hemiabdomen, followed by injection of contrast media solution [low volume (LV ) 0.3 mL kg−1 or high volume (HV ) 0.6 mL kg−1 ]. Phase 2: postoperative pain of five dogs was managed by injecting 0.3 mL kg−1 of ropivacaine 0.5% through QL catheters every eight hours, up to 72 h after abdominal surgery. Pain was assessed using the Short Form of the Glasgow Composite Measure Pain Scale, and methadone 0.2 mg kg−1 was administered intravenously when the pain score was ≥6. The number of VBs stained by the contrast solution between the QL and psoas minor muscles was significantly higher in group HV than group LV . The catheter tip was visualized in the retroperitoneal space in 1/16 and 2/10 hemiabdomens in phases 1 and 2, respectively. Rescue analgesia was required in 3/5 dogs during the postoperative period. The QL catheter placement technique appears feasible and may be included in a multimodal analgesic approach for dogs undergoing abdominal surgeries. [ABSTRACT FROM AUTHOR]- Published
- 2024
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