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To compare perioperative opioid consumption in dogs undergoing pelvic limb surgeries and receiving a lumbosacral plexus block by combining a lumbar [lateral pre-iliac (LPI)] block with a lumbosacral trunk [i.e. parasacral (PS group) or greater ischiatic notch plane (GIN group)] block. Study design Retrospective, descriptive, exploratory, noninferiority cohort study. Medical records of 37 client-owned dogs were analyzed. Intraoperative (primary outcome) and postoperative (24 hours) opioid use, 24 hour cumulative pain scores and prevalence of complications were compared between the two groups. Opioid use was quantified in morphine equivalents (ME, mg kg–1). The noninferiority limit for intraoperative opioid consumption was set at 0.05 ME kg–1 hour–1. Demographic data, procedure duration, surgery type and perioperative dexmedetomidine and ketamine use were also collected. A t -test or Wilcoxon rank-sum test, a Fisher's exact test and multivariable linear regression were used. Significance was set at p < 0.05. The GIN and PS groups comprised 17 and 20 dogs, respectively. Total intraoperative ME consumption was 0.17 (0.11–0.21) and 0.22 (0.16–0.30) mg kg–1 hour–1 for the GIN and PS groups, respectively (p = 0.077). The noninferiority analysis adjusted by surgery type and body mass revealed that the mean difference between the groups (GIN – PS) was –0.039 (95% CI –0.11–0.03, p = 0.247) ME mg kg–1 hour–1, indicating that the GIN group was not inferior to the PS group regarding intraoperative ME consumption. Dexmedetomidine and ketamine use, postoperative ME consumption and pain scores were similar between groups. This retrospective study and preliminary observations support the clinical use of the GIN plane block, demonstrating its noninferiority to the PS block when combined with the LPI block for multimodal perioperative analgesia in dogs undergoing pelvic limb surgeries. [ABSTRACT FROM AUTHOR]

To compare the perioperative use of analgesics and complication rates in dogs administered an erector spinae plane (ESP) block or a traditional opioid-based (OP) treatment as part of analgesic management during hemilaminectomy. Retrospective cohort study. Medical records of 114 client-owned dogs. General data included demographics, duration of procedure, number of laminae fenestrated, perioperative use of steroid and non-steroidal anti-inflammatory drugs. Intra- and postoperative analgesics used in 48 hours and complications rates were compared between groups. Opioid use was expressed in morphine equivalents [ME (mg kg−1)]. Continuous data were compared using the Mann–Whitney U test and incidence of events with a Fisher's exact tests. Multiple linear regression was used to evaluate association between perioperative ME consumption (dependent variable) with other independent variables. Data are presented as median (range). Differences were considered significant when p < 0.05. Group ESP comprised 42 dogs and group OP 72 dogs. No differences were observed in the general data. Intraoperative ME was 0.65 (0.20–3.74) and 0.79 (0.19–5.60) mg kg−1 in groups ESP and OP, respectively (p = 0.03). Intraoperative infusion of lidocaine was administered intravenously (IV) to 23.8% and 68% of groups ESP and OP, respectively (p < 0.0001). Intraoperative infusion of ketamine was administered IV to 21% and 40% of groups ESP and OP, respectively (p = 0.04). Regression analysis revealed the ESP block as the only independent variable affecting the perioperative ME consumption. Pharmacological intervention to treat cardiovascular complications was administered to 21.4% and 47.2% of dogs in groups ESP and OP, respectively (p = 0.008). There were no differences in postoperative complication rates. ESP block was associated with reduced perioperative opioid consumption, intraoperative adjuvant analgesic use and incidence of pharmacological interventions to treat cardiovascular complications in dogs undergoing hemilaminectomy. [ABSTRACT FROM AUTHOR]

To compare the dye distribution following either two lateral abdominal or one lateral abdominal and one subcostal ultrasound-guided transversus abdominis plane (TAP) injections of a clinically relevant volume of dye solution in dogs. Randomized cadaveric study. A total of eight canine cadavers. On one side of each cadaver, two TAP injections were performed on the lateral aspect of the abdomen (approach LL), caudal to the last rib and cranial to the iliac crest. On the contralateral hemiabdomen, one subcostal (caudal to the costal arch) and one lateral abdominal injection (between last rib and iliac crest), were performed (approach SL). Side allocation was randomly determined. A spinal needle was introduced in-plane to the transducer for each injection of methylene blue (0.25 mL kg−1). All cadavers were dissected to assess dye distribution and number of stained target nerves. All injections were performed in the TAP. The proportion of target nerve staining was 53.5% versus 80.4% with approaches LL and SL, respectively (p = 0.005). Approach LL stained the first lumbar (L1) spinal nerve in 100% of injections and ninth thoracic (T9), T10, T11, T12, T13 and L2 were stained in 0%, 0%, 37.5%, 62.5%, 87.5% and 87.5% of injections, respectively. Approach SL stained T11, L1 and L2 in 100% of injections and T9, T10, T12 and T13 were stained in 37.5%, 87.5%, 75% and 62.5% of injections, respectively. Approach SL resulted in greater staining of nerves cranial to T12 compared with approach LL. The two approaches were equivalent in staining nerves caudal to T12. Approach SL provided a broader distribution of the injected solution than approach LL, which may result in a larger blocked area in live animals undergoing celiotomy. [ABSTRACT FROM AUTHOR]

Objectives To compare the effects of regional anaesthesia and opioid administration on adrenocortical and glycaemic responses, postoperative pain and recovery quality in dogs undergoing stifle surgery. Study design Prospective, blinded clinical study. Animals Forty-five dogs anaesthetized for tibial tuberosity advancement or tibial plateau levelling osteotomy, and 15 healthy dogs undergoing noninvasive orthopaedic diagnostic procedures. Methods The baseline behaviour of each dog was classified on a descriptive scale before anaesthesia. Dogs were anaesthetized using a standard protocol. Those undergoing surgery were randomly assigned to one of three intraoperative analgesia protocols: 1) peripheral (femoral and sciatic) nerve block (bupivacaine 0.5%; 0.15 mL kg -1 in each nerve; group PNB); 2) spinal anaesthesia (isobaric bupivacaine 0.5%; 0.05 mL kg -1; group SPI); and 3) intravenous fentanyl variable rate infusion and postoperative methadone (0.2 mg kg -1; group FEN). Blood samples were collected for measurement of cortisol and glucose concentrations on arrival (TAR), at induction (TIND), at tracheal extubation (TEXT), and 1 hour post-extubation (TPEX). After extubation, a researcher unaware of the dog's group assignment evaluated pain and recovery quality using the Glasgow Composite Measure Pain Scale (Short- Form) and a descriptive scale, respectively. Results Median recovery quality was significantly worse in group FEN (p < 0.0001) compared with all other groups. Postoperative pain scores were lower in group PNB compared with groups SPI and FEN. Cortisol and glucose concentrations increased significantly from TAR at TEXT and TPEX (p < 0.0001) in group FEN, and were unchanged from TAR in the other groups. Conclusions and clinical relevance Analgesia with a peripheral nerve block or spinal anaesthesia prevented the glycaemic and cortisol responses to surgery, promoted better recovery quality, and decreased postoperative pain scores compared with FEN. In the present study, the regional anaesthesia techniques used were found to be excellent alternatives to fentanyl administration. [ABSTRACT FROM AUTHOR]

To develop an ultrasound-guided approach to intercostal nerve injection and to compare the success rate of intercostal nerve injections using blind or ultrasound-guided technique in canine cadavers. Prospective, randomized, descriptive, experimental anatomic study. A total of 14 mid-sized adult canine cadavers. Ultrasound landmarks were identified by dissection of four cadavers and used to develop an ultrasound-guided technique. The remaining 10 cadavers were randomly assigned to blind (five cadavers) or ultrasound-guided (five cadavers) injections of the third to the ninth intercostal nerves bilaterally with 0.03 mL kg–1 of colorant per injection. The target for intercostal injections was the caudal border of the respective rib, between the internal intercostal membrane and the parietal pleura. Additionally, displacement of the parietal pleura without visible intramuscular distribution was considered the end point for ultrasound-guided injections. For each cadaver, a practitioner in training performed the blocks on one hemithorax, while an experienced practitioner performed the blocks on the opposite hemithorax. Injections were considered successful if ≥1 cm of the target nerve was stained with colorant upon dissection. Success rates and length of nerve staining were analyzed with Fisher's exact and t tests, respectively. Data were considered statistically different with p < 0.05. Success rates of blind and ultrasound-guided technique were 57.1% and 91.4%, respectively (p < 0.0001). The length of intercostal nerve staining was 3.1 ± 1.2 cm and 3.6 ± 1.0 cm using blind and ultrasound-guided techniques, respectively (p = 0.02). No differences were observed between the two practitioners for blind (p = 0.33) and ultrasound-guided techniques (p = 0.67). Ultrasound guidance improves the accuracy of intercostal nerve injections when compared with blind technique, independently of the level of expertise in regional anesthesia. [ABSTRACT FROM AUTHOR]

To describe the gross and ultrasound anatomy of the parasacral region and an ultrasound-guided greater ischiatic notch (GIN) plane approach aimed at staining the lumbosacral trunk (LST) in canine cadavers. To evaluate if the ultrasound-guided GIN plane approach is non-inferior to the previously described ultrasound-guided parasacral approach at staining the LST. Prospective, randomized, non-inferiority experimental anatomic study. A total of 17 (23.9 ± 5.2 kg) mesocephalic canine cadavers. Anatomic and echographic landmarks, and the feasibility of performing a GIN plane technique were evaluated using two canine cadavers. The remaining 15 cadavers had each hemipelvis randomly assigned to be administered either parasacral or GIN plane injection of 0.15 mL kg–1 dye solution. The parasacral region was dissected after injections to assess the staining of LST, cranial gluteal nerve, pararectal fossa and pelvic cavity. The stained LST were removed and processed for histological evaluation of intraneural injections. A one-sided z-test for non-inferiority (non-inferiority margin –14%) was used to statistically evaluate the success of the GIN plane versus the parasacral approach. Data were considered statistically significant when p < 0.05. The GIN plane and parasacral approach stained the LST in 100% and 93.3% of the injections, respectively. The success rate difference between treatments was 6.7% [95% confidence interval, –0.6 to 19.0%; p < 0.001 for non-inferiority]. The GIN plane and parasacral injections stained the LST for 32.7 ± 16.8 mm and 43.1 ± 24.3 mm, respectively (p = 0.18). No evidence of intraneural injection was found. The ultrasound-guided GIN plane technique resulted in nerve staining that was non-inferior to the parasacral technique and may be considered an alternative to the parasacral approach to block the LST in dogs. [ABSTRACT FROM AUTHOR]