Peer-reviewed veterinary case report
Preoperative eye nerve block controls pain better than splash block
By Zibura, Ashley E et al.·Published in Veterinary ophthalmology·2020·Department of Clinical Sciences, United States·View original on PubMed →
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Original publication title: A preoperative bupivacaine retrobulbar block offers superior antinociception compared with an intraoperative splash block in dogs undergoing enucleation.
- Species:
- dog
Plain-English summary
A group of dogs undergoing eye removal surgery (enucleation) received either a pain relief injection before the procedure or during the surgery. The dogs that got the injection before surgery had better pain control and experienced less bruising and swelling afterward compared to those who received it during the surgery. The dogs that received the pain relief during the surgery needed more additional pain medication afterward. Overall, giving the pain relief before surgery was found to be the better option for managing pain and reducing complications.
People also search for: dog eye surgery pain relief · enucleation recovery bruising · dog surgery pain management
Abstract
PURPOSE: Investigate nociception differences in dogs undergoing enucleation administered bupivacaine either via preoperative retrobulbar block (pRB) or intraoperative splash block (iSB). METHODS: Prospective, randomized, double-masked, clinical comparison study. Dogs undergoing unilateral enucleation were randomized to two groups: one received bupivacaine pRB and saline iSB of the same volume, and the other received saline pRB and bupivacaine iSB. The following intraoperative parameters were recorded: heart rate (HR), respiratory rate (RR), end-tidal CO(EtCO); systolic, mean, and diastolic arterial blood pressure (SAP, MAP, and DAP respectively); inspired end-tidal isoflurane concentration (EtISOIns), and expired end-tidal isoflurane concentration (EtISOExp). Pain scores were recorded pre- and postoperatively. Analgesic rescue was documented. Surgical hemorrhage and postoperative bruising and swelling were graded subjectively by the surgeon (HDW) and study coordinator (AEZ). RESULTS: A significant (P = .0399) increase from baseline in overall mean heart rate was recorded in iSB bupivacaine patients (n = 11) compared with pRB bupivacaine patients (n = 11), with no significant differences in other intraoperative physiologic parameters, or pain scores. More analgesic rescue events occurred in iSB bupivacaine patients compared to pRB bupivacaine patients. A near-significant increase in intraoperative bleeding (P = .0519), and a significant increase in bruising (P = .0382) and swelling (P = .0223) was noted in the iSB bupivacaine group. CONCLUSIONS: Preoperative retrobulbar block bupivacaine is more effective than an iSB bupivacaine at controlling both intraoperative and postoperative nociception in dogs undergoing enucleation. Additionally, iSB causes more postoperative bruising and swelling and may be associated with increased intraoperative hemorrhage.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/31566883/