Peer-reviewed veterinary case report
Nerve blocks versus epidural for dog knee surgery pain control
By Campoy, Luis et al.·Published in Veterinary anaesthesia and analgesia·2012·Department of Clinical Sciences, United States·View original on PubMed →
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Original publication title: Comparison of bupivacaine femoral and sciatic nerve block versus bupivacaine and morphine epidural for stifle surgery in dogs.
- Species:
- dog
Plain-English summary
Twenty dogs undergoing knee surgery were given either an epidural (a combination of bupivacaine and morphine) or a nerve block (bupivacaine injected near the femoral and sciatic nerves) to manage pain during and after the procedure. The dogs that received the nerve block needed less pain medication afterward and had fewer issues with urinary retention compared to those who had the epidural. While the epidural group showed lower anesthesia requirements during surgery, the nerve block proved to be a practical alternative with fewer side effects. Overall, the nerve block helped the dogs recover more comfortably after their surgery.
People also search for: dog knee surgery pain management · epidural vs nerve block for dogs · dog urinary retention after surgery
Abstract
OBJECTIVE: To evaluate the efficacy of combined femoral and sciatic nerve blocks as an alternative to epidural anesthesia and analgesia in dogs undergoing stifle surgery under general anesthesia. STUDY DESIGN: Prospective, blinded, randomized, clinical comparison. ANIMALS: Twenty dogs weighing 37 ± 11 (mean ± SD) kg, aged 3 (1-8) [median (minimum-maximum)] years undergoing elective unilateral tibial-plateau leveling osteotomy. METHODS: Dogs were assigned randomly to receive either epidural anesthesia (bupivacaine 0.5%, 0.5 mg kg(-1) + morphine 0.1%, 0.1 mg kg(-1), in 0.2 mL kg(-1); EPID) or femoral and sciatic nerve blocks (Bupivacaine 0.5%, 0.1 mL kg(-1), was administered at each site; F + S) guided by electrolocation. All patients received a standard general anesthesia technique. Pain and sedation were scored (on scales of 0-10 and 0-3, respectively) pre-operatively, at extubation, and at 1, 4 and then every 4 hours thereafter up to 24 hours. Postoperatively, hydromorphone was administered to any patient with a pain score of >5 or whenever the blinded caregiver determined that more hydromorphone was necessary. Intraoperative heart rate (HR), mean arterial pressure (MAP), end tidal isoflurane (FE'ISO), body temperature, post-operative pain scores, time to first hydromorphone dose after surgery, time to first feeding, time to first drinking, time to first urination, time to first ambulation (walk on a lead) and cumulative dose of hydromorphone were recorded. RESULTS: Intra-operatively, FE'ISO and MAP were significantly lower in the EPID group (p = 0.05 and p = 0.04, respectively). Postoperatively, the cumulative hydromorphone consumption (p = 0.04) and the incidence of urinary retention (p = 0.03) were higher in the EPID group. CONCLUSION AND CLINICAL RELEVANCE: F + S is a practical alternative to EPID that produces less urine retention and reduces opioid consumption in the 24 hours after surgery. EPID might be associated with a lower isoflurane requirement and lower systemic blood pressure.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/22117792/