Peer-reviewed veterinary case report
Nerve blocks used to reduce pain in dogs during knee surgery
By Papadopoulos, Georg et al.·Published in Veterinary anaesthesia and analgesia·2022·Small Animal Referral Clinic Papadopoulos and Eß, Germany·View original on PubMed →
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Original publication title: Femoral and sciatic nerve blockade of the pelvic limb with and without obturator nerve block for tibial plateau levelling osteotomy surgery in dogs.
- Species:
- dog
Plain-English summary
A group of 88 dogs undergoing knee surgery (tibial plateau leveling osteotomy) were given different types of nerve blocks to see if adding an obturator nerve block would help reduce pain during the procedure. The dogs received either a combination of three nerve blocks or just two, with the third being a placebo. The results showed that there were no significant differences in pain management or vital signs between the two groups. This means that adding the obturator nerve block didn't provide any extra benefit for pain relief during surgery.
People also search for: dog knee surgery pain management · TPLO surgery recovery · nerve block for dog surgery
Abstract
OBJECTIVE: To determine the effect of blocking the obturator nerve in addition to performing femoral nerve and sciatic nerve blocks on intraoperative nociception in dogs undergoing unilateral tibial plateau levelling osteotomy (TPLO) surgery. STUDY DESIGN: Prospective, blinded, randomized, placebo-controlled, clinical comparison. ANIMALS: A total of 88 client-owned dogs undergoing unilateral TPLO surgery (100 procedures). METHODS: Dogs were randomly assigned to either group FSO (femoral, sciatic and obturator nerve blocks) [n = 50; ropivacaine 0.75% (0.75 mg kg)] or group FSP (femoral, sciatic and placebo) [n = 50; ropivacaine 0.75% (0.75 mg kg) femoral and sciatic nerve blocks plus saline solution 0.9% (0.1 mL kg) as a placebo injection around the obturator nerve]. The anaesthetic protocol was standardized. Data collection included intraoperative cardiopulmonary variables and opioid consumption. Rescue analgesia consisted of an intravenous bolus of fentanyl (2 μg kg) and was administered when a change in cardiopulmonary variables (20% increase in mean arterial pressure or heart rate) was attributed to a sympathetic stimulus. Data were analysed using generalized linear mixed models, cross tables and multivariable binary logistic regression. Results were expressed as adjusted odds ratios with 95% confidence intervals and Wald p values (α = 0.05). RESULTS: There were no clinically relevant differences between groups in intraoperative cardiopulmonary variables and need for rescue analgesia. The requirement for rescue analgesia was significantly higher in dogs with a body weight >34 kg. CONCLUSIONS AND CLINICAL RELEVANCE: Anaesthesia of the obturator nerve in addition to the femoral and sciatic nerves was not associated with clinically significant differences in cardiopulmonary variables or a reduced need for rescue analgesia. Therefore, the clinical benefit of an additional obturator nerve block for intraoperative antinociception in dogs undergoing unilateral TPLO surgery using the described anaesthetic regimen is low.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/35550342/