Peer-reviewed veterinary case report
Comparing three nerve block methods for dog leg surgery pain control
By Ferrero, Camilla et al.·Published in Veterinary anaesthesia and analgesia·2021·Anaesthesia Department, United Kingdom·View original on PubMed →
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Original publication title: Retrospective comparison of three locoregional techniques for pelvic limb surgery in dogs.
- Species:
- dog
Plain-English summary
A group of 236 dogs undergoing surgery on their back legs received one of three types of pain relief methods. The study found that while all methods were effective in managing pain after surgery, the epidural technique (EPI) led to fewer dogs needing extra pain relief during surgery compared to one other method, but it also caused more dogs to experience low blood pressure and difficulty urinating afterward. Overall, all three pain relief techniques worked similarly for managing pain after surgery, but the EPI method had some drawbacks.
People also search for: dog back leg surgery pain relief · dog urinary retention after surgery · dog low blood pressure during surgery
Abstract
OBJECTIVE: To retrospectively compare the efficacy and duration of effect of three commonly used locoregional blocks in dogs undergoing pelvic limb orthopaedic surgery. STUDY DESIGN: Retrospective clinical study. ANIMALS: A total of 236 dogs that underwent pelvic limb surgery and were administered a locoregional technique. METHODS: A total of 236 hospital records were reviewed and 230 included in statistical analysis. Dogs were grouped as following: electrostimulation-guided pre-iliac femoral and sciatic nerve block (group PFS, n = 70); ultrasound-guided saphenous and sciatic nerve block (group SS, n = 76); or lumbosacral epidural (group EPI, n = 84). In group EPI, bupivacaine 0.5% or ropivacaine 0.75% was used with morphine. Dogs were pain scored (short form of the Glasgow Composite Measure Pain Scale) hourly following recovery from anaesthesia. Analysed data included: time to first postoperative dose of methadone, pain score at that time, intraoperative rescue analgesia, intraoperative hypotension and ability to walk and urinate overnight. Separate analyses were performed including all pelvic limb surgeries and including only elective stifle surgeries. Kruskal-Wallis and Mann-Whitney tests were performed. A p value < 0.05 was considered significant. The median (range) is reported. RESULTS: For all pelvic limb surgeries, the time to first postoperative methadone was 530 (110-1337), 440 (140-1030) and 466 (135-1094) minutes in groups EPI, PFS and SS, respectively, and was not significantly different. Postoperatively, 10/84, 15/70 and 12/76 dogs in groups EPI, PFS and SS, respectively, did not require methadone (nonsignificant). Significantly fewer dogs in group EPI (18%) required intraoperative rescue analgesia compared with group SS (38%), but not compared with PFS (30%). Significantly more dogs in group EPI had hypotension intraoperatively (30%) and urinary retention postoperatively (62%). CONCLUSIONS AND CLINICAL RELEVANCE: Intraoperative analgesia may be superior with EPI than SS for some surgeries of the pelvic limb, but not for stifle surgeries. All three techniques provided similar requirement for postoperative analgesia, but EPI caused higher incidence of intraoperative hypotension and postopertive urinary retention.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/34083139/