Clinical Assessment of Introducing Locoregional Anaesthesia Techniques as Part as the Intraoperative Analgesia Management for Canine Ovariohysterectomy in a Veterinary Teaching Hospital

Abstract

This study compared four methods to provide intraoperative analgesia during canine ovariohysterectomy in a veterinary teaching hospital. A retrospective study was designed to assess the nociceptive response, cardiorespiratory stability, quality of recovery and complications of four analgesic protocols: epidural analgesia (EPIDURAL group), Quadratus Lumborum block (QLB group), Transversus Abdominis Plane block (TAP group), and just systemic analgesia (GENERAL group). Undergraduate students carried out all the loco-regional techniques under the direct supervision of a qualified anaesthetist. A total of 120 cases met the inclusion criteria and were included in the study and were distributed as follows: 22, 27, 32 and 39 cases with EPIDURAL, GENERAL, QLB and TAP groups, respectively. Data were analysed with statistical software R using different statistical methods. Significant differences among groups were defined as p < 0.05. Based on our results, all the groups needed the same number of rescue analgesia during the intra-operative period. The use of loco-regional techniques anticipated a better quality of recovery compared with the general group. The EPIDURAL group showed a statistically lower expired fraction of sevoflurane. No differences were found regarding complications. In conclusion, these four analgesic methods are suitable and safe to be performed for canine ovariohysterectomy, although loco-regional techniques might have some advantages.

Use of Transversus Abdominis Plane and Intercostal Blocks in Bitches Undergoing Laparoscopic Ovariectomy: A Randomized Controlled Trial

“…In humans, the inadvertent puncture of abdominal organs (mainly liver, spleen and gastro-intestinal tract) has been reported, although it appears to be a rare event [38]. The results of this study are in agreement with a recently published retrospective study in which no complications were associated with the TAP block in a canine population undergoing ovariohysterectomy [19]. When intercostal blocks are performed, each needle insertion may cause a lung puncture or the intramuscular, intravascular, and interpleural injection of local anesthetic as the main complications.…”

“…Based on the findings of this study, this combination of TAP and intercostal blocks was associated with lower peri-operative opioid consumption and a lower post-operative pain scored during the first 6 h post-extubation in a population of healthy bitches undergoing laparoscopic ovariectomy. Similar findings come from other studies in which the TAP block was used as part of a multi-modal analgesia in bitches undergoing ovariohysterectomy [18,19] and queens undergoing ovariectomy via midline celiotomy [23]. The most likely reason for this observation seems to be a desensitization of the abdominal skin, muscles and parietal peritoneum [8,14,24].…”

“…Although several small animal cadaveric studies, case reports and randomized controlled trials have been published [8,[11][12][13][14][18][19][20], to date, no clinical trial has investigated the intraor post-operative efficacy of the TAP block in dogs undergoing laparoscopic surgery.…”

Opioid‐free anaesthesia for surgical attenuation of a congenital extrahepatic portosystemic shunt in a dog

“…14,15 The QL block is one such technique, although its mechanism has not yet been fully clarified, it provides analgesia of the ventral branches of caudal thoracic and lumbar spinal nerve roots, responsible for somatic innervation. [16][17][18] Some studies suggest that the QL block provides somatic analgesia in the mid-caudal abdomen and possibly visceral analgesia in the mid-abdomen. 16,17 However, the only published evidence relates to dogs underdoing ovariohysterectomy.…”

“…[16][17][18] Some studies suggest that the QL block provides somatic analgesia in the mid-caudal abdomen and possibly visceral analgesia in the mid-abdomen. 16,17 However, the only published evidence relates to dogs underdoing ovariohysterectomy. 16,17 In human medicine, the QL block has been reported as a suitable intraoperative analgesic in open abdominal surgery, particularly in surgeries involving the liver, reducing administration of general and rescue anaesthetics, as well as resulting in faster postoperative recovery.…”