Evaluation of Quadratus Lumborum Block as Part of an Opioid-Free Anaesthesia for Canine Ovariohysterectomy

Abstract

Quadratus lumborum block (QLB) is used to provide analgesia for abdominal surgery in humans. The aim of this study was to assess an anaesthetic protocol involving the QLB for canine ovariohysterectomy. Ten dogs were included. Anaesthetic protocol consisted of premedication with IM medetomidine (20 μg kg−1) and SC meloxicam (0.1 mg kg−1), induction with propofol to effect, and maintenance with sevoflurane in oxygen/medical air. QLB was performed injecting 0.4 mL kg−1 of 0.25% bupivacaine/iohexol per side. Computed Tomography (CT) was performed before and after surgery. Fentanyl was administered as rescue analgesia during surgery. The Short Form of The Glasgow Composite Pain Scale and thermal threshold (TT) at the level of the elbow, T10, T13 and L3 were assessed before premedication and every hour postoperatively. Methadone was given as rescue analgesia postoperatively when pain score was >3. A Yuen’s test on trimmed means for dependent samples was used to analyse the data (p < 0.05). CT images showed spreading of the contrast/block for a median (range) of 3 (2–5) vertebrae, without differences between preoperative and postoperative images. One dog needed rescue analgesia during surgery. Pain score was less than 4/24 in all the animals during the first 4 h after surgery. TT showed a significant increased signal in all the areas tested, apart from the humerus, 30 min after surgery. The QLB may provide additional analgesia for canine ovariohysterectomy. Further studies are needed to assess the specific contribution of the QLB in abdominal analgesia.

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

“…are widely used [ 7 , 8 , 9 ]. However, over the last years, many locoregional anaesthesia techniques have been used together with systemic analgesia to obtain a multimodal approach to nociception and decrease the dose and the potential side effects of systemic analgesics and anaesthetic drugs [ 10 , 11 , 12 ]. Some locoregional anaesthetic techniques such as infiltration or splash block are very easy to be carried out and have shown good results in previous studies in small animals [ 12 ].…”

Ultrasound-Guided Saphenous Nerve Block in Rabbits (Oryctolagus cuniculus): A Cadaveric Study Comparing Two Injectate Volumes

“…While no single technique or drug regimen has been shown to eliminate peri-anesthetic morbidity and mortality in any species, a pre-emptive analgesia strategy and a multimodal approach to pain management should ensure optimal peri-operative analgesia in rabbits, reducing the risk of underdetection of pain and the occurrence of possible related complications in the peri-anesthetic period, such as ileus [1,4,5,8]. Loco-regional anesthesia techniques, such as peripheral nerve blocks (PNB) and interfascial blocks, are fundamental components of a multimodal approach to pain management and are effective in reducing the need for systemically-administered analgesic and anesthetic drugs, potentially limiting the latters' side effects [9,10]. However, in addition to preventing the transmission of nociceptive signals to the cortex, many loco-regional techniques will also result in a degree of motor block that may affect the rabbit's normal behavior pattern.…”

“…Loco-regional anesthesia techniques, such as peripheral nerve blocks (PNB) and interfascial blocks, are fundamental components of a multimodal approach to pain management and are effective in reducing the need for systemically-administered analgesic and anesthetic drugs, potentially limiting the latters’ side effects [ 9 , 10 ]. However, in addition to preventing the transmission of nociceptive signals to the cortex, many loco-regional techniques will also result in a degree of motor block that may affect the rabbit’s normal behavior pattern.…”

Local and Regional Anaesthetic Techniques in Canine Ovariectomy: A Review of the Literature and Technique Description

“…This review shows that the techniques and methods for controlling operative pain vary and are often new. In fact, in addition to the described techniques, quadratus lumborum (QL) block is being tested [ 78 ]. This is an ultrasound-guided technique of loco-regional anaesthesia involving the injection of a large volume of anaesthetic into the fascial plane surrounding the quadratus lumborum muscle, thus providing both somatic and visceral abdominal analgesia.…”

“…This is an ultrasound-guided technique of loco-regional anaesthesia involving the injection of a large volume of anaesthetic into the fascial plane surrounding the quadratus lumborum muscle, thus providing both somatic and visceral abdominal analgesia. QL block is an effective and safe method to provide intraoperative and postoperative analgesia for ovariohysterectomy in dogs, ensuring better pain control, and decreases the requirements of opioids in the perioperative period [ 78 ]. Regional anaesthesia has been increasingly used for analgesia in the perioperative period in veterinary medicine to improve pain control and the patient outcomes.…”