Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1)

Abstract

Pain management in veterinary patients is a crucial component of appropriate patient care. Multimodal analgesia that includes both systemically and locally/regionally administered drugs is generally the most effective approach to providing pain relief. Local anaesthetic drugs used in local and regional blockade are unique in that they can completely block the transmission of pain (in conscious patients) or nociceptive (in anaesthetized patients) signals, thereby providing profound analgesia. In addition, local and regional administration of drugs, when compared with systemic bolus administration, generally results in a lower incidence of dose‐related adverse effects. Due to the potential to provide profound analgesia and the high safety margin (when used correctly) of this drug class, local anaesthetics are recommended as part of the analgesic protocol in the majority of patients undergoing surgical procedures or suffering traumatic injuries. This manuscript, Part 1 of a two‐part instalment, emphasizes the importance of using local and regional anaesthesia as a component of multimodal analgesia, provides a review of the basic pharmacokinetics/pharmacodynamics of local anaesthetic drugs in general, lists information on commonly used local anaesthetic drugs for local and regional blockade in dogs and cats, and briefly introduces the novel liposome‐encapsulated bupivacaine (NOCITA®). Part 2 is a review of local and regional anaesthetic techniques used in dogs and cats (Grubb & Lobprise, 2020).

Use of Spinal Anaesthesia with Anaesthetic Block of Intercostal Nerves Compared to a Continuous Infusion of Sufentanyl to Improve Analgesia in Cats Undergoing Unilateral Mastectomy

“…In fact, one of the objectives of veterinary medicine is to provide adequate analgesia to help the patient not feel pain, and to move, eat, and sleep without discomfort, particularly in the first hours after the operation [ 17 ]. The use of local anaesthetics, despite its benefits, can cause side effects, including allergic reactions, sedation, respiratory depression, convulsions, hyperexcitability, tissue irrigation, and coma [ 18 , 19 , 20 , 21 ]. In this study, which included 20 cats, no side effects, complications, or mortality occurred in any of the patients.…”

3D anatomical model for teaching canine lumbosacral epidural anesthesia

“…The epidural anesthesia was also performed by the veterinary anesthesiologist in the animals that the students failed to anesthetize at the test. As a general rule, the addition of a vasoconstrictor to a local anesthetic agent, such as epinephrine, allows for decreased local perfusion, delayed rate of vascular absorption of local anesthetic, and therefore increased intensity and prolonged anesthetic activity 24 .…”

Caudal inferior alveolar nerve block in a Bennett’s wallaby (Macropus rufogriseus)

“…Locoregional anaesthesia has been shown to have significant benefits in improving the perioperative control of pain, sparing systemic analgesia, improving the quality of anaesthetic recovery and reducing morbidity 3. Use of locoregional techniques in Macropus rufogriseus by both blind and ultrasound‐guided techniques have previously been reported,4 5 but to the authors’ knowledge, the use of an inferior alveolar nerve block in this species has never been reported.…”