Onset of Action of Bupivacaine Administered via Dural Puncture Epidural versus Spinal, Lumbosacral, and Sacrococcygeal Epidural Injections in Dogs: Randomised Clinical Trial

Abstract

The study aimed to compare bupivacaine onset time when administered via epidural anaesthesia injecting both at the lumbosacral and sacrococcygeal spaces, spinal anaesthesia, and DPE in clinical dogs. A total of 41 dogs requiring neuraxial anaesthesia as part of their anaesthetic protocol were recruited. They were randomly allocated to receive an epidural injection in the sacrococcygeal space aided by the nerve stimulator (SCO), an epidural injection in the lumbosacral (LS), a subarachnoid injection (SPI), or a DPE. The onset of anaesthesia was assessed every 30 s after the injection by testing the presence of patellar ligament reflex. The number of attempts and time to perform the technique were also recorded. Data were analysed using a one-way ANOVA for trimmed means with post hoc Lincoln test and a Kaplan–Meier curve. The significance level was set at p < 0.05, and the results are presented in absolute values and median (range). There was no difference in the number of attempts required to complete the techniques between groups (p = 0.97). Epidural injections (LS and SCO) tended to be shorter than SPI and DPE techniques, but there was no statistically significant difference (p = 0.071). The time to the disappearance of patellar ligament reflex (Westphal’s sign) in the SCO group was longer than in any other group. In conclusion, all techniques provided a rapid block of the patellar reflex. The SCO technique was the slowest in onset, while the other groups (SPI, DPE, and LS) were faster and almost indistinguishable.

Effect of Dural-Puncture Epidural vs Standard Epidural for Epidural Extension on Onset Time of Surgical Anesthesia in Elective Cesarean Delivery

“…The mechanisms determining flux of local anesthetics through the meninges and the hole created by the dural puncture are complex and have not yet been fully elucidated. 16 , 17 , 18 , 19 The size of the dural puncture is important, but there are likely other important factors involved, such as the total drug mass of the injectate, timing since DPE was performed, epidural bolus administration, and the injectate pressure generated.…”

Efficacy of lumbosacral and sacrococcygeal epidural ropivacaine in dogs undergoing surgery for perineal hernia

“…In particular, the technique has been used with success for catheterization and pain management in the treatment of feline urethral obstruction ( 13 ). More recently, the technical aspects of a sacrococcygeal injection have been investigated in a comparative study on dogs ( 14 ), but no clinical comparison between the intra- and postoperative effects of an LS versus an SC epidural injection has been carried out in dogs.…”

Comparative Study of the Sedative and Anti-nociceptive Effects of Sacrococcygeal Epidural Administration of Romifidine, Lidocaine, and Romifidine/Lidocaine in the Dromedary Camel

“…Furthermore, caudal epidural analgesia can provide efficient analgesia with superior therapeutic efficacy in the management of pre-and postoperative pain in the hind limbs, pelvis and caudal regions in ruminants (1,2). Therefore, the utility of this technique in the field of veterinary anesthesia has garnered increased clinical attention over the last decade (3)(4)(5). Caudal epidural administration of local analgesic agents (usually a 2% lidocaine solution) has been widely reported for surgical interventions of the tail, anus, rectum, perineum and urogenital system (vulva, vagina, urethra and bladder) in the camel (6).…”