Opioid‐sparing anaesthesia techniques in dog and cat undergoing bilateral thoracotomy

Abstract

Multimodal analgesia is the foundation of opioid-sparing analgesia protocols in major surgery, being locoregional anaesthesia their keystone. Its aim is to provide adequate analgesia while minimising opioid requirements, and thus opioid-related adverse effects. The blossoming of ultrasound-guided fascial plane blocks offers a new spectrum of safer and simpler alternatives to traditional locoregional anaesthesia techniques. This report describes the anaesthetic management of a dog and a cat that underwent bilateral thoracotomy for treatment of chylothorax. The multimodal analgesia protocol consisted of preoperative methadone, ultrasound-guided serratus plane and erector spinae plane blocks, and epidural catheter for postoperative analgesia management. The combination of these techniques allowed for a reduction of perioperative opioid requirements, good-quality recovery and opioid-free analgesia in the postoperative period.

Anaesthetic management of three Maine Coon cats undergoing hybrid intervention for treatment of cor triatriatum sinister

“…40 The combination of ESP and the serratus plane block allowed a reduction in perioperative opioid requirements in both a dog and a cat undergoing bilateral thoracotomy. 41 In humans, the ESP block has also been described as successful in treating post thoracotomy pain syndrome. 42 In the cases reported in this case series, which were managed before advanced locoregional techniques have been increasingly described, all three cats received an intravenous combination of a fentanyl CRI and a bolus of methadone to supplement the epidural approach described.…”

“…The ESP block has been described to provide effective antinociception in dogs undergoing thoracotomy when combined with epidural morphine 40 . The combination of ESP and the serratus plane block allowed a reduction in perioperative opioid requirements in both a dog and a cat undergoing bilateral thoracotomy 41 . In humans, the ESP block has also been described as successful in treating post thoracotomy pain syndrome 42 .…”