Retrospective study on the use of lumbosacral epidural analgesia during caesarean section surgery in 182 dogs: Impact on blood pressure, analgesic use and delays

Abstract

Background: We evaluated the use of lumbosacral epidural anaesthesia (LEA) in dogs undergoing caesarean section over 10 years. Methods: Anaesthetic records were reviewed and divided into two treatment groups: LEA and control. Outcome variables identified a priori as potentially affected by LEA were compared between groups. Results are frequency or median (minimum–maximum). Results: Ninety‐five dogs received LEA and 87 did not. LEA consisted of 0.2 (0.1–0.3) ml/kg containing bupivacaine (n = 63), ropivacaine (n = 15), or lidocaine (n = 12) at concentrations ranging between 0.06% and 2%. Morphine, fentanyl, or buprenorphine were used as part of LEA. Groups were similar for demographic variables (all p > 0.06). Intravenous opioids were used more often in control than in LEA (p < 0.0005). Incidence of hypotension (MAP < 60 mm Hg) was LEA 68% and control 56% (p = 0.12). Duration of hypotension was longer in LEA (p = 0.03). Use of crystalloids and vasoactive drugs did not differ (all p > 0.1). Time from induction to operating room was 30 (8–75) min for control and 35 (18–65) min for LEA (p = 0.003). Discussion: LEA during caesarean section in dogs was associated with lower rates of opioid administration and did not exacerbate the incidence of hypotension.

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

“…Indeed, when ropivacaine was injected into the thoracic epidural space, the MAP decreased significantly in humans only at a dose of ropivacaine 0.75% but not with ropivacaine 0.375% or 0.2% ( 33 ). In dogs undergoing a cesarean section, the use of lumbosacral epidural analgesia (ropivacaine, bupivacaine or lidocaine) at a maximum volume of 0.3 mL kg −1 did not exacerbate hypotension ( 34 ). In our study, MAP differed between the SC and LS group at 30 min after the injection, but since the MAP was above the set threshold for treatment in both groups, this information might be not clinically relevant.…”

Preliminary study on fluid bolus administration for prevention of spinal hypotension in dogs undergoing elective cesarean section

“…It has been reported that during cesarean section (CS), hypotension following EA can occur in up to 80% of women (2)(3)(4); similar findings have also been noted in dogs (5)(6)(7)(8)(9)(10). The consequences of low blood pressure affect both, the mother and unborn fetus.…”

“…The dogs were healthy, and without any systemic diseases based on routine clinical, hematological, and biochemical examinations. The mean body weight of the females was 14.6 kg (3–46 kg), and the mean age was 4.1 ( 2 – 8 ) years. Cesarean section was performed independently in this research.…”

Comparison of rostral spread of lumbosacral epidural volume calculated by body weight or length of the vertebral column in dogs

“…Animal anatomical variability and physicochemical properties of the drug that limit rostral spread and incomplete effects include highly lipophilic drugs, meningovertebral ligaments that cause compartmentalization, increased epidural space pressures, positioning that increases frictional and gravity forces against the injectate, and leakage from the epidural space through intervertebral foramina ). In addition, insufficient dose and inappropriate technique may be contributing factors (Hermanides et al 2012;Martin-Flores et al 2021).…”