Two cases of sinus arrest following erector spinae plane block in dogs

Sambugaro, Beatrice; Campbell, Nigel; Drożdżyńska, Maja

doi:10.1016/j.vaa.2022.05.002

Cited by 3 publications

(3 citation statements)

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“…In group ESPB, 10 dogs (7.6%) were excluded from the postoperative analysis because their behaviour made pain assessment impossible, and methadone was administered every 4 h. One dog was not included in the study as sinus arrest occurred 10 minutes after a thoracic (T13) ESPB performed administering 1 mL/kg of 0.125% levobupivacaine to each side (2.4 mg/ kg in total). As no improvement was noticed after multiple atropine administrations (0.02 mg kg − 1 IV; Atropine Sulfate, Martindale Pharma, UK), an intralipid solution (1.5 mL/kg followed by 0.25 mL/kg/minute; Intralipid 20%, Fresenius Kabi Ltd., UK) was administrated IV and sinus rhythm was re-established [21].…”

Section: Resultsmentioning

confidence: 99%

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Analgesic efficacy of a bilateral erector spinae plane block versus a fentanyl constant rate infusion in dogs undergoing hemilaminectomy: a retrospective cohort study

Viilmann¹,

Drożdżyńska²,

Vettorato

2022

BMC Vet Res

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Background Erector spinae plane block (ESPB) is an ultrasound-guided interfascial plane block used to provide analgesia in dogs undergoing hemilaminectomy. The aim of this study is to compare the analgesic efficacy of a bilateral ESPB with a fentanyl constant rate infusion (CRI) in dogs undergoing hemilaminectomy. Methods This is a retrospective cohort study. Anaesthetic records of client-owned dogs undergoing hemilaminectomy (June 2019–August 2020), and in which a bilateral ESPB was performed (group ESPB), were retrieved and compared to a cohort of 39 dogs that underwent hemilaminectomy (September 2014 – June 2017) and in which a fentanyl CRI (2 μg/kg bolus followed by 5 μg/kg/hour) was used as a primary intraoperative analgesia (group CRI). The prevalence of dogs in which intraoperative rescue fentanyl boluses were administered, the total dose of rescue fentanyl boluses administered, the postoperative methadone requirement and anaesthetic complications during the first 24 postoperative hours were evaluated. Univariate statistical analysis was used. Results Group ESPB comprised of 93 dogs. The bilateral ESPB was performed using a median (range) levobupivacaine volume of 1 (0.5–1.7) mL/kg per side, at a concentration of 0.125% (0.12–0.25). At least one rescue fentanyl bolus was administered in 54.8% and in 56.4% of dogs in group ESPB and CRI, respectively (p > 0.99). The number of rescue fentanyl boluses was higher in group CRI (p = 0.006), especially during lumbar hemilaminectomy. Rescue fentanyl boluses were more frequently administered from skin incision to end of vertebral lamina drilling in group CRI (p = 0.001), and from end of vertebral lamina drilling to end of surgery in group ESPB (p = 0.0002). During the first 6 (p = 0.0035) and 6–12 (p = 0.0005) postoperative hours, the number of dogs that required at least one dose of methadone was higher in group CRI. In group ESPB, dogs were more likely to become hypothermic (p = 0.04). One dog, not included in the study, developed sinus arrest after performing a caudal thoracic ESPB. Conclusions Under the conditions of this study, a bilateral ESPB was associated with a lower number of rescue fentanyl boluses administered in dogs undergoing hemilaminectomy, especially between skin incision to end of vertebral lamina drilling. Despite ESPB being associated with a reduced opioid consumption during the first 12 hours postoperatively, differences in the postoperative management precluded any firm conclusion regarding its postoperative effect.

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Section: Resultsmentioning

confidence: 99%

“…A dog developed sinus arrest 10 minutes after a T13 ESPB and it was not responsive to antimuscarinic therapy and intralipid solution was administered as local anaesthetic systemic toxicity (LAST) was suspected [21]. However, we cannot categorically exclude that the response to the intralipid solution was coincidental.…”

Section: Discussionmentioning

confidence: 99%

Analgesic efficacy of a bilateral erector spinae plane block versus a fentanyl constant rate infusion in dogs undergoing hemilaminectomy: a retrospective cohort study

Viilmann¹,

Drożdżyńska²,

Vettorato

2022

BMC Vet Res

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show abstract

“…Although aspiration was performed before injecting bupivacaine, muscles in this region are very vascular, which may have contributed to rapid systemic absorption of local anesthetic drug. 5 The total amount of bupivacaine used was below the toxic dose, but since the plasma concentration of the drug was not measured, the possibility of systemic toxicity cannot be ruled out. Fluids and vasopressor therapy improved the patient's blood pressure, and intervention with intralipid was not considered.…”

Section: Commentsmentioning

confidence: 99%