Ultrasound-guided serratus plane block as an effective adjunct to systemic analgesia in four dogs undergoing thoracotomy

Abstract

Background: Ultrasound-guided serratus plane block (UGSPB) is a loco-regional anesthesia technique designed to desensitize the thoracic wall. It is a compartmental block, where local anesthetic is delivered to the fascial, intermuscular plane. Since its original description in humans, two cadaveric veterinary studies, redefining the technique, have been performed. Taking into account the successful use of the UGSPB in human medicine, we employed the veterinary description to perform this block in four dogs undergoing thoracotomy. The case series described below aims to share our experience of the clinical application of this new loco-regional anesthesia technique in dogs. Case Description: Four dogs, with different underlying medical conditions underwent cranial lateral thoracotomy. The analgesia protocol consisted of intravenous methadone and UGSPB performed half an hour before the beginning of the procedure. The cardiovascular system was closely monitored for any signs of nociception. Fentanyl, although available as rescue analgesia, was not required in any of these cases as no signs of nociception were present. Conclusion: To the authors’ knowledge, this is the first veterinary clinical report using the UGSPB as a part of a multimodal analgesia protocol in dogs undergoing thoracotomy. Based on this observation, UGSPB has the potential to prevent nociception and reduce the intraoperative opioid requirements in dogs undergoing thoracotomy. A prospective randomized clinical trial is required to confirm these promising results.

Description of an Ultrasound-Guided Transverse Approach to the Transversus Thoracis Plane Block and Evaluation of Injectate Spread in Canine Cadavers

“…In veterinary medicine, neuraxial techniques and peripheral anaesthetic blocks, as thoracic paravertebral block, erector spinae plane block, serratus plane block, intercostal blocks or pleural irrigation with local anaesthetics, have been used to provide chest wall analgesia [4][5][6][7][8][9]. No studies have been reported suggesting the efficacy of the TTP block to provide analgesia to the ventral aspect of the chest wall in dogs.…”

Ultrasound‐guided parasternal block in a cat undergoing median sternotomy for pulmonary lobectomy

“…Two different case series have investigated the analgesic efficacy of serratus plane block 18 and erector spinae plane block 19 in dogs submitted to lateral thoracotomy. More recently, another case series reported the use of erector spinae plane block in combination with a constant‐rate infusion of dexmedetomidine in dogs submitted to sternotomy 20 .…”

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

“…Despite the fact that both of these techniques have already been described in cadaveric studies in dogs, 16,17 the clinical evidence of their use for thoracotomies is still scarce in veterinary anaesthesia. UG‐SPB prevented nociception and reduced the intraoperative opioid requirements in four dogs undergoing lateral thoracotomy 18 . Similarly, UG‐ESPB as part of MA provided good intraoperative analgesia in six dogs undergoing lateral thoracotomy 19 .…”

“…UG-SPB prevented nociception and reduced the intraoperative opioid requirements in four dogs undergoing lateral thoracotomy. 18 Similarly, UG-ESPB as part of MA provided good intraoperative analgesia in six dogs undergoing lateral thoracotomy. 19 To the authors' knowledge, neither of these LA techniques has been described yet in cats undergoing thoracic surgery.…”