Ultrasound-Guided Transversus Abdominis Plane Block in Shetland Ponies: A Description of a Three-Point Injection Technique and Evaluation of Potential Analgesic Effects

Küls, Nina; Trujanovic, Robert; Otero, Pablo E.; Larenza-Menzies, M. Paula

doi:10.1016/j.jevs.2020.102994

Cited by 28 publications

(42 citation statements)

References 35 publications

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“…Nine publications focused on different loco-regional techniques [272][273][274][275][276][277][278][279][280]. In the last few years, a renaissance of loco-regional techniques on standing horses has occurred with the advent of ultrasound guided technology [469,470]. When general anaesthesia is unavoidable, loco-regional techniques can still be used to provide intra-and postoperative analgesia, reduce surgical stimulations and produce muscle relaxation.…”

Section: Other Drugs Used During Maintenancementioning

confidence: 99%

Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature

Gozalo-Marcilla

Ringer

2021

Animals

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Recovery remains the most dangerous phase of general anaesthesia in horses. The objective of this publication was to perform a structured literature review including levels of evidence (LoE) of each study with the keywords “recovery anaesthesia horse”, entered at once, in the search browsers PubMed and Web of Science. The two authors independently evaluated each candidate article. A final list with 444 articles was obtained on 5 April 2021, classified as: 41 “narrative reviews/expert opinions”, 16 “retrospective outcome studies”, 5 “surveys”, 59 “premedication/sedation and induction drugs”, 27 “maintenance with inhalant agents”, 55 “maintenance with total intravenous anaesthesia (TIVA)”, 3 “TIVA versus inhalants”, 56 “maintenance with partial intravenous anaesthesia (PIVA)”, 27 “other drugs used during maintenance”, 18 “drugs before/during recovery”, 18 “recovery systems”, 21 “respiratory system in recovery”, 41 “other factors”, 51 “case series/reports” and 6 “systems to score recoveries”. Of them, 167 were LoE 1, 36 LoE 2, 33 LoE 3, 110 LoE 4, 90 LoE 5 and 8 could not be classified based on the available abstract. This review can be used as an up-to-date compilation of the literature about recovery after general anaesthesia in adult horses that tried to minimise the bias inherent to narrative reviews.

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Section: Other Drugs Used During Maintenancementioning

confidence: 99%

Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature

Gozalo-Marcilla

Ringer

2021

Animals

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“…Recently, the TAP block has been introduced in veterinary anaesthesia, both in experimental and clinical settings [4][5][6][7]. This technique involves injecting a volume of local anaesthetic into the neurovascular plane between the transversus abdominis and internal oblique muscle in order to saturate somatic afferents before they leave the TAP and provide analgesia in that anatomical area [8,9]. The lateral abdominal wall in mammals consists of three major muscle layers: the external oblique (EO), the internal oblique (IO), and the transversus abdominis (TA), along with their associated fascial sheaths [10,11].…”

Section: Introductionmentioning

confidence: 99%

“…The sensory supply for the skin, subcutaneous tissues, mammary glands, muscles, and parietal peritoneum of the cranial, lateral, and caudoventral areas of the abdominal wall is derived from the afferent branches of the ventral thoracic and lumbar nerves. These originate from the thoracolumbar spinal roots that course through the lateral abdominal wall within the fascial plane between the IO and TA muscles, termed 'TAP plexus' [9,12]. This site is the target of the regional block that allows obtaining lower abdominal wall analgesia [13].…”

Section: Introductionmentioning

confidence: 99%

“…Alternative approaches with two sites of injection, one caudal to the last rib and the other cranial to the iliac crest, have been used to provide successful analgesia in dogs [12][13][14][15][16]. The spread of the volume injected and the features of these two different approaches were evaluated in dog [14,17,18], cat [7], pony [11], and calf [6] cadavers, as well as in one Canadian lynx [4], cats [19], ponies [9], and dogs [12] in vivo studies. To the authors' knowledge, there are no studies describing the US-guided lateral TAP block in rabbits.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided Lateral Transversus Abdominis Plane (TAP) Block in Rabbits: A Cadaveric Study

Bella

Pennasilico

Staffieri

et al. 2021

Animals

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The aims of the study were to describe the ultrasonographic-guided lateral TAP block in rabbit cadavers and evaluate the spread of a lidocaine/methylene blue solution through a single fascial infiltration. The US-guided block and anatomical dissections were performed in 17 New Zealand rabbit cadavers. The probe was placed perpendicular to the column, one centimetre ventrally to the transverse processes, halfway between the iliac crest and the costal margin. External oblique (EO), internal oblique (IO), and transversus abdominis (TA) muscles were visualised, and 1 mL/kg of lidocaine 2% plus methylene blue 1% was injected. After dissection, the branches of spinal nerves stained were measured. Moreover, the percentage of length and height of the area marked were calculated. A good visualisation of the TAP was obtained in all 34 hemiabdomens. T11 nerve eminence was successfully stained in 52% of cases. T12, L1, and L2 were stained in 75%, 95%, and 100% of cases, respectively. L3 and L4 were stained in 60% and 40% of cases, respectively. The lateral TAP block with a single point of injection can be easily performed in rabbits, but it is not sufficient to cover the nerve eminences of the cranial abdomen. The two-point TAP block (lateral and subcostal) could represent a better option, particularly when large surgical incisions are required.

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“…It can be applied in a focused manner to minimize the energy applied to the surrounding, nontargeted tissues. Many of the current ultrasound-triggerable drug release systems, such as micelles, liposomes, composites and hybrid materials, are responsive to the thermal and mechanical effects of ultrasound waves [13][14][15][16]. To improve the effect of sonodynamic therapy, more sonosensitizers have been developed, such as protoporphyrin IX (PPIX) [4].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-triggered on Demand Lidocaine Release Relieves Postoperative Pain

Chen

Zhang

et al. 2021

Preprint

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BackgroundSafe and noninvasive on-demand relief is a crucial and effective treatment for postoperative pain because it considers variable timing and intensity of anesthetics. Ultrasound modulation is a promising technique for this treatment because it allows convenient timed and noninvasive controlled drug release.MethodsWe created an ultrasound-triggered lidocaine (Lido) release platform using an amino acid hydrogel functioning as three dimensional (3D) scaffold material (Lido-PPIX@ER hydrogel). Optimal preparation conditions and ultrasound-triggered parameters were evaluated. In the postoperative pain SD rat model, the Lido-PPIX@ER hydrogel or free lidocaine was administered by subcutaneous injection immediately after making the paw incision. Mechanical hypersensitivity was assessed using calibrated von Frey filaments after an individualized (highly variable) ultrasound-triggered process. The safety of the treatment was also evaluated.ResultsThe Lido-PPIX@ER hydrogel allows control of the timing, intensity and duration of lidocaine (Lido) to relieve postoperative pain. The hydrogel releases Lido due to the elevated reactive oxygen species (ROS) levels generated by PPIX under ultrasound triggering. The optimal ultrasound parameter (0.3 W/cm2, 30 s) was chosen for in vitro and in vivo studies. The Lido-PPIX@ER hydrogel (with lidocaine, 5.6 mg/mL) under individualized ultrasound triggering (every 2 h in the first 12 h, every 4 h for the next 36 h, and then every 6 h until 72 h postsurgery) released lidocaine and provided effective analgesia for more than 72 h. Additionally, the withdrawal threshold was higher than that in the control group at all time points measured. The hydrogel showed repeatable and adjustable ultrasound-triggered nerve blocks in vivo, the duration of which depended on the extent and intensity of insonation. On histopathology, no systemic effect or tissue reaction was observed in the ultrasound-triggered Lido-PPIX@ER hydrogel-treated group.ConclusionsThe Lido-PPIX@ER hydrogel with individualized (highly variable) ultrasound triggering is a convenient and effective method that offers timed and spatiotemporally controlled Lido release to manage postoperative pain.

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Ultrasound-Guided Transversus Abdominis Plane Block in Shetland Ponies: A Description of a Three-Point Injection Technique and Evaluation of Potential Analgesic Effects

Cited by 28 publications

References 35 publications

Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature

Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature

Ultrasound-Guided Lateral Transversus Abdominis Plane (TAP) Block in Rabbits: A Cadaveric Study

Ultrasound-triggered on Demand Lidocaine Release Relieves Postoperative Pain

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