Abstract
Simple SummaryThe aim of this study was to assess an anaesthetic protocol involving the quadratus lumborum block (QLB) for canine ovariohysterectomy. Ten healthy dogs were included. Anaesthetic protocol consisted of medetomidine and meloxicam, induction of anaesthesia with propofol and maintenance with sevoflurane in oxygen/medical air. The QLB was performed at the level of L1–L2 injecting 0.4 mL kg−1 of 0.25% bupivacaine/iohexol per side. Computed Tomography (CT) was performed before and after surgery. Fentanyl was administered as rescue analgesia during surgery. The Short Form of The Glasgow Composite Pain Scale and thermal threshold (TT) at the level of the humerus, T10, T13 and L3 were assessed before premedication and every hour postoperatively. Methadone was given as rescue analgesia when it was needed. CT images showed spreading of a median (range) of 3 (2–5) vertebrae, without differences between preoperative and postoperative images. One out of ten dogs needed intraoperative rescue analgesia. Pain score was less than 4/24 in all the animals until four hours after surgery. TT showed significative increase in all the areas tested apart from the elbow 30 min after the recovery. The QLB provides additional analgesia for canine ovariohysterectomy. Quadratus lumborum block (QLB) is used to provide analgesia for abdominal surgery in humans. The aim of this study was to assess an anaesthetic protocol involving the QLB for canine ovariohysterectomy. Ten dogs were included. Anaesthetic protocol consisted of premedication with IM medetomidine (20 μg kg−1) and SC meloxicam (0.1 mg kg−1), induction with propofol to effect, and maintenance with sevoflurane in oxygen/medical air. QLB was performed injecting 0.4 mL kg−1 of 0.25% bupivacaine/iohexol per side. Computed Tomography (CT) was performed before and after surgery. Fentanyl was administered as rescue analgesia during surgery. The Short Form of The Glasgow Composite Pain Scale and thermal threshold (TT) at the level of the elbow, T10, T13 and L3 were assessed before premedication and every hour postoperatively. Methadone was given as rescue analgesia postoperatively when pain score was >3. A Yuen’s test on trimmed means for dependent samples was used to analyse the data (p < 0.05). CT images showed spreading of the contrast/block for a median (range) of 3 (2–5) vertebrae, without differences between preoperative and postoperative images. One dog needed rescue analgesia during surgery. Pain score was less than 4/24 in all the animals during the first 4 h after surgery. TT showed a significant increased signal in all the areas tested, apart from the humerus, 30 min after surgery. The QLB may provide additional analgesia for canine ovariohysterectomy. Further studies are needed to assess the specific contribution of the QLB in abdominal analgesia.
Highlights
The ultrasound (US)-guided quadratus lumborum block (QLB) is a regional anaesthesia technique firstly described in human medicine by Blanco et al [1]
QLB performed by administering bupivacaine 0.25% at 0.4 mL kg−1 per side allowed a satisfactory intraoperative analgesic plan in a relatively light anaesthetic plane (ETSevo about 1.8%)
The spreading of contrast after the QLB seems similar in live dogs than in canine cadavers
Summary
The ultrasound (US)-guided quadratus lumborum block (QLB) is a regional anaesthesia technique firstly described in human medicine by Blanco et al [1]. Several clinical studies have been published in the human literature reporting the analgesic effect of this technique for abdominal procedures [2,3,4]. Several studies have been published in veterinary medicine describing the technique in dogs [7,8,9,10] and cats [11] and assessing the contrast spreading in cadavers. Three studies administered the contrast between the quadratus lumborum and psoas muscles [7,10,11] In both dogs and cats, it was found to have a similar distribution, staining the ventral branches of the spinal nerves from L1 to L3 and the sympathetic trunk from T13 to L3
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