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Eliav A, Ofri R, Brust K, Kushnir Y, Shilo-Benjamini Y. Improving rat welfare through the development of a peribulbar anaesthesia technique for ophthalmic procedures: A preliminary study. Lab Anim 2024; 58:116-126. [PMID: 37728920 DOI: 10.1177/00236772231178433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Rats are a commonly used animal model for the study of the pathogenesis and novel treatments of glaucoma, which is induced experimentally using invasive, painful procedures. Peribulbar anaesthesia (PBA) is frequently used in people and domestic animals prior to ophthalmic surgeries to provide excellent perioperative analgesia. Our goal was to develop a PBA technique adapted to rat anatomy, improving the welfare of animals used as a model for glaucoma. Eighteen rat cadavers (n = 36 eyes) were used to establish the optimal needle insertion location. Five injection techniques using 0.1 mL/100 g lidocaine 2% and a contrast agent (1:1 volume ratio) were compared via computed tomography (CT). CT images were scored for injectate distribution at four locations: extraconal, intraconal, around the optic nerve and at the orbital fissure (scale 0-8, where 0 = none and 8 = excellent). Median scores using the dorso-medial-75° (5; range 2-6) and medial-canthus (4.5; range 2-8) injection techniques were not different from the dorso-medial-45° (4; range 3-6) technique and were higher (better distribution) compared with mid-ventral (3; range 2-5) and ventro-lateral (2; range 1-3) techniques. The two superior techniques were used in two experimental rats (n = 4 eyes) to determine the volume of bupivacaine 0.5% necessary to affect corneal touch threshold (CTT) and periocular skin sensitivity (PSS). A volume of 0.05 mL/100 g decreased CTT and PSS for several hours, while a larger volume produced excessively long effects. Dorso-medial-75° or medial-canthus PBA using 0.05 mL/100 g bupivacaine are likely to provide ocular and periocular analgesia in rats, with minor transient adverse effects.
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Affiliation(s)
- Ady Eliav
- The Authority for Biological and Biomedical Models, The Hebrew University of Jerusalem, Israel
| | - Ron Ofri
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Israel
| | - Kelsey Brust
- Department of Veterinary Surgery and Radiology, School of Veterinary Medicine, University of California, USA
| | - Yishai Kushnir
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Israel
| | - Yael Shilo-Benjamini
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Israel
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Bayley KD, Gates MC, Anastassiadis Z, Read RA. The use of sub-Tenon's anesthesia versus a low-dose neuromuscular blockade for canine cataract surgery: A comparative study of 224 eyes. Vet Ophthalmol 2024; 27:114-126. [PMID: 37199512 DOI: 10.1111/vop.13111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 04/11/2023] [Accepted: 05/03/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Assess the utility of a Sub-Tenon's anesthesia (STA) protocol to provide suitable operating conditions for canine cataract surgery and compare it to an alternative low-dose neuromuscular blockade (LD-NMB) protocol used for canine cataract surgery. PROCEDURES Clinical study of dog eyes undergoing cataract surgery with either an STA or LD-NMB protocol. While intraoperative vitreal expansion scores and intraoperative complications were collected prospectively, globe position, intraocular pressure, return of vision, and postoperative complications were collected retrospectively. Statistical testing was used to compare results between the STA and the LD-NMB groups for the data available. RESULTS A total of 224 eyes from 126 dogs were assessed, with 133/224 (59.4%) eyes from 99/126 (78.6%) dogs receiving STA and 91/124 (40.6%) eyes from 72/126 (57.1%) dogs receiving LD-NMB. Forty-five of these dogs (45/126; 37.7%) received STA for one eye and LD-NMB for the other eye. There was no significant change in intraocular pressure measurements following STA administration. This was not measured for the LD-NMB group. The globe achieved a central position in 110/133 (82.7%) of eyes that received STA. This was not measured for the LD-NMB group. Intraoperative vitreal expansion scores were slightly higher in STA-treated eyes compared to LD-NMB-treated eyes. The intraoperative complication rate for STA-treated eyes was higher (73/133; 54.8%) compared to NMB-treated eyes (12/91; 13.2%). The most common intraoperative complication for STA was chemosis (64/133; 48.1%), the risk of which increased with an increase in the volume of local anesthetic injected. The post-operative complication rate was higher in STA-treated eyes (28/133; 21.1%) compared to NMB-treated eyes (16/91; 17.6%). Post-operative corneal ulceration was the most common postoperative complication in STA-treated eyes (6/133; 4.5%). CONCLUSION The STA protocol described resulted in suitable operating conditions, but more intraoperative and postoperative complications compared to the LD-NMB protocol. Despite these complications, the STA protocol did not cause a significant deleterious impact on post-operative outcomes as defined in the present study.
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Affiliation(s)
| | - M Carolyn Gates
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | | | - R A Read
- Veterinary Ophthalmic Referrals, Adelaide, Australia
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Ryan AC, Dutton TAG, Gurney MA. Peribulbar block in a rabbit presenting for enucleation. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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4
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Hagag U, El Nahas A. Ultrasound-guided retrobulbar nerve block in donkey cadavers. Vet Anaesth Analg 2022; 49:197-202. [DOI: 10.1016/j.vaa.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 01/09/2022] [Accepted: 01/09/2022] [Indexed: 10/19/2022]
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DiGeronimo PM, da Cunha AF. Local and Regional Anesthesia in Zoological Companion Animal Practice. Vet Clin North Am Exot Anim Pract 2021; 25:321-336. [PMID: 34823697 DOI: 10.1016/j.cvex.2021.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Local anesthetics provide analgesia and can be incorporated into multimodal anesthetic protocols. They work by blocking the voltage-dependent sodium ion channels along neurons that mediate nociception. Systemically, these drugs can be cardiotoxic in a dose-dependent manner. Lidocaine and bupivacaine are the most commonly used local anesthetics and their use has been reported in all classes of vertebrates. Despite anecdotal reports to the contrary, zoologic companion animals are unlikely to be more susceptible to the cardiotoxic effects of local anesthetics than domestic small animals. Local anesthetics can be clinically useful for analgesia and anesthesia in zoologic companion animal practice.
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Affiliation(s)
- Peter M DiGeronimo
- Adventure Aquarium, 1 Riverside Drive, Camden, NJ 08103, USA; Animal & Bird Health Care Center, 1785 Springdale Road, Cherry Hill, NJ 08003, USA.
| | - Anderson F da Cunha
- College of Veterinary Medicine, Midwestern University, 5715 W Utopia Road, Glendale, AZ 85308, USA
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Greco A, Costanza D, Senatore A, Bruzzese D, Micieli F, Chiavaccini L, Di Giancamillo M, Della Valle G, Vesce G, Brunetti A, Meomartino L. A computed tomography-based method for the assessment of canine retrobulbar cone volume for ophthalmic anaesthesia. Vet Anaesth Analg 2021; 48:759-766. [PMID: 34391668 DOI: 10.1016/j.vaa.2021.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/01/2021] [Accepted: 03/12/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To develop a comprehensive formula for calculating the volume of local anaesthetic solution used for retrobulbar anaesthesia in dogs with different skull morphologies. STUDY DESIGN Retrospective cohort imaging study. ANIMALS Skull computed tomography (CT) images of 188 dogs of different breeds collected between January 2009 and December 2017. METHODS Anatomical integrity of the orbit and adjacent structures, presenting complaint, clinical signs and CT findings were verified to exclude ocular abnormalities. The volume of the retrobulbar cone of 376 eyes was calculated using CT scans of the dogs' skulls. Additional data recorded included morphology of the skull, body weight, sex and size of the dogs, all of which were matched for possible association to the retrobulbar cone volume through univariable and multivariable linear regression models. Results of linear regression models were expressed as estimated beta coefficients with the corresponding 95% confidence intervals (95% CIs). RESULTS Using univariate analysis, the retrobulbar cone volume was positively associated with weight and male sex. In addition, brachycephalic and dolichocephalic dogs showed a larger retrobulbar cone volume than mesocephalic dogs, while sex was no longer significantly associated with the retrobulbar cone volume. In multivariate analysis, when considering all variables in the model, weight emerged as the strongest predictor (beta coefficient: 0.062 mL kg-1, 95% CI: 0.056-0.067 mL kg-1, p < 0.001). CONCLUSIONS and clinical relevance In the veterinary literature, there is no agreement on the precise volume of local anaesthetic solution that should be used to achieve intraconal retrobulbar anaesthesia in dogs. Here we suggest a formula to calculate the retrobulbar cone volume and, accordingly, the injection volume of local anaesthetic solution for effective retrobulbar anaesthesia.
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Affiliation(s)
- Adelaide Greco
- Centro Interdipartimentale di Radiologia Veterinaria, Università di Napoli 'Federico II', Naples, Italy; Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy.
| | - Dario Costanza
- Centro Interdipartimentale di Radiologia Veterinaria, Università di Napoli 'Federico II', Naples, Italy
| | - Andrea Senatore
- Centro Intedipartimentale di Ricerca sui Biomateriali, Università degli Studi di Napoli 'Federico II', Naples, Italy
| | - Dario Bruzzese
- Dipartimento di Sanità Pubblica, Università di Napoli 'Federico II', Naples, Italy
| | - Fabiana Micieli
- Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy
| | - Ludovica Chiavaccini
- Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Mauro Di Giancamillo
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Della Valle
- Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy
| | - Giancarlo Vesce
- Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy
| | - Arturo Brunetti
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli 'Federico II', Naples, Italy
| | - Leonardo Meomartino
- Centro Interdipartimentale di Radiologia Veterinaria, Università di Napoli 'Federico II', Naples, Italy; Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy
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Scott EM, Vallone LV, Olson NL, Han G, Loria Lepiz MA, Simon BT. Analgesic effects of a retrobulbar block with 0.75% ropivacaine in dogs undergoing enucleation. Vet Anaesth Analg 2021; 48:749-758. [PMID: 34144876 DOI: 10.1016/j.vaa.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 04/20/2021] [Accepted: 04/24/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the analgesic effects of a retrobulbar block with ropivacaine in dogs undergoing enucleation. STUDY DESIGN Prospective, randomized, masked placebo-controlled trial. ANIMALS A total of 23 client-owned dogs. METHODS Dogs were randomized to be administered a preoperative inferior-temporal palpebral retrobulbar injection of either ropivacaine 0.75% (1 mL 10 kg-1; group RG) or equivalent volume of 0.9% saline (control; group CG). Intraoperative variables recorded to detect a response to noxious stimuli included heart rate (HR) and mean arterial pressure (MAP). Three observers assessed and recorded pain using a numerical rating pain scale and visual analog scale (VAS) before anesthesia (baseline) and postoperatively at 0, 0.5, 1, 2, 3, 4, 5, 6 and 24 hours after extubation. Rescue analgesia was administered if intraoperative HR or MAP increased by ≥ 20% from the previously recorded surgical time point, average postoperative pain scores totaled ≥ 9/20, scored ≥ 3/4 in any one category with VAS ≥ 35/100, or if VAS was ≥ 35/100 with a palpation score > 0/4. RESULTS Intraoperatively, there was no significant difference in HR or MAP between groups. Rescue analgesia was administered intraoperatively to four and one dogs and postoperatively to five and seven dogs in groups CG and RG, respectively, with no significant difference between groups. VAS scores were significantly lower in ropivacaine dogs at extubation (p = 0.02), but not at other postoperative time points. Adverse events were not observed in either group. CONCLUSIONS AND CLINICAL RELEVANCE Preoperative retrobulbar 0.75% ropivacaine injection (1 mL 10 kg-1) provided analgesia in dogs following enucleation at extubation; however, intraoperative and postoperative pain control did not differ from a placebo injection with saline. Lack of differences between groups may have been influenced by sample size limitations.
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Affiliation(s)
- Erin M Scott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA.
| | - Lucien V Vallone
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Natalie L Olson
- Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Gang Han
- Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Mauricio A Loria Lepiz
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Bradley T Simon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
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Rabbogliatti V, De Zani D, Zani DD, Di Cesare F, Brioschi FA, Gioeni D, Crivellari B, Ravasio G. Comparison of four peribulbar anaesthetic techniques: a preliminary study in equine cadavers. Vet Anaesth Analg 2020; 48:442-450. [PMID: 33640273 DOI: 10.1016/j.vaa.2020.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 07/07/2020] [Accepted: 10/01/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To compare the peribulbar injectate distribution and probability of regional anaesthesia of four peribulbar anaesthetic techniques in equine cadavers. STUDY DESIGN Prospective experimental cadaver study. ANIMALS A total of 12 isolated equine cadaver heads and 24 eyes. METHODS The 24 orbits underwent one of four injection techniques (six orbits each) with a mixture (1:4) of contrast medium and saline (CM): 20 mL ventrolateral peribulbar injection (V-20), 20 mL dorsolateral peribulbar injection (D-20), combined ventrolateral and dorsolateral peribulbar injections 10 mL each (VD-20) or 20 mL each (VD-40). To evaluate and score CM distribution at the base of, within the extraocular muscle cone (EOMC), and around the optic nerve (before and after pressure application to the periorbital area), computed tomography was performed. To assess the probability of achieving locoregional anaesthesia, two criteria were applied and both scored as 'likely', 'possible' or 'unlikely'. To compare CM distribution scores between injection techniques, Kruskal-Wallis analysis of variance was used. Mann-Whitney U test was used for post hoc comparisons between groups when needed. A p value < 0.05 was considered significant. RESULTS The CM distribution within the EOMC and around the optic nerve circumference was detected as 'possible' only after pressure application in seven out of 24 orbits (V-20, 3; D-20, 1; VD-40, 3). It was never considered 'likely' either before or after pressure application. The CM distribution at the EOMC base was considered 'likely' to provide regional anaesthesia in 50% (V-20), 0% (D-20), 33% (VD-20), 100% (VD-40) and in 66% (V-20), 16% (D-20), 50% (VD-20), 100% (VD-40) before and after applying pressure, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Complete regional anaesthesia seems more likely using the VD-40 technique, although the authors advise caution due to the risk of potential complications. Future studies are necessary to evaluate the efficacy of the technique in vivo.
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Affiliation(s)
- Vanessa Rabbogliatti
- Department of Veterinary Medicine, Centro Clinico Veterinario e Zootecnico Sperimentale, Università degli Studi di Milano, Milan, Italy
| | - Donatella De Zani
- Department of Veterinary Medicine, Centro Clinico Veterinario e Zootecnico Sperimentale, Università degli Studi di Milano, Milan, Italy
| | - Davide D Zani
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy
| | - Federica Di Cesare
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Milan, Italy
| | - Federica A Brioschi
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy
| | - Daniela Gioeni
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy
| | | | - Giuliano Ravasio
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy.
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9
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Mahler S, Betti E, Guintard C. Evaluation of injectate distribution after ultrasound-guided peribulbar injections in canine cadavers. Vet Anaesth Analg 2020; 47:720-723. [PMID: 32778453 DOI: 10.1016/j.vaa.2020.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 04/09/2020] [Accepted: 04/17/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To describe a contrast medium distribution pattern after peribulbar injection in cadavers. STUDY DESIGN A cadaveric study. ANIMALS A group of eight male dogs and four canine cadaver heads. METHODS In phase 1, ultrasound-guided peribulbar injections (1.0 mL dye) were performed in four orbits using a subzygomatic approach. After dissection, the procedure was considered successful if 1) no dye was found in the retrobulbar space, 2) the peribulbar compartment was stained and 3) the dye reached the orbital fissure. In phase 2, using 16 orbits, the same technique was used to inject 0.1 mL kg-1 contrast medium into (group A, n = 8) or outside (group B, n = 8) the peribulbar compartment. After freezing at -20°C, orbits were imaged using computed tomography, and the contrast medium distribution was analysed. RESULTS In phase 1, the procedure was successful in all four eyes. In phase 2, two orbits (one in each group) were removed from the study: one was not injected and the other was injected twice. The contrast medium was found inside the peribulbar compartment in six of seven (85.7%) group A orbits and two of seven (28.6%) group B orbits. In all of these cases, distribution to the orbital fissure, rostral alar foramen, mandibular foramen and inside the skull was observed. The oval foramen was reached in three of seven (42.9%) group A orbits and one of seven (14.3%) group B orbits. In one/seven (14.3%) group A orbits and five/seven (71.4%) group B orbits, the contrast medium was found inside the masseter and temporal muscles, and no distribution towards the aforementioned structures was observed. CONCLUSIONS AND CLINICAL RELEVANCE Ultrasound-guided peribulbar injection of 0.1 mL kg-1 contrast medium in canine cadavers can lead to an extensive distribution of the injectate that reaches the orbital fissure, the rostral alar, oval, and mandibular foramina and can be found intra-cranially.
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Affiliation(s)
- Stephan Mahler
- School of Veterinary Medicine, St Matthew's University, West Bay, Cayman Islands.
| | - Eric Betti
- Service d'anatomie comparée, Ecole Vétérinaire ONRIS, Nantes, France
| | - Claude Guintard
- Service d'anatomie comparée, Ecole Vétérinaire ONRIS, Nantes, France
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Bartholomew KJ, Smith LJ, Bentley E, Lasarev MR. Retrospective analysis of complications associated with retrobulbar bupivacaine in dogs undergoing enucleation surgery. Vet Anaesth Analg 2020; 47:588-594. [PMID: 32653165 DOI: 10.1016/j.vaa.2020.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate complications associated with, and without, bupivacaine retrobulbar local anesthesia in dogs undergoing unilateral enucleation surgery. STUDY DESIGN Retrospective, observational study. ANIMALS A total of 167 dogs underwent unilateral enucleation surgery via a transpalpebral approach. METHODS Records from 167 dogs that underwent unilateral enucleation surgery that did (RB) or did not (NB) include retrobulbar bupivacaine anesthesia were reviewed, including anesthetic record, daily physical examination records, surgery report, patient discharge report and patient notes within 14 days of the surgery. Specific complications and severity were compared between RB and NB using the Wilcoxon rank-sum test. A 'complication burden' (0-5) comprising five prespecified complications was assigned and tested using rank-sum procedures. Statistical significance was set to 0.05. RESULTS Group RB included 97 dogs and group NB 70 dogs. Dogs in NB had a 17.0 percentage points (points) greater risk for a postoperative recovery complication (38.6% versus 21.6%; 95% confidence interval: 3.0-30.6 points; p = 0.017). There was inconclusive evidence that dogs in group RB had a lower risk of requiring perioperative anticholinergic administration (12.4% versus 22.9%; 10.5 points; p = 0.073). Other complications were similar between groups RB and NB with risks that differed by <10 points. The risk of hemorrhage was similar between groups RB (22.7%) and NB (20.0%) with no significant difference in the level of severity (p = 0.664). CONCLUSIONS AND CLINICAL RELEVANCE In this retrospective study, the use of retrobulbar bupivacaine for enucleation surgery in dogs was not associated with an increased risk of major or minor complications.
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Affiliation(s)
- Kyle J Bartholomew
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin - Madison, Madison, WI, USA
| | - Lesley J Smith
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin - Madison, Madison, WI, USA.
| | - Ellison Bentley
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin - Madison, Madison, WI, USA
| | - Michael R Lasarev
- Department of Biostatistics and Medical Informatics, University of Wisconsin - Madison, Madison, WI, USA
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11
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Zibura AE, Posner LP, Ru H, Westermeyer HD. A preoperative bupivacaine retrobulbar block offers superior antinociception compared with an intraoperative splash block in dogs undergoing enucleation. Vet Ophthalmol 2019; 23:225-233. [PMID: 31566883 DOI: 10.1111/vop.12708] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Investigate nociception differences in dogs undergoing enucleation administered bupivacaine either via preoperative retrobulbar block (pRB) or intraoperative splash block (iSB). METHODS Prospective, randomized, double-masked, clinical comparison study. Dogs undergoing unilateral enucleation were randomized to two groups: one received bupivacaine pRB and saline iSB of the same volume, and the other received saline pRB and bupivacaine iSB. The following intraoperative parameters were recorded: heart rate (HR), respiratory rate (RR), end-tidal CO2 (EtCO2 ); systolic, mean, and diastolic arterial blood pressure (SAP, MAP, and DAP respectively); inspired end-tidal isoflurane concentration (EtISOIns), and expired end-tidal isoflurane concentration (EtISOExp). Pain scores were recorded pre- and postoperatively. Analgesic rescue was documented. Surgical hemorrhage and postoperative bruising and swelling were graded subjectively by the surgeon (HDW) and study coordinator (AEZ). RESULTS A significant (P = .0399) increase from baseline in overall mean heart rate was recorded in iSB bupivacaine patients (n = 11) compared with pRB bupivacaine patients (n = 11), with no significant differences in other intraoperative physiologic parameters, or pain scores. More analgesic rescue events occurred in iSB bupivacaine patients compared to pRB bupivacaine patients. A near-significant increase in intraoperative bleeding (P = .0519), and a significant increase in bruising (P = .0382) and swelling (P = .0223) was noted in the iSB bupivacaine group. CONCLUSIONS Preoperative retrobulbar block bupivacaine is more effective than an iSB bupivacaine at controlling both intraoperative and postoperative nociception in dogs undergoing enucleation. Additionally, iSB causes more postoperative bruising and swelling and may be associated with increased intraoperative hemorrhage.
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Affiliation(s)
- Ashley E Zibura
- Comparative Ophthalmology, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Lysa P Posner
- Anesthesiology, Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Hongyu Ru
- Department of Population Health and Pathobiology, College of Veterinary Medicine, Raleigh, NC, USA
| | - Hans D Westermeyer
- Comparative Ophthalmology, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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12
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Shilo-Benjamini Y. A review of ophthalmic local and regional anesthesia in dogs and cats. Vet Anaesth Analg 2019; 46:14-27. [DOI: 10.1016/j.vaa.2018.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 10/19/2018] [Accepted: 10/20/2018] [Indexed: 12/17/2022]
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