Abstract
Objective
To compare the perioperative use of analgesics and complication rates in dogs administered
an erector spinae plane (ESP) block or a traditional opioid-based (OP) treatment as
part of analgesic management during hemilaminectomy.
Study design
Retrospective cohort study.
Animals
Medical records of 114 client-owned dogs.
Methods
General data included demographics, duration of procedure, number of laminae fenestrated,
perioperative use of steroid and non-steroidal anti-inflammatory drugs. Intra- and
postoperative analgesics used in 48 hours and complications rates were compared between
groups. Opioid use was expressed in morphine equivalents [ME (mg kg−1)]. Continuous data were compared using the Mann–Whitney U test and incidence of events with a Fisher's exact tests. Multiple linear regression
was used to evaluate association between perioperative ME consumption (dependent variable)
with other independent variables. Data are presented as median (range). Differences
were considered significant when p < 0.05.
Results
Group ESP comprised 42 dogs and group OP 72 dogs. No differences were observed in
the general data. Intraoperative ME was 0.65 (0.20–3.74) and 0.79 (0.19–5.60) mg kg−1 in groups ESP and OP, respectively (p = 0.03). Intraoperative infusion of lidocaine was administered intravenously (IV)
to 23.8% and 68% of groups ESP and OP, respectively (p < 0.0001). Intraoperative infusion of ketamine was administered IV to 21% and 40%
of groups ESP and OP, respectively (p = 0.04). Regression analysis revealed the ESP block as the only independent variable
affecting the perioperative ME consumption. Pharmacological intervention to treat
cardiovascular complications was administered to 21.4% and 47.2% of dogs in groups
ESP and OP, respectively (p = 0.008). There were no differences in postoperative complication rates.
Conclusions and clinical relevance
ESP block was associated with reduced perioperative opioid consumption, intraoperative
adjuvant analgesic use and incidence of pharmacological interventions to treat cardiovascular
complications in dogs undergoing hemilaminectomy.
Keywords
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References
- The effect of erector spinae plane block on respiratory and analgesic outcomes in multiple rib fractures: a retrospective cohort study.Anaesthesia. 2019; 74: 585-593
- A retrospective comparison of two analgesic strategies after uncomplicated tibial plateau levelling osteotomy in dogs.Vet Anaesth Analg. 2018; 45: 557-565
- Adverse effects of opioid agonists and agonist–antagonists in anaesthesia.Drug Saf. 1998; 19: 173-189
- Do cutaneous nerves cross the midline?.Clin Anat. 2015; 28: 96-100
- Opioid-sparing multimodal analgesia with bilateral bi-level erector spinae plane blocks in scoliosis surgery: a case report of two patients.Eur Spine J. 2019; 42: 838
- Perioperative opioid analgesia—when is enough too much? A review of opioid-induced tolerance and hyperalgesia.Lancet. 2019; 393: 1558-1568
- 2015 AAHA/AAFP Pain management guidelines for dogs and cats.J Am Anim Hosp Assoc. 2015; 51: 67-84
- Spinal nerves.in: Evans H.E. de Lahunta A. Miller’s Anatomy of the Dog. 4th edn. Saunders Elsevier, USA2013: 611-657
- Description of an ultrasound-guided erector spinae plane block and the spread of dye in dog cadavers.Vet Anaesth Analg. 2019; 46: 516-522
- Impact of epidural bupivacaine on perioperative opioid requirements, recovery characteristics, and duration of hospitalization in dogs undergoing cystotomy: a retrospective study of 56 cases.Vet Surg. 2019; 48: 1330-1337
- Innervation of the canine thoracolumbar vertebral column.Anat Rec. 1984; 208: 57-63
- The rising tide of opioid use and abuse: the role of the anesthesiologist.Perioper Med (Lond). 2018; 7: 16
- The erector spinae plane block: a narrative review.Korean J Anesthesiol. 2019; 72: 209-220
- Blood supply and vascular reactivity of the spinal cord under normal and pathological conditions.J Neurosurg Spine. 2011; 15: 238-251
- Lumbar erector spinae plane (ESP) block in the dog: anatomical study and assessment of two ultrasound-guided techniques in dog cadavers (abstract).Vet Anaesth Analg. 2020; 47: 285
- Opioid-related adverse drug events in surgical hospitalizations: impact on costs and length of stay.Ann Pharmacother. 2007; 41: 400-406
- Ultrasound-guided erector spinae plane block in canine cadavers: relevant anatomy and injectate distribution.Vet Anaesth Analg. 2020; 47: 229-237
- Retrospective studies provide valuable information.Anaesthesia. 2014; 69: 1052-1053
- Spinal versus epidural anesthesia for cesarean section: a comparison of time efficiency, costs, charges, and complications.Anesth Analg. 1995; 80: 709-712
- Efficacy of the erector spinae plane block for lumbar spinal surgery: a retrospective study.Asian Spine J. 2019; 13: 254-257
- Opioid-free total intravenous anesthesia with bilateral ultrasound-guided erector spinae plane block for perioperative pain control in a dog undergoing dorsal hemilaminectomy.Vet Anaesth Analg. 2020; 47: 728-731
Article info
Publication history
Published online: November 02, 2020
Accepted:
October 24,
2020
Received:
July 15,
2020
Identification
Copyright
© 2020 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
