scholarly journals Use of Spinal Anaesthesia with Anaesthetic Block of Intercostal Nerves Compared to a Continuous Infusion of Sufentanyl to Improve Analgesia in Cats Undergoing Unilateral Mastectomy

Animals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 887
Author(s):  
Vincenzo Cicirelli ◽  
Pasquale Debidda ◽  
Nicola Maggio ◽  
Michele Caira ◽  
Daniela Mrenoshki ◽  
...  
Keyword(s):  
Evaluation Criteria ◽  
Analgesic Efficacy ◽  
Postoperative Pain Management ◽  
Intercostal Nerve ◽  
Intercostal Nerve Block ◽  
Constant Rate ◽  
Anaesthetic Block ◽  
Intercostal Nerves ◽  
Unilateral Mastectomy ◽  
Rate Infusion

Unilateral mastectomy is a common surgical procedure in feline species and requires postoperative pain management. Our study aimed to evaluate the analgesic efficacy of subarachnoid anaesthesia combined with an intercostal nerve block, in comparison with the use of sufentanyl citrate administered as a constant-rate infusion (CRI). Twenty cats were randomly divided into two groups (n = 10/group) based on the analgesic protocol used: the first received loco-regional anaesthesia with levobupivacaine (LR group), and the second received a CRI of sufentanyl (SUF group). The evaluation criteria during surgery were the need for a bolus of fentanyl in the event of an increased heart rate or increased blood pressure. In the postoperative period, the levels of comfort/discomfort and pain were used to obtain a score according to the UNESP-Botucatu multimodal scale. Subjects who scored above seven received analgesic drug supplementation. Intraoperative analgesia was satisfactory, with good haemodynamic stability in both groups. Four patients in the LR group required an extra dose of methadone after they achieved the sternal decubitus position, whereas those in the SUF group required many more doses. The analgesia achieved in the LR group was more satisfactory than that in the SUF group.

Perioperative analgesic efficacy of constant rate infused tramadol hydrochloride as an adjunct to postoperative ketoprofen in ovariohysterectomized bitches

2018 ◽  
Author(s):  
N. E. Ugwu ◽  
C. A. Eze ◽  
R. I. Udegbunam ◽  
T. O. Nnaji
Keyword(s):  
Pain Score ◽  
Analgesic Efficacy ◽  
Constant Rate Infusion ◽  
Tramadol Hydrochloride ◽  
Constant Rate ◽  
Physiologic Parameters ◽  
Group 3 ◽  
And Control ◽  
Mean Glucose ◽  
Rate Infusion

The study evaluated the peri-operative analgesic efficacy of tramadol administered by constant rate infusion as an adjunct to ketoprofen in ovariohysterectomized bitches. Pre- and postoperative assessment of pain was made using physiologic parameters, glucose, cortisol, pain score and body weight. Dogs were randomly assigned to one of the three groups using the protocol: 1.0mg/kg/hr, 2.0mg/kg/hr of CRI tramadol and control. Ketoprofen (5mg/kg, SC) was administered at one, twenty-four and seventy-two hours post-OVH to all the dogs. Mean glucose and cortisol levels of group 3 dogs were at intra- and at one-hour post-OVH higher (pliss than 0.05) than those of groups 1 and 2. Mean pain score of group 3 was significantly higher (p less than 0.05) than those of groups 1 and 2 at one, four, twenty-four and seventy-two hours post-OVH. The use of CRI tramadol at doses of 1.0mg/kg/hr and 2.0mg/kg/hr attenuated rise in pain markers and produced balanced analgesia as an adjunct to ketoprofen.

scholarly journals Continuous Extrapleural Intercostal Nerve Block for Post Thoracotomy Analgesia in Children

1997 ◽  
Vol 25 (4) ◽  
pp. 390-397 ◽  
Author(s):  
C. S. Downs ◽  
M. G. Cooper
Keyword(s):  
Nerve Block ◽  
Lung Resection ◽  
Postoperative Nausea And Vomiting ◽  
Intercostal Nerve ◽  
Parietal Pleura ◽  
Intercostal Nerve Block ◽  
Regional Analgesia ◽  
Morphine Infusion ◽  
Opioid Administration ◽  
Intercostal Nerves

The safety and efficacy of continuous extrapleural intercostal nerve block has been well established in adults. This review of our initial paediatric experience suggests a role for this technique in children and discusses risks and benefits relative to other forms of regional analgesia for thoracotomy. Nine children aged one to twelve years received extrapleural infusions of bupivacaine 0.1-0.2% following lateral thoracotomy for lung resection. An extrapleural catheter was placed by the surgeon prior to thoracotomy closure, and correctly positioned under direct vision external to the parietal pleura alongside the vertebral column. An intraoperative loading dose of bupivacaine, 0.25-0.5% (0.28±0.1 ml/kg, mean±SD) was injected so as to raise a bleb under the parietal pleura which spread longitudinally to bathe several intercostal nerves in the paravertebral gutter. The chest wall was then closed. Infusions of bupivacaine were commenced in the recovery room and continued at a constant rate of 0.21±0.09 ml/kg/h for 72±15 hours. The mean dose of bupivacaine was 284±97 μg/kg/h. Patients also received standard analgesia as an intravenous morphine infusion (10-50 μg/kg/h), or patient-controlled analgesia. Nursing staff were specifically instructed not to alter their usual management of variable rate morphine infusions which are titrated to adequate analgesia. Morphine requirements in the first 48 postoperative hours remained less than 30 μg/kg/h, oral fluids were well tolerated after 31.2±19.1 hours, nasogastric tubes were removed at 16.7±11.2 hours. Postoperative nausea and vomiting and respiratory depression were not observed in any patient and all were able to comply with physiotherapy. There were no complications of catheter placement or bupivacaine administration. Our initial experience suggests that this is a safe technique which minimizes complementary opioid administration and provides adequate analgesia for children postthoracotomy for lung resection.

scholarly journals Analgesic and Sedative Effects of Epidural Lidocaine-Xylazine in Elective Bilateral Laparoscopic Ovariectomy in Standing Mule Mares

Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2419
Author(s):  
Cecilia Vullo ◽  
Adolfo Maria Tambella ◽  
Marina Meligrana ◽  
Giuseppe Catone
Keyword(s):  
Analgesic Efficacy ◽  
Epidural Block ◽  
Efficacy And Safety ◽  
Constant Rate Infusion ◽  
Arterial Blood ◽  
Constant Rate ◽  
Sedative Effects ◽  
Caudal Epidural Block ◽  
Sedation And Analgesia ◽  
Rate Infusion

The purpose of this study was to determine the analgesic efficacy and safety of epidural lidocaine-xylazine administration in standing mules undergoing elective bilateral laparoscopic ovariectomy in order to suppress unwanted behaviour. Eight mule mares were sedated with intramuscular 0.05 mg/kg acepromazine followed by 1.3 mg/kg of xylazine and 0.02 mg/kg of butorphanol intravenously. Sedation was maintained by a constant rate infusion of 0.6 mg/kg/h of xylazine. The paralumbar fossae were infiltrated with 30 mL of 2% lidocaine. Epidural anaesthesia was performed at the first intercoccygeal space with 0.2 mg/kg of lidocaine and 0.17 mg/kg of xylazine. After 15 min, bilateral laparoscopic ovariectomy was performed. Heart rate, respiratory rate, rectal temperature, invasive arterial blood pressure, degree of analgesia, sedation and ataxia were evaluated during surgery. The laparoscopic ovariectomy was successfully completed in all animals. Sedation and analgesia were considered satisfactory in six out of the eight mules. In conclusion, caudal epidural block allowed surgery to be easily completed in six out of eight. The animals did not show any signs of discomfort associated with nociception and were mostly calm during the procedures, however additional studies are needed to establish epidural doses of xylazine and lidocaine that result in reliable abdominal pain control in mules for standing ovariectomy.

Analgesic efficacy of an intravenous constant rate infusion of a morphine-lidocaine-ketamine combination in Holstein calves undergoing umbilical herniorrhaphy

2020 ◽  
Vol 81 (1) ◽  
pp. 25-32
Author(s):  
Amanda K. Hartnack ◽  
Andrew J. Niehaus ◽  
Jeffrey Lakritz ◽  
Johann F. Coetzee ◽  
Michael D. Kleinhenz
Keyword(s):  
Analgesic Efficacy ◽  
Constant Rate Infusion ◽  
Constant Rate ◽  
Holstein Calves ◽  
Rate Infusion

scholarly journals Constant Rate Infusion of Lidocaine, Tumescent Anesthesia and Their Combination in Dogs Undergoing Unilateral Mastectomy

Animals ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 1280
Author(s):  
Cecilia Vullo ◽  
Adolfo Maria Tambella ◽  
Annastella Falcone ◽  
Gabriele Marino ◽  
Giuseppe Catone
Keyword(s):  
Postoperative Pain ◽  
Loading Dose ◽  
Constant Rate Infusion ◽  
Analgesic Requirement ◽  
Tumescent Anesthesia ◽  
Ringer’S Solution ◽  
Constant Rate ◽  
Lactated Ringer's Solution ◽  
Unilateral Mastectomy ◽  
Rate Infusion

Tumescent anesthesia (TUM) is a technique that was initially used to perform liposuction under local anesthesia, which consists of the injection of such large volumes of local anesthetic until to produce swelling and firmness (tumescence) of the surgical area. The aim of this study was to compare the intraoperative analgesic efficacy of lidocaine (LID) constant rate infusion (CRI), of TUM, or their combination (LID/TUM) and the postoperative pain and analgesic requirement in dogs undergoing unilateral mastectomy. Twenty-four dogs were premedicated with dexmedetomidine (3 μg/kg) and methadone (0.2 mg/kg) intravenously (IV). After induction with propofol IV to effect, dogs were randomly allocated to receive a loading dose of lidocaine (2 mg/kg) followed by a CRI of 100 μg/kg/min (Group LID) in addition to an equivalent volume of lactated Ringer’s solution instead of local TUM; a loading dose of lactated Ringer’s solution followed by a CRI of Ringer’s solution in addition to TUM (Group TUM); a loading dose of lidocaine (2 mg/kg) followed by a CRI of 100 μg/kg/min in addition to TUM (Group LID/TUM). Anesthesia was maintained with isoflurane in oxygen. Postoperative pain scores were assessed once the dogs had fully recovered from the sedative effects, and following 15, 30, 45 and 60 min. The results of the current study allow us to assert that all three treatments provided satisfactory intraoperative antinociceptive effects but administration of LID/TUM induced greater inhibition on sympathetic stimulating effect up to 60 min from recovery, thus, providing better early postoperative pain relief in dogs undergoing mastectomy.

scholarly journals Analgesic efficacy of intercostal nerve block in percutaneous nephrolithotomy: systematic review and meta-analysis

2021 ◽  
Vol 8 (4) ◽  
pp. 586-593
Author(s):  
Gopal Sharma ◽  
Seema Prasad ◽  
Saket Singh ◽  
Yashasvi Thummala ◽  
Santosh Kumar
Keyword(s):  
Systematic Review ◽  
Nerve Block ◽  
Percutaneous Nephrolithotomy ◽  
Meta Analysis ◽  
Analgesic Efficacy ◽  
Intercostal Nerve ◽  
Control Group ◽  
Intercostal Nerve Block ◽  
Analgesic Requirement ◽  
Standard Mean Difference

Pain is important morbidity following percutaneous nephrolithotomy (PNL). Various adjunctive procedures such as intercostals nerve block (ICNB) have been described to reduce post-operative pain. The aim of this review was to determine the analgesic efficacy of ICNB in PNL patients. Systematic literature search was conducted to identify relevant publications. We followed preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines while conducting this review. In this review, five randomized studies with 319 patients were included. The analgesic requirement was statistically similar in ICNB and control group (Standard mean difference (SMD) -0.48 confidence interval (CI)[-1.4, 0.44] p=0.31) whereas analgesic requirement was lower for peritubal infiltration group (PTI) as compared to ICNB (SMD 0.85 CI[0.25,1.44] p=0.005). Also, time to first analgesic requirement was similar between ICNB and PTI (SMD 0.86 CI[-9.3,11.0]), p=0.87). Pain according to VAS (visual analog scale) and Dynamic VAS (DVAS) at 24 hours was lower in ICNB group as compared to the control group; however, only DVAS at 24 hours was statistically significant. DVAS and VAS at 24 hours were similar for both ICNB and PTI. Intercostal nerve block in terms of analgesic requirement appears to be inferior to peritubal block and no better than control group. Also, mean pain scores for ICNB were similar to control group and peritubal block.

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