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Thoracolumbar retrolaminar block in seven dogs undergoing spinal surgery

BACKGROUND: Thoracolumbar intervertebral disc extrusion is a common neurologic complaint in dogs and is associated with debilitating pain that requires careful analgesic management to avoid the transition to a chronic pain state. Recently, there has been an increased effort to incorporate regional a...

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Autores principales: Pentsou, Kyratsoula, Huuskonen, Vilhelmiina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9375286/
https://www.ncbi.nlm.nih.gov/pubmed/35962415
http://dx.doi.org/10.1186/s13620-022-00224-7
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author Pentsou, Kyratsoula
Huuskonen, Vilhelmiina
author_facet Pentsou, Kyratsoula
Huuskonen, Vilhelmiina
author_sort Pentsou, Kyratsoula
collection PubMed
description BACKGROUND: Thoracolumbar intervertebral disc extrusion is a common neurologic complaint in dogs and is associated with debilitating pain that requires careful analgesic management to avoid the transition to a chronic pain state. Recently, there has been an increased effort to incorporate regional anaesthetic techniques whenever possible, both for perioperative analgesia management and for prevention of chronic pain. A novel regional anaesthetic technique named retrolaminar block is a fascial plane block where the local anaesthetic is injected directly on top of the dorsal aspect of the vertebral lamina, in the fascial plane between the lamina and the epaxial muscles. The technique was recently described in humans and it is claimed to provide analgesia in patients undergoing thoracic and lumbar procedures. To the authors’ knowledge, the retrolaminar block has not been previously reported in live dogs. CASE PRESENTATION: Seven dogs presented to our hospital for suspected thoracolumbar intervertebral disc extrusion were anaesthetised using an anaesthetic premedication and induction protocol tailored for each individual animal. Once the suspected diagnosis was confirmed, all seven dogs were placed in sternal recumbency, and the target thoracolumbar vertebral spinous process was identified with palpation. A unilateral retrolaminar block was performed in all dogs with 2 mg/kg of 0.25% bupivacaine. Physiologic parameters, as well as responses to nociceptive stimuli, were monitored throughout the anaesthetic event. Intraoperatively, one dog required a bolus of fentanyl to control nociceptive stimulation while the epaxial muscles were retracted. No further intraoperative rescue analgesia was required in any of the cases. The postoperative pain was assessed using the Short Form of Glasgow Composite Measure Pain Scale for dogs every four hours for the duration of the dogs’ hospitalization. The retrolaminar block reduced the intraoperative requirement for systemic opioids and other adjunct analgesic agents and all dogs were comfortable throughout their hospitalization and up until the time of their discharge. CONCLUSIONS: This case report presents the performance of the retrolaminar block technique as part of multimodal analgesia management in seven dogs undergoing thoracolumbar spinal surgery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13620-022-00224-7.
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spelling pubmed-93752862022-08-14 Thoracolumbar retrolaminar block in seven dogs undergoing spinal surgery Pentsou, Kyratsoula Huuskonen, Vilhelmiina Ir Vet J Case Report BACKGROUND: Thoracolumbar intervertebral disc extrusion is a common neurologic complaint in dogs and is associated with debilitating pain that requires careful analgesic management to avoid the transition to a chronic pain state. Recently, there has been an increased effort to incorporate regional anaesthetic techniques whenever possible, both for perioperative analgesia management and for prevention of chronic pain. A novel regional anaesthetic technique named retrolaminar block is a fascial plane block where the local anaesthetic is injected directly on top of the dorsal aspect of the vertebral lamina, in the fascial plane between the lamina and the epaxial muscles. The technique was recently described in humans and it is claimed to provide analgesia in patients undergoing thoracic and lumbar procedures. To the authors’ knowledge, the retrolaminar block has not been previously reported in live dogs. CASE PRESENTATION: Seven dogs presented to our hospital for suspected thoracolumbar intervertebral disc extrusion were anaesthetised using an anaesthetic premedication and induction protocol tailored for each individual animal. Once the suspected diagnosis was confirmed, all seven dogs were placed in sternal recumbency, and the target thoracolumbar vertebral spinous process was identified with palpation. A unilateral retrolaminar block was performed in all dogs with 2 mg/kg of 0.25% bupivacaine. Physiologic parameters, as well as responses to nociceptive stimuli, were monitored throughout the anaesthetic event. Intraoperatively, one dog required a bolus of fentanyl to control nociceptive stimulation while the epaxial muscles were retracted. No further intraoperative rescue analgesia was required in any of the cases. The postoperative pain was assessed using the Short Form of Glasgow Composite Measure Pain Scale for dogs every four hours for the duration of the dogs’ hospitalization. The retrolaminar block reduced the intraoperative requirement for systemic opioids and other adjunct analgesic agents and all dogs were comfortable throughout their hospitalization and up until the time of their discharge. CONCLUSIONS: This case report presents the performance of the retrolaminar block technique as part of multimodal analgesia management in seven dogs undergoing thoracolumbar spinal surgery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13620-022-00224-7. BioMed Central 2022-08-13 /pmc/articles/PMC9375286/ /pubmed/35962415 http://dx.doi.org/10.1186/s13620-022-00224-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Pentsou, Kyratsoula
Huuskonen, Vilhelmiina
Thoracolumbar retrolaminar block in seven dogs undergoing spinal surgery
title Thoracolumbar retrolaminar block in seven dogs undergoing spinal surgery
title_full Thoracolumbar retrolaminar block in seven dogs undergoing spinal surgery
title_fullStr Thoracolumbar retrolaminar block in seven dogs undergoing spinal surgery
title_full_unstemmed Thoracolumbar retrolaminar block in seven dogs undergoing spinal surgery
title_short Thoracolumbar retrolaminar block in seven dogs undergoing spinal surgery
title_sort thoracolumbar retrolaminar block in seven dogs undergoing spinal surgery
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9375286/
https://www.ncbi.nlm.nih.gov/pubmed/35962415
http://dx.doi.org/10.1186/s13620-022-00224-7
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