Multimodal perioperative pain management in a horse undergoing partial phallectomy

A well-balanced multimodal pain management including local anaesthetic techniques was used to provide perioperative analgesia in a horse undergoing partial phallectomy. This surgical intervention has been associated with moderate to severe pain and may present additional challenges to the veterinarian when providing pain relief postoperatively.In the present case, preoperative analgesia included morphine and flunixin meglumine, both intravenously. Throughout surgery, adaptable constant rate infusions (CRIs) with ketamine and xylazine were supplemented to address different receptors of the pain pathway. Additionally, a pudendal nerve block with ropivacaine was added intraoperatively to reduce nociception and decrease sensitisation of the central nervous system. An epidural injection of morphine and dexmedetomidine was performed after recovery from general anaesthesia. Postoperative pain treatment included morphine and flunixin meglumine that resulted in adequate pain relief, based on pain assessment every 6–12 hours. Neither side effects nor complications were observed during the hospital stay.

Combined ultrasound/electrostimulation-guided block of the lumbosacral plexus in a cat undergoing pelvic limb amputation

A cat was anaesthetised with midazolam and alfaxalone for a pelvic limb amputation due to a metatarsal fracture complicated with soft tissue necrosis. The femoral nerve and lumbosacral trunk were blocked with ropivacaine 0.75 per cent using a combined ultrasound/nervestimulation-guided approach. Anaesthesia was maintained with end-tidal concentrations of isoflurane between 1 per cent and 1.1 per cent. Vital parameters were stable during anaesthesia although moderate hypothermia (33.6°C–35.5°C) was encountered. The lateral cutaneous branch of the femoral nerve was desensitised with lidocaine 2 per cent at the end of the surgical procedures. The cat recovered well from anaesthesia and received meloxicam 0.05 mg/kg daily for postoperative pain treatment. Repeated evaluations using a composite pain scale showed values compatible with low probability of pain during the following 48 hours. Only one dose of methadone (0.2 mg/kg) was given. The combined femoral nerve and lumbosacral trunk block provided optimal intraoperative antinociception and postoperative pain relief.

Erector Spinae Block for Analgesia : A Safe and Novel Technique with Diverse Applications

Erector Spinae Block is a paraspinal musculofascial plane block where we inject local anesthetics superficial to the tip of the transverse processes and deep to the erector spinae muscle .It works at the origin of spinal nerves based on cadaveric and contrast study. It is effective and safe regional anesthetic technique. It has a wide variety of applications ranging from acute postoperative pain treatment to chronic pain management. In this series, we report a series of two cases, which include postoperative pain management in Partial Nephrectomy and chronic pain management in Post Herpetic Neuralgia. Keywords: Analgesia; erector spinae block; regional.