Small Animal Regional Anesthesia and Analgesia E-Book
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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Small Animal Regional Anesthesia and Analgesia Explore regional techniques for anesthesia and analgesia in dogs and cats in this thoroughly expanded and revised edition of the most comprehensive book on the topic Small Animal Regional Anesthesia and Analgesia, Second Edition expands and updates the information in the first edition, making this a truly comprehensive and practical reference for regional anesthetic techniques in dogs and cats. Written by leading international experts in the field, this book provides an authoritative yet practical guide to using ultrasound-guided local and regional anesthesia techniques in clinical practice. Grounded in the latest scientific literature, the book presents a wealth of new or updated information, and incorporates a logical, standardized format and high-quality color images, making it easier and faster to find information about each block. Small Animal Regional Anesthesia and Analgesia, Second Edition: * Provides an expanded and updated new edition of this practical, clinically-oriented resource, with step-by-step details for each procedure * Features more images to support the visual aspect of learning that is necessary when using ultrasound to perform locoregional anesthesia * Has been reorganized to present information based on the individual technique, rather than the general anatomical region of the body Small Animal Regional Anesthesia and Analgesia, Second Edition is a must-have reference for veterinary practitioners and specialists.
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Seitenzahl: 849
Veröffentlichungsjahr: 2024
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Table of Contents
Cover
Table of Contents
Dedication Page
Title Page
Copyright Page
List of Contributors
Foreword
Preface
Acknowledgments
PART 1: Considerations for Locoregional Anesthesia
CHAPTER 1: Ultrasound Guidance
INTRODUCTION
ULTRASOUND TECHNOLOGY
HOW ULTRASOUND GUIDANCE HAS CHANGED LOCOEGIONAL ANESTHESIA
VETERINARY MEDICINE
WHAT IS NEXT?
SUMMARY
REFERENCES
CHAPTER 2: Use of Ultrasound for Locoregional Anesthesia
INTRODUCTION
BASIC PHYSICS AND TECHNOLOGY
IMAGE OPTIMIZATION
TRANSDUCER MANIPULATION
ARTIFACTS
HOW TO PERFORM A GENERIC ULTRASOUND‐GUIDED NERVE BLOCK
REFERENCES
CHAPTER 3: How to Document the Use of Locoregional Anesthesia in the Medical Record
WHY?
HOW?
RECORD‐KEEPING SYSTEMS
WHAT?
SUMMARY OF WHAT TO DOCUMENT
REFERENCES
CHAPTER 4: Local Anesthetic Pharmacology
PHYSIOCHEMICAL PROPERTIES OF LOCAL ANESTHETICS
MODE OF ACTION
COMMONLY USED LOCAL ANESTHETICS
MIXTURES OF LOCAL ANESTHETIC AGENTS
ADJUVANTS COMMONLY USED TO ENHANCE LOCOREGIONAL ANESTHESIA AND ANALGESIA
BUPIVACAINE LIPOSOME SUSPENSION
FUTURE OF LOCAL ANESTHETICS/ADJUVANTS?
REFERENCES
PART 2: Locoregional Anesthetic Blocks for Small Animal Patients
CHAPTER 5: The Eye
OVERVIEW
FUNCTIONAL ANATOMY
TOPICAL CORNEAL ANESTHESIA
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
AURICULOPALPEBRAL NERVE BLOCK
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
FRONTAL NERVE BLOCK
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
RETROBULBAR ANESTHESIA
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
PERIBULBAR ANESTHESIA
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
SUB‐TENON’S CAPSULE ANESTHESIA
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
TOPICAL ORBITAL ANESTHESIA TECHNIQUES
INTRACAMERAL ANESTHESIA
PATIENT SELECTION
GENERAL CONSIDERATION
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
REFERENCES
CHAPTER 6: Ultrasound‐Guided Blocks for the Ear
WHAT DO WE ALREADY KNOW
?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 7: Ultrasound‐Guided Brachial Plexus Block (Subscalene Approach)
WHAT DO WE ALREADY KNOW
?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 8: Ultrasound‐Guided Brachial Plexus Block (Axillary Approach)
WHAT DO WE ALREADY KNOW
?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 9: Ultrasound‐Guided Proximal RUMM Block (Axillary Sheath)
WHAT DO WE ALREADY KNOW
?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 10: Ultrasound‐Guided (Distal) RUMM Block
WHAT DO WE ALREADY KNOW
?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 11: The Thoracic Spinal Nerves
OVERVIEW
SPINAL NERVE ANATOMY
REFERENCES
CHAPTER 12: Introduction to Fascial Plane Blocks
INTRODUCTION
WHAT IS FASCIA?
FASCIAL PLANE BLOCKS
RELEVANT ANATOMY FOR FASCIAL PLANE BLOCKS
MECHANISMS OF ACTION
ADVANTAGES OF FASCIAL PLANE BLOCKS
LIMITATIONS OF FASCIAL PLANE BLOCKS
SUMMARY
REFERENCES
CHAPTER 13: Ultrasound‐Guided Thoracic Paravertebral Block
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 14: Ultrasound‐Guided Intercostal Nerve Block
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 15: Ultrasound‐Guided Serratus Plane Block
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 16: Ultrasound‐Guided Parasternal Blocks
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
CONCLUSIONS
REFERENCES
CHAPTER 17: Ultrasound‐Guided Erector Spinae Plane Block
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 18: Ultrasound‐Guided Quadratus Lumborum Block
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 19: Ultrasound‐Guided Transversus Abdominis Plane (TAP) Block
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 20: Ultrasound‐Guided Rectus Sheath Block
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 21: Ultrasound‐Guided Femoral Nerve Block (Psoas Compartment Block)
WHAT DO WE ALREADY KNOW
?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 22: Ultrasound‐Guided Femoral Nerve Block (Inguinal Approach)
WHAT DO WE ALREADY KNOW
?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 23: Ultrasound‐Guided Saphenous Nerve Block
WHAT DO WE ALREADY KNOW
?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 24: Ultrasound‐Guided Parasacral Lumbosacral Trunk Block
WHAT DO WE ALREADY KNOW
?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 25: Ultrasound‐Guided Sciatic Nerve Block (Caudal Approach)
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 26: Ultrasound‐Guided Pudendal Nerve Block in Male Cats
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
STEP‐BY‐STEP PERFORMANCE
COMPLICATIONS AND HOW TO AVOID THEM
COMMON MISTAKES AND HOW TO AVOID THEM
HOW TO TALK TO CLIENTS/PROFESSIONAL COLLEAGUES
REFERENCES
CHAPTER 27: Ultrasound‐Assisted Epidural Anesthesia
WHAT DO WE ALREADY KNOW?
PATIENT SELECTION
GENERAL CONSIDERATIONS
ULTRASOUND‐ASSISTED LUMBOSACRAL EPIDURAL INJECTION TECHNIQUE
ULTRASOUND‐ASSISTED SACROCOCCYGEAL EPIDURAL INJECTION TECHNIQUE
CONCLUSIONS
REFERENCES
CHAPTER 28: Complications Associated with Locoregional Anesthesia
WHAT DO WE KNOW ALREADY?
TYPES OF COMPLICATIONS
SUMMARY
REFERENCES
Index
End User License Agreement
List of Tables
Chapter 2
Table 2.1 Attenuation coefficients of different tissues (at 1 MHz).
Chapter 4
Table 4.1 Characteristics of commonly use local anesthetics.
Table 4.2 Summary of nerve fiber characteristics and functions.
Chapter 5
Table 5.1 Characteristics of drugs used for topical ocular anesthesia.
Table 5.2 Reported local anesthetic volumes used for RBA in dogs.
Table 5.3 Calculations of the reported local anesthetic volumes (in ml) use...
Chapter 8
Table 8.1 Sensory and motor distributions of the nerves to the thoracic limb...
Chapter 12
Table 12.1 Fascial plane blocks used in veterinary medicine. The reader is ...
Chapter 28
Table 28.1 Summary of the relative potencies for toxicity of local anesthet...
Table 28.2 Treatment of local anesthetic systemic toxicity (LAST).
List of Illustrations
Chapter 1
FIGURE 1.1 Drawing of the 2‐D compound scanner, developed through the collab...
FIGURE 1.2 Ultrasound images of (a) brachial plexus (supraclavicular level);...
Chapter 2
FIGURE 2.1 Graphical representation of the number of publications relating t...
FIGURE 2.2 The many responses that an ultrasound wave produces when travelin...
FIGURE 2.3 Attenuation (energy loss) is directly proportional to the frequen...
FIGURE 2.4 Axial resolution is the ability to discern objects in‐line with t...
FIGURE 2.5 Lateral resolution is demonstrated here for a hypothetical linear...
FIGURE 2.6 Characteristics of an ultrasound beam. The focal zone is where th...
FIGURE 2.7 The Doppler effect. Doppler is used to measure velocity and direc...
FIGURE 2.8 Ultrasonographic image of the relevant area following administrat...
FIGURE 2.9 Ultrasonographic image demonstrating the use of CPD to indicate b...
FIGURE 2.10 Series of ultrasonographic images showing the effects of adjusti...
FIGURE 2.11 (a) Example of a silicone standoff pad and the corresponding ult...
FIGURE 2.12 Series of ultrasonographic images showing the effects of adjusti...
FIGURE 2.13 Series of ultrasonographic images showing the effects of adjusti...
FIGURE 2.14 Series of ultrasonographic images to demonstrate the different t...
FIGURE 2.15 (a) A proximal RUMM block is being performed on a canine patient...
FIGURE 2.16 Example of using tilt to change the angle of insonation to chang...
FIGURE 2.17 Ultrasonographic image of the lateral thoracic body wall of a ca...
FIGURE 2.18 Ultrasonographic image of the femoral artery of a canine patient...
FIGURE 2.19 Reverberation artifact, detailed in a stepwise manner. Each numb...
FIGURE 2.20 Examples of reverberation artifact resulting from reflection of ...
FIGURE 2.21 Examples of mirror imaging artifacts resulting from strong retur...
FIGURE 2.22 (a) An ultrasound transducer has been positioned for a
sciatic n
...
FIGURE 2.23 Examples of how to stabilize the dominant hand when manipulating...
FIGURE 2.24 Series of ultrasonographic images to demonstrate the appearance ...
FIGURE 2.25 (a) In‐plane and (b) out‐of‐plane needle techniques. (c) A needl...
Chapter 3
FIGURE 3.1 Examples of text labels that can be pre‐populated using the “anno...
FIGURE 3.2 Example of three key images to save when performing an ultrasound...
Chapter 4
FIGURE 4.1 Diagrams of the chemical structures of an ester (left) and amide ...
FIGURE 4.2 The fraction of a local anesthetic that is ionized changes as pH ...
FIGURE 4.3 When the change in voltage is sufficiently large, voltage‐gated N...
Chapter 5
FIGURE 5.1 Diagram showing the
frontal
,
lacrimal
,
zygomaticotemporal
, and
zy
...
FIGURE 5.2 Diagram showing the overlapping innervation of the
frontal
,
lacri
...
FIGURE 5.3 Diagram of the nerves supplying innervation to ocular structures....
FIGURE 5.4 Administration of an
auriculopalpebral nerve
block in a dog. This...
FIGURE 5.5
Frontal
and
zygomaticotemporal nerves
stained following injection...
FIGURE 5.6 Administration of
frontal
(a) and
zygomaticotemporal
(b)
nerve
bl...
FIGURE 5.7 Administration of retrobulbar block with the inferior‐temporal‐pa...
FIGURE 5.8 Diagrams of RBA administration in cats: sagittal view (a); dorsal...
FIGURE 5.9 Ultrasound‐guided approach to retrobulbar block in cats. Note the...
FIGURE 5.10 Administration of PBA single‐injection at the medial canthus (a)...
FIGURE 5.11 Administration of PBA: (a) diagram (sagittal view) and (b) in a ...
FIGURE 5.12 Administration of an extraconal block with ultrasound‐guided pos...
FIGURE 5.13 Exophthalmos, chemosis, and ecchymosis in a dog following PBA. T...
FIGURE 5.14 Diagram of STA administration (sagittal view).
FIGURE 5.15 Splash block is administered in a cat following enucleation and ...
FIGURE 5.16 Absorbable gelatin sponge (Gelfoam
®
) infused with local ane...
FIGURE 5.17 Eyelid infiltration in a dog.
Chapter 6
FIGURE 6.1 Dissection of the right cervical area of a dog. The
great auricul
...
FIGURE 6.2 (a) Dissection of the right side of the head and neck of a dog sh...
FIGURE 6.3 (a) Left
great auricular nerve
block is being performed in a dog ...
FIGURE 6.4 (a) Ultrasonographic image relevant to the
great auricular nerve
...
Chapter 7
FIGURE 7.1 (a) Anatomy of the lateral aspect of the left brachial plexus in ...
FIGURE 7.2 A dog has been positioned for a subscalene approach to the right ...
FIGURE 7.3 (a) Positioning for an ultrasound‐guided subscalene approach to t...
FIGURE 7.4 (a) Longitudinal (long‐axis) ultrasound image of the caudal area ...
FIGURE 7.5 Color flow Doppler ultrasound image showing the axillary artery m...
FIGURE 7.6 Ultrasound‐guided subscalene brachial plexus block in a dog. The ...
Chapter 8
FIGURE 8.1 Dissection of the left axillary area of a dog in dorsal recumbenc...
FIGURE 8.2 (a) Dog positioned in dorsal recumbency for brachial plexus block...
FIGURE 8.3 Optimal ultrasound image for the axillary approach to a brachial ...
FIGURE 8.4 (a) Left brachial plexus block being performed with the dog posit...
Chapter 9
FIGURE 9.1 Visualization of the
radial
(R),
ulnar
(U),
median
(M), and
muscu
...
FIGURE 9.2 (a) A dog has been positioned for a proximal RUMM block prior to ...
FIGURE 9.3 The ultrasound transducer has been placed perpendicular to limb o...
FIGURE 9.4 (a) Pre‐block ultrasonographic image of the target area for a pro...
FIGURE 9.5 An insulated needle has been advanced in‐plane from the cranial a...
FIGURE 9.6 (a) Ultrasonographic image of proximal RUMM block in a dog. (b) S...
FIGURE 9.7 (a) Postinjection ultrasonographic image following a proximal RUM...
Chapter 10
FIGURE 10.1 Dissection of the left tricipital region of a dog in right later...
FIGURE 10.2 (a) Dog positioned in lateral recumbency for a left RUMM block. ...
FIGURE 10.3 Ultrasound image showing the relevant anatomy for a RUMM block i...
FIGURE 10.4 (a) Ultrasound image of a
radial nerve
block in a dog. The marke...
Chapter 11
FIGURE 11.1 (a) Schematic representation of the components of a thoracic spi...
FIGURE 11.2 Schematic representation of the branching of the fifth thoracic ...
FIGURE 11.3 (a) Cross section of the trunk at the level of the fifth thoraci...
FIGURE 11.4 Schematic representation of the cross section of the thoracic pa...
Chapter 12
FIGURE 12.1 The thorax of a dog cadaver. The lateral cutaneous branches of t...
FIGURE 12.2 Diagram of a spinal nerve. Dorsal and ventral roots converge pri...
FIGURE 12.3 Dermatome map of the dog demonstrating the cutaneous innervation...
FIGURE 12.4 Dissection of the abdominal wall of a canine cadaver following i...
Chapter 13
FIGURE 13.1 Schematic representation of a transverse view of a thoracic para...
FIGURE 13.2 Sonoanatomy of the TPV space in a dog (a) and schematic represen...
FIGURE 13.3 Sequence of dog positioning, transducer placement, and needle in...
FIGURE 13.4 (a) Ultrasound image of the fifth thoracic paravertebral space i...
FIGURE 13.5 “Off‐side” transducer position to facilitate needle introduction...
Chapter 14
FIGURE 14.1 A canine patient is positioned for performance of
intercostal ne
...
FIGURE 14.2 (a) Pre‐block ultrasonographic image of the target area for inte...
FIGURE 14.3 (a) An
intercostal nerve
block is being performed in a dog. The ...
FIGURE 14.4 Ultrasonographic images of local anesthetic distributions follow...
Chapter 15
FIGURE 15.1 (a) Dissection of the right lateral chest wall of a canine cadav...
FIGURE 15.2 A dog has been positioned for Serratus Plane Block prior to late...
FIGURE 15.3 A regional nerve block needle has been inserted in‐plane, in a c...
FIGURE 15.4 (a) Pre‐block ultrasonographic image of the target area for a Se...
FIGURE 15.5 (a) Ultrasonographic image of “
superficial
” SPB. (b) Same image ...
FIGURE 15.6 (a) Post‐injection ultrasonographic image following a “
superfici
...
Chapter 16
FIGURE 16.1
Transverse
ultrasound‐guided approach to the transversus thoraci...
FIGURE 16.2
Sagittal
ultrasound‐guided approach to the transversus thoracis ...
FIGURE 16.3 Ultrasound‐guided approach to the pecto‐intercostal fascial plan...
FIGURE 16.4 Inner visualization of the thorax before (a) and after (b) disse...
FIGURE 16.5 (a) Computed tomographic (CT) image of the thorax of a dog at th...
FIGURE 16.6 Sagittal ultrasound image of the intercostal space in the parast...
FIGURE 16.7 (a) Ultrasound image of the fifth interchondral space in a canin...
FIGURE 16.8 Ultrasound image showing the distribution of injectate following...
FIGURE 16.9 (a) Ultrasound image of the pecto‐intercostal fascial plane (PIF...
Chapter 17
FIGURE 17.1 Illustrations of representative thoracic and lumbar vertebrae. (...
FIGURE 17.2 Illustration of the superficial epaxial muscles. (a) Thoracolumb...
FIGURE 17.3 Illustration of a generalized spinal nerve and its branches.
FIGURE 17.4 Image of a canine patient receiving an ultrasound‐guided ESP blo...
FIGURE 17.5 (A1, B1, and C1) Sonoanatomy of the relevant structures that are...
FIGURE 17.6 (a) Ultrasound image of a needle (solid arrows) at the target lo...
FIGURE 17.7 Needle attached to a T‐connector. A stopcock is located between ...
FIGURE 17.8 (a) Ultrasound image of ESP block being performed. The needle (a...
Chapter 18
FIGURE 18.1 Schematic illustration of a cross section at the level of the fi...
FIGURE 18.2 Patient positioning to perform the QLB. (a) A dog is positioned ...
FIGURE 18.3 Ultrasound transducer positioning to perform the QLB. Generally,...
FIGURE 18.4 Ultrasound transducer positioning to perform the
longitudinal
ap...
FIGURE 18.5 (a) Sonoanatomy of the lumbar musculature and landmarks to perfo...
FIGURE 18.6 (a) Sonoanatomy of the lumbar musculature and landmarks to perfo...
FIGURE 18.7 Ultrasound transducer position and needle insertion to perform t...
FIGURE 18.8 (a) Ultrasound image of the lumbar musculature and landmarks to ...
FIGURE 18.9 Caudal view of ultrasound transducer position and needle inserti...
FIGURE 18.10 (a) Ultrasound image of the lumbar musculature and landmarks to...
FIGURE 18.11 (a) Ultrasound image of the lumbar musculature and landmarks to...
FIGURE 18.12 (a) Ultrasound image of the lumbar musculature and landmarks to...
FIGURE 18.13 Ultrasound transducer position and needle insertion to perform ...
FIGURE 18.14 (a) Ultrasound image of the lumbar musculature and landmarks to...
FIGURE 18.15 (a) Ultrasound image of the lumbar musculature after performing...
Chapter 19
FIGURE 19.1 Innervation of the canine abdominal wall. The ventral branches o...
FIGURE 19.2 (a) Ultrasound transducer position for a “
subcostal
” TAP block. ...
FIGURE 19.3 (a) Ultrasound transducer position for lateral abdominal “
retroc
...
FIGURE 19.4 Representation and ultrasound pictures showing the anatomy of th...
FIGURE 19.5 Mirroring artifact during performance of a postoperative TAP blo...
FIGURE 19.6 Ultrasound anatomy and representation of the lateral abdominal w...
FIGURE 19.7 Ultrasound anatomy and representation of the subcostal TAP.
FIGURE 19.8 Ultrasound anatomy when the transducer is positioned transversal...
FIGURE 19.9 Deposition of local anesthetic during a lateral abdominal TAP. N...
FIGURE 19.10 Deposition of local anesthetic during a “
subcostal
” TAP block. ...
FIGURE 19.11 Inadvertent intramuscular injection during performance of a lat...
Chapter 20
FIGURE 20.1 Illustration of the muscles of the canine abdominal wall. Note t...
FIGURE 20.2 Illustration of the canine abdominal wall demonstrating the cont...
FIGURE 20.3 Positioning of a canine patient for ultrasound‐guided rectus she...
FIGURE 20.4 The ultrasound transducer is initially positioned on the patient...
FIGURE 20.5 (a) Ultrasonographic image of the relevant anatomy prior to perf...
FIGURE 20.6 Ultrasonographic images from two different dogs taken at the sam...
FIGURE 20.7 Needle attached to a T‐connector. A stopcock is located between ...
FIGURE 20.8 Performance of an ultrasound‐guided rectus sheath block in a dog...
FIGURE 20.9 (a) Optimized ultrasonographic image prior to needle insertion. ...
FIGURE 20.10 (a) Ultrasonographic image showing ideal dispersion of the loca...
FIGURE 20.11 (a) Ultrasonographic image showing incorrect dispersion of the ...
Chapter 21
FIGURE 21.1 (a) Gross anatomy of the
femoral nerve
as it leaves the
m. iliop
...
FIGURE 21.2 Patient positioned for right‐sided US‐guided
femoral nerve
block...
FIGURE 21.3 Positioning the ultrasound transducer to perform a right US‐guid...
FIGURE 21.4 (a) Transverse ultrasound image of the
femoral nerve
within the
FIGURE 21.5 (a) In‐plane introduction of a needle into the
m. iliopsoas
on a...
FIGURE 21.6 (a) Final needle position before injection of a local anesthetic...
FIGURE 21.7 (a) Final distribution of local anesthetic around the
femoral ne
...
Chapter 22
FIGURE 22.1 Dissection of the femoral triangle region of the left pelvic lim...
FIGURE 22.2 (a) Medial aspect view of the right pelvic limb of a dog positio...
FIGURE 22.3 Ultrasound image of the
femoral nerve
. Cross‐section view (short...
FIGURE 22.4 (a) Right
femoral nerve
block being performed in a dog positione...
Chapter 23
FIGURE 23.1 Dissection of the medial aspect of the left thigh. The
saphenous
...
FIGURE 23.2 (a) Medial aspect view of the right pelvic limb in a dog positio...
FIGURE 23.3 Ultrasonographic image of the
saphenous nerve
at the level of th...
FIGURE 23.4 (a) Right
saphenous nerve
block being carried out in a dog posit...
FIGURE 23.5 Ultrasound image of the
saphenous nerve
at the level of the midt...
Chapter 24
FIGURE 24.1 Anatomical preparation of the lumbosacral trunk and cross‐sectio...
FIGURE 24.2 Anatomical dissection of the lumbosacral trunk. Ventral view of ...
FIGURE 24.3 (a) Surface anatomy and initial ultrasound transducer position (...
FIGURE 24.4 (a) Ultrasound image and (b) schematic representation of the par...
Chapter 25
FIGURE 25.1 Dissection of the lateral aspect of the left thigh of a canine c...
FIGURE 25.2 (a) Dog positioned in left lateral recumbency for a right
sciati
...
FIGURE 25.3 Ultrasonographic image of the
sciatic nerve
in short‐axis view. ...
FIGURE 25.4 (a) Right
sciatic nerve
block in a dog. The ultrasound transduce...
Chapter 26
FIGURE 26.1 Dissection of the feline pelvic region showing the right
pudenda
...
FIGURE 26.2 Performance of a
pudendal nerve
block in a cat. Note the positio...
FIGURE 26.3 (a) Ultrasonographic landmarks for the para‐coccygeal
pudendal n
...
Chapter 27
FIGURE 27.1 Dorsal view of a dog pelvis and caudal lumbar vertebrae. A, Spin...
FIGURE 27.2 Lateral view (sagittal section) of the lumbar spine of a dog.
FIGURE 27.3 Transverse view (axial section) of a dog spine at the level of t...
FIGURE 27.4 Dorsal view (coronal section) of the lumbar spine of a dog.
FIGURE 27.5 Positioning a Pug for a lumbosacral injection. (a) When the pelv...
FIGURE 27.6 Orientations of an ultrasound transducer over the lumbosacral in...
FIGURE 27.7 Comparison between the anatomic transverse slice (a) and the tra...
FIGURE 27.8 Comparison between the anatomic parasagittal slice (a) and the p...
FIGURE 27.9 Looking caudally a dog that has been positioned in sternal recum...
FIGURE 27.10 (a) Computed tomography (CT) image showing the dorsal view of t...
FIGURE 27.11 (a) Sonoanatomy of the lumbosacral epidural space in a dog show...
FIGURE 27.12 Transverse CT image (bone window) of the lumbosacral region of ...
FIGURE 27.13 CT three‐dimensional volume rendering of the sacrococcygeal are...
FIGURE 27.14 (a) Cadaver of a dog in sternal recumbency with hindlimbs pulle...
FIGURE 27.15 (a) Ultrasound‐guided insertion of a needle using a 45°–60° ang...
Chapter 28
FIGURE 28.1 Diagram depicting anatomy of a peripheral nerve.
FIGURE 28.2 Duration of limb paresis following high‐pressure intraneural (>2...
FIGURE 28.3 (a) Short (30°) and (b) long (15°) bevel needles shown here at 2...
FIGURE 28.4 Illustration depicting Compressed Air Injection Technique (CAIT)...
FIGURE 28.5 BSmart™ manometer (B. Braun Medical Inc., Germany) used for moni...
FIGURE 28.6 Horner’s syndrome following subscalene brachial plexus block in ...
FIGURE 28.7 Ready‐to‐use lipid emulsion (lipid rescue) for treatment of loca...
Guide
Cover Page
Table of Contents
Dedication
Title Page
Copyright
List of Contributors
Foreword
Preface
Acknowledgments
Begin Reading
Index
WILEY END USER LICENSE AGREEMENT
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Dedication
I would first like to thank my family for their support and patience while I have worked on this project over the last few years. Emma, thank you for being our family’s rock, for inspiring me to be the best version of myself every day, and for challenging me to think of new ways to do things. Grace and Kate, thank you for putting up with the endless hours “on my computer” at the airport and at your horse shows. I am so proud to be your dad and have loved every minute of watching you pursue your passions and succeed in ways we could have never imagined a few short years ago! Our family means everything to me, and I am so thankful to have all of you in my life. Love you guys!
I’d also like to recognize the patients that I get to work with every day. I learn so much from getting to practice anesthesia as part of your medical care and have grown so much as a veterinarian since I have started to see what lies inside and can be better at my job on your behalf.
Finally, I’d like to thank Luis and Berit for years and years of wonderful friendship and their tireless efforts in getting this edition of our book across the finish line. I can’t wait to start working on the third edition with you!
Matt Read
At the time of writing this, it feels like we have written and edited a book and a half! It has been a difficult time, filled with unprecedented challenges, and yet, here we are, we made it! During this time, there were many times in which this project was still a big question mark. This is when my partner in crime comes in. Always with encouragement and amazing management skills! Matt Read has guided me through this process all the way to the end! Thank you auld friend!
To Berit Fischer, our new addition to the team and dear friend for many years … since her Ithaca times! We go back a while, I know … What a journey! This one will be difficult to forget!
To all the authors in this book and those that were authors and then weren’t anymore … This project went through many stages and many designs … as I said … unprecedented times and challenges in making this book a reality. This book is also yours!
To all my workmates, especially Drs. Manuel Martin‐Flores, Robin Gleed, and Jordyn Boesch, for allowing me to go into close confinement to “type and read stuff”!
Finally, to my beloved wife and children, Ewa, Kyla, and Kian, for being so patient with me and never asking why…
Luis Campoy
To my mom, my editor growing up in more ways than one, who taught me to always pay attention to the details. To my dad, my running partner, who never let me quit. To my husband, Mike, who smiled and said “Go for it” when I was presented with the opportunity to be an editor for this book. His support throughout my career has been steadfast and in ways I can never repay. To my two amazing daughters, Abigail and Ilse, who continue to inspire me daily with their creativity and thirst for knowledge. I am so incredibly fortunate. And to my co‐editors and friends, Matt and Luis, who, having both been mentors at different points in my career, decided to share this journey with me. Until next time…
Berit Fischer
Small Animal Regional Anesthesia and Analgesia
SECOND EDITION
Edited by
Matt Read
Anesthesiologist and Specialty Team Leader
MedVet, Worthington, OH, USA
Luis Campoy
Clinical Professor of Anesthesiology and Pain Medicine
Section Chief of Anesthesiology and Pain Medicine
College of Veterinary Medicine
Cornell University
Ithaca, NY, USA
Berit Fischer
Head of Anesthesia and Pain Management
Eastern Pennsylvania Veterinary Medical Center
Allentown, PA, USA
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Library of Congress Cataloging‐in‐Publication DataNames: Read, Matt, editor. | Campoy, Luis, MRCVS, editor. | Fischer, Berit (Berit L.), editor.Title: Small animal regional anesthesia and analgesia / edited by Matt Read, Luis Campoy, Berit Fischer.Description: Second edition. | Hoboken, New Jersey : Wiley‐Blackwell, [2024] | Includes index.Identifiers: LCCN 2023048958 (print) | LCCN 2023048959 (ebook) | ISBN 9781119514152 (cloth) | ISBN 9781119514145 (adobe pdf) | ISBN 9781119514138 (epub)Subjects: MESH: Anesthesia, Conduction–veterinary | Anesthesia, Conduction–methods | Nerve Block–veterinary | Ultrasonography, Interventional–veterinary | Dogs–surgery | Cats–surgeryClassification: LCC SF914 (print) | LCC SF914 (ebook) | NLM SF 914 | DDC 636.089/796–dc23/eng/20231208LC record available at https://lccn.loc.gov/2023048958LC ebook record available at https://lccn.loc.gov/2023048959
Cover Design: WileyCover Images: © Matt Read, Luis Campoy and Berit Fischer
List of Contributors
Chiara AdamiDepartment of Veterinary MedicineUniversity of CambridgeCambridgeUnited Kingdom
Eric D. BrumbergerWeill Cornell Medicine, Department of AnesthesiologyNewYork‐Presbyterian HospitalNew York, NYUSA
Luis CampoyCollege of Veterinary MedicineCornell UniversityIthaca, NYUSA
Tatiana H. FerreiraSchool of Veterinary MedicineUniversity of Wisconsin, MadisonMadison, WIUSA
Berit L. FischerEastern Pennsylvania Veterinary Medical CenterAllentown, PAUSA
Marta GarbinDepartment of Clinical Sciences, Faculty of Veterinary MedicineUniversité de MontréalSaint‐Hyacinthe, QCCanada
Augusto Matias LorenzuttiFacultad de Ciencias AgropecuariasIRNASUS CONICET‐Universidad Católica de CórdobaCórdobaArgentina
Stephan MahlerBestin’VetSaint GrégoireFrance
Manuel Martin‐FloresDepartment of Clinical Sciences, College of Veterinary MedicineCornell UniversityIthaca, NYUSA
Micheál Ó CathasaighMOC Veterinary Radiology Ltd.St. Neots, CambridgeshireUK
Pablo E. OteroDivision of Anaesthesiology and Pain ManagementCollege of Veterinary MedicineBuenos Aires UniversityCiudad Autónoma de Buenos AiresArgentina
Peter PascoeDepartment of Surgical and Radiological SciencesUniversity of CaliforniaDavis, CAUSA
Diego A. PortelaDepartment of Comparative, Diagnostic and Population MedicineCollege of Veterinary MedicineUniversity of FloridaGainesville, FLUSA
Matt ReadMedVetWorthington, OHUSA
Marta RomanoDepartment of Comparative, Diagnostic and Population MedicineCollege of Veterinary MedicineUniversity of FloridaGainesville, FLUSA
Yael Shilo‐BenjaminiKoret School of Veterinary MedicineThe Hebrew University of JerusalemRehovotIsrael
Alexander C. S. ThomsonCityU Veterinary Medical CentreSham Shui Po, KowloonHong Kong
Jaime ViscasillasAnaesthesia Service and Pain ClinicSilla, ValenciaSpain
Foreword
For many years, the use of local anesthetics in general veterinary practice was largely confined to providing surgical anesthesia for ruminants and performing diagnostic nerve blocks in horses. The first edition of Small Animal Regional Anesthesia and Analgesia, published in 2013, was a driving force behind the widespread adoption of locoregional anesthesia by companion animal practitioners. Since that edition of the book, the practice of locoregional anesthesia has progressed substantially, and this eagerly awaited second edition is an up‐to‐date reference and learning guide for the small animal practitioner.
Local anesthetic techniques are now used routinely in surgical practice to provide intra‐ and postoperative analgesia. These techniques allow major surgery to be accomplished at minimal depths of anesthesia and even with procedural sedation. When longer‐acting local anesthetics are used, good‐quality pain relief can persist well into the postoperative period. Systemic analgesics, such as opioids and nonsteroidal anti‐inflammatory drugs (NSAIDs), are beset with adverse side effects and regulatory impediments to their use. The need for opioids and NSAIDs in veterinary practice will be reduced with increasing use of locoregional anesthesia. Some of the procedures described here are of interest to practitioners for relief of chronic pain, e.g., palliative care of patients with limb osteosarcoma.
The chapters are named for the nerves that are to be blocked – and each starts with a section (Block at a Glance) that summarizes the technique and its probable uses. The images include high‐quality photographs, dissections, and ultrasonographs that are essential complements to the text. The quality of a nerve block is related directly to the precision with which a local anesthetic is injected. Echolocation is the most precise method available to clinicians for depositing local anesthetic proximate to target nerves – it is superior even to electrolocation. In general, such ultrasound‐guided blocks performed by educated operators produce better‐quality analgesia than alternative techniques and generate fewer adverse side effects. Fortunately, high‐definition ultrasound equipment is now available to the general practitioner, and the editors of this book describe the approach to each block using echolocation.
As was its predecessor, this edition will surely become a primary resource for veterinary students, technicians, general practitioners, surgeons, anesthesiologists, and pain practitioners.
Robin D. Gleed, BVSc, MA, MRCVS, DVA, DACVAA, DipECVAA, MRCA
Professor of Anesthesiology and Pain Management
Senior Associate Chair,Department of Clinical SciencesCornell University
Preface
2023 marked the ten‐year anniversary of the first edition of Small Animal Regional Anesthesia and Analgesia, aka “The Green Book”, whose success over the last decade was based on the nature of its novel content and practicality. Publication of that book changed our professional lives as well as the lives of many veterinarians and veterinary team members who had an interest in anesthesia and pain management. We are so appreciative of the amazing group of contributors who helped bring that book to fruition and shared their expertise and enthusiasm for this growing area of anesthesia with our readers. We have heard time and again how the information in that edition contributed to the improved comfort and well‐being of many pets worldwide and are still somewhat shocked that our book could have made such an impact.
When the first edition of Small Animal Regional Anesthesia and Analgesia was published, veterinary locoregional anesthesia was still considered by many to be more “art” than “science” and something that was practiced by few. Over the past ten years, interest in and knowledge of small animal locoregional anesthesia have grown exponentially beyond the scope of the first edition. Blocks have now reached into parts of the body that many of us had never envisioned (or even heard of!) and the field is maturing as a subspecialty thanks to the tireless efforts, thoughtful research, and reporting of clinical experiences of many, many people from around the world. Dissemination of new information pertaining to this exciting area of small animal anesthesia continues to rise through publications, instruction, and casual conversations, and our collective knowledge continues to grow every year for the betterment of the patients we serve.
This new, second edition of Small Animal Regional Anesthesia and Analgesia represents a significant revision of our original book, and we are very excited to share it with you. Following a similar path to the one taken by many of our physician counterparts, we have chosen to focus this edition almost exclusively on the use of ultrasound‐guided techniques since that is the direction the published literature and clinical practice are taking us. Although we will undoubtedly miss including something, we have tried to be as all‐encompassing as we could in terms of summarizing what has been published to date and including as much as is currently known about the anesthetic and analgesic techniques that the use of ultrasound affords us. We have also restructured the presentation of the content to follow a relatively consistent template, making it easier for you, the reader, to find the specific information you might be looking for. We have also tried to include the types of images that will enhance your learning and understanding of the information that is presented in the text, allowing you to appreciate many of the subtle aspects that still fall under the category of “art.” This mammoth endeavor led us to add another editor to the project and to invite a dozen new and distinguished colleagues from around the world to share their varied expertise and experiences with us. Together, they have made our vision for the new edition a reality, and we are so very grateful for their support of this project and their continued friendships.
We originally set out on this project with the same goals that we outlined in the first edition of Small Animal Regional Anesthesia and Analgesia: to summarize the peer‐reviewed and evidence‐based literature for our readers, to standardize the techniques and associated nomenclature that are described, to further stimulate interest in this exciting area of veterinary anesthesia, and to improve patient care by creating a resource that would be accessible and helpful to everyone, regardless of their level of experience or training. Although we are confident that this book will be of use to students, veterinarians, technicians, veterinary anesthesiologists, and other veterinary specialists who are interested in improving their understanding of how local and regional anesthesia might fit into their practices, we appreciate that there is still so much for all of us to learn. We hope that we have achieved these goals and that you enjoy and benefit from the information in this book as much as we and our colleagues have enjoyed and benefited from preparing it.
Leave no patient unblocked! But first, do no harm… Let us continue on this journey together.
Matt, Luis, and Berit
January 2024
Acknowledgments
We would first like to acknowledge our amazing collaborators and coauthors, all of whom had great enthusiasm for seeing this new edition of Small Animal Regional Anesthesia and Analgesia come to fruition. So much has been learned and developed since the first edition was published, and it took a village to distill everything that is currently known into a single resource. Thank you all for your time, energy, and passion for sharing what you know with the world!
We also want to thank the exceptional team at Wiley for their support and patience. After many delays, we are all very thankful to see this project finally completed! We would especially like to extend our thanks to Ms. Erica Judisch, Executive Editor, Veterinary Medicine and Dentistry, for her friendship, tireless patience, and understanding over the last ten years. Without her, this edition would never have happened. We are also very grateful for Ms. Vallikkannu Narayanan, Managing Editor, Health Professions and Veterinary Medicine; Ms. Merryl Le Roux, our previous Managing Editor, Health and Life Sciences; and Ms. Susan Engelken, Editorial Publication Coordinator and all that they contributed to the process.
