Watanabe Ryota, Bertolizio Gianluca, Benedetti Inga-Catalina Cruz, Garbin Marta
Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas 77843, USA (Watanabe); Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Quebec J2S 2M2 (Watanabe, Cruz Benedetti, Garbin); Division of Pediatric Anesthesia, Montreal Children's Hospital, McGill University, Montreal, Quebec H4A 3J1 (Bertolizio).
Can Vet J. 2024 Dec;65(12):1234-1240.
Extrahepatic bile-duct obstruction is commonly caused by pancreatitis in canines. Surgical decompression of the biliary tree is required when medical management is unsuccessful. The clinical presentation often includes severe vomiting and abdominal pain requiring targeted analgesic and anesthetic protocols. Locoregional anesthesia has been largely advocated as part of multimodal analgesic plans to reduce opioid consumption and decrease opioid-related side effects. This report describes a case where the lateral quadratus lumborum block provided effective analgesia and opioid-sparing effect in a 7-year-old mixed-breed dog with extrahepatic bile-duct obstruction undergoing common bile-duct stent placement. Key clinical message: Anesthetic stability in critically ill patients undergoing abdominal surgery is challenging. However, implementation of an ultrasound-guided locoregional technique may help blunt the sympathetic response to surgery and reduce opioid requirements, facilitating anesthetic stability and a comfortable early postoperative period. This is apparently the first report on using ultrasound-guided quadratus lumborum block in a critically ill dog with pancreatitis.
肝外胆管梗阻在犬类中通常由胰腺炎引起。当药物治疗失败时，需要对胆管进行手术减压。临床表现通常包括严重呕吐和腹痛，需要针对性的镇痛和麻醉方案。局部区域麻醉在很大程度上被提倡作为多模式镇痛计划的一部分，以减少阿片类药物的使用并减少与阿片类药物相关的副作用。本报告描述了一例病例，在一只7岁患有肝外胆管梗阻的混血犬接受胆总管支架置入术时，腰方肌外侧阻滞提供了有效的镇痛作用和阿片类药物节省效应。关键临床信息：接受腹部手术的重症患者的麻醉稳定性具有挑战性。然而，实施超声引导下的局部区域技术可能有助于减弱对手术的交感反应并减少阿片类药物需求，促进麻醉稳定性和术后早期舒适。这显然是关于在患有胰腺炎的重症犬中使用超声引导下腰方肌阻滞的首例报告。
