Repeated bolus injections of bupivacaine for continuous bilateral transversus thoracis plane block undergoing median sternotomy in a dog: A case report

D Kim, D Shin, S Yun, G An, J Jung and Son Wg
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D Kim: Ilsan Animal Medical Center, Goyang, Republic of Korea
D Shin: Ilsan Animal Medical Center, Goyang, Republic of Korea
S Yun: Ilsan Animal Medical Center, Goyang, Republic of Korea
G An: Ilsan Animal Medical Center, Goyang, Republic of Korea
J Jung: Ilsan Animal Medical Center, Goyang, Republic of Korea
Son Wg: Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea

Veterinární medicína, 2024, vol. 69, issue 4, 123-129

Abstract: An 8-year-old, 6.5 kg, neutered female Shih-Tzu dog was presented for surgical resection of a mediastinal mass. A median sternotomy and left cranial lung lobectomy were performed. Intraoperatively, with the patient under general anaesthesia, a bilateral transversus thoracis plane (TTP) block was performed by injecting 0.5% bupivacaine (0.2 ml/kg) per side using real-time ultrasound guidance. After surgery, indwelling catheters for repeated bolus injections of bupivacaine in TTP were placed as follows: the fifth sternebra was palpated in dorsal recumbency, and the transducer was placed in the longitudinal plane lateral to the sternal border. A 16 gauge over-the-needle catheter was inserted caudo-cranially using an in-plane technique and located in the TTP. An intermittent bolus of bupivacaine (0.1 ml/kg) per side was injected via the indwelling catheter every 8 h for 3 days, with a constant rate infusion of an intravenous fentanyl (1 μg/kg/h) and ketamine (0.12 mg/kg/h) combination. Post-operative pain was evaluated using the Glasgow composite measure pain scale and the score was 4-5/24 on the day of surgery and gradually decreased over time. Additional rescue analgesia was not required. Repeated boluses of bupivacaine for a continuous bilateral TTP block may be a useful adjuvant for perioperative pain management strategies, including median sternotomy, in dogs.

Keywords: acute pain; indwelling catheter; lobectomy; thoracotomy; ultrasound-guided (search for similar items in EconPapers)
Date: 2024
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Persistent link: https://EconPapers.repec.org/RePEc:caa:jnlvet:v:69:y:2024:i:4:id:118-2023-vetmed

DOI: 10.17221/118/2023-VETMED

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