Hypobaric intrathecal anaesthesia for partial hemipelvectomy in a dog

Summary Objective: To report the intrathecal use of a hypobaric anaesthetic solution for partial hemipelvectomy in a nine-year-old, neutered female, Golden Retriever dog, weighing 34 kg. Methods: Under inhalational anaesthesia, with the dog lying in lateral recumbency and the surgical side uppermost, 1.9 ml of a hypobaric solution containing 3.42 mg of bupivacaine and 0.66 mg of morphine were administered in the subarachnoid space at L5–6 level 30 minutes before surgery. Following the intrathecal injection the dog was maintained for five minutes in a 10° head-down position, then for three minutes in a 10° head-up position. Results: Apart from a transient increase in heart and respiratory rates during resection of the sartorius muscle, which was treated with a plasma Target Controlled Infusion (TCI) of fentanyl, spinal anaesthesia provided cardiovascular stability and excellent relaxation of the surgical site. Neither motor blockade nor proprioceptive deficit were apparent in the contra-lateral hind limb at recovery, 200 minutes after injection. Postoperatively, rescue analgesia was not required in the 48 hours following surgery. Clinical significance: In dogs, the use of intrathecal hypobaric bupivacaine and morphine as a part of a balanced anaesthetic protocol should be considered during unilateral major orthopaedic surgeries of the pelvis and hind limb, as it allowed a reduction in the dose administered compared to isobaric solutions, providing selective spinal anaesthesia, excellent longlasting analgesia, and rapid recovery of ambulation.

[1]  M. Mochizuki,et al.  Pharmacokinetics of fentanyl after single intravenous injection and constant rate infusion in dogs. , 2006, Veterinary anaesthesia and analgesia.

[2]  F. Corletto,et al.  Combined spinal-epidural anesthesia in a dog. , 2006, Veterinary surgery : VS.

[3]  D. Goldstein,et al.  Definitions of “respiratory depression” with intrathecal morphine postoperative analgesia: a review of the literature , 2003, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[4]  A. Casati,et al.  Intrathecal anesthesia , 2002, Current opinion in anaesthesiology.

[5]  K. McGoldrick The role of spinal anesthesia in the ambulatory venue: current issues and concerns , 2001, Current opinion in anaesthesiology.

[6]  B. Hansen Epidural Catheter Analgesia in Dogs and Cats: Technique and Review of 182 Cases (1991–1999) , 2001 .

[7]  Spencer S. Liu Current issues in spinal anesthesia , 2001, Anesthesiology.

[8]  H. Vaghadia,et al.  Selective spinal anesthesia for outpatient laparoscopy. I: Characteristics of three hypobaric solutions , 2001, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[9]  O. Kirvelä,et al.  Spinal Anesthesia With Hypobaric Bupivacaine for Knee Arthroscopies: Effect of Posture on Motor Block , 2001, Regional Anesthesia & Pain Medicine.

[10]  D. Dyson,et al.  Epidural analgesia and anesthesia. , 2000, The Veterinary clinics of North America. Small animal practice.

[11]  G. Fanelli,et al.  Frequency of hypotension during conventional or asymmetric hyperbaric spinal block. , 1999, Regional anesthesia and pain medicine.

[12]  M. Markel,et al.  A comparison of transdermal fentanyl versus epidural morphine for analgesia in dogs undergoing major orthopedic surgery. , 1999, Journal of the American Animal Hospital Association.

[13]  H. Singh Intrathecal fentanyl with small-dose dilute bupivacaine: better anesthesia without prolonging recovery. , 1998, Anesthesia and analgesia.

[14]  J. Neal,et al.  Dose-Response Characteristics of Spinal Bupivacaine in Volunteers: Clinical Implications for Ambulatory Anesthesia , 1997 .

[15]  G. Pittoni,et al.  Spinal Anesthesia in Outpatient Knee Surgery: 22-Gauge Versus 25-Gauge Sprotte Needle , 1995, Anesthesia and analgesia.

[16]  J. Neal,et al.  Fentanyl Prolongs Lidocaine Spinal Anesthesia Without Prolonging Recovery , 1995, Anesthesia and analgesia.

[17]  J. Whitwam,et al.  Specific Enhancement by Fentanyl of the Effects of Intrathecal Bupivacaine on Nociceptive Afferent But Not on Sympathetic Efferent Pathways in Dogs , 1993, Anesthesiology.

[18]  R. Wheatley,et al.  Double‐blind comparison of epidural diamorphine and intramuscular morphine after elective Caesarean section, with computerised analysis of continuous pulse oximetry , 1991, Anaesthesia.

[19]  J. Jones,et al.  Postoperative hypoxaemia: comparison of extradural, i.m. and patient-controlled opioid analgesia. , 1990, British journal of anaesthesia.

[20]  H. Yamaguchi,et al.  Intrathecal Morphine Dose‐Response Data for Pain Relief After Cholecystectomy , 1990, Anesthesia and analgesia.

[21]  D. Ilstrup,et al.  Intrathecal Morphine for Post‐Thoracotomy Pain , 1986, Anesthesia and analgesia.

[22]  B. Covino,et al.  A Dose‐Response Study of Bupivacaine for Spinal Anesthesia , 1983, Anesthesia and analgesia.

[23]  K. Mathews Non-steroidal Anti-inflammatory Analgesics for Acute Pain Management in Dogs and Cats , 1997, Veterinary and Comparative Orthopaedics and Traumatology.