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- Title
Repeated bolus injections of bupivacaine for continuous bilateral transversus thoracis plane block undergoing median sternotomy in a dog: A case report.
- Authors
DALHAE KIM; DONGMIN SHIN; SOOKYUNG YUN; GAYEON AN; JOOHYUN JUNG; WON-GYUN SON
- 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.
- Subjects
BUPIVACAINE; INJECTIONS; FEMALE dogs; INTRAVENOUS therapy; POSTOPERATIVE pain; IMPLANTABLE catheters
- Publication
Veterinární Medicína, 2024, Vol 69, Issue 4, p123
- ISSN
0375-8427
- Publication type
Article
- DOI
10.17221/118/2023-VETMED