Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (2024)

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Animals

Volume 14

Issue 12

10.3390/ani14121764

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Article

by

Pablo E. Otero

Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (5)Pablo E. Otero

1,*Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (6),

Jorge A. Guerrero

Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (7)Jorge A. Guerrero

1,

Lisa Tarragona

Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (8)Lisa Tarragona

1,

Fabiana Micieli

Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (9)Fabiana Micieli

2Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (10),

María Fernanda Sanchez

Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (11)María Fernanda Sanchez

1,

Pablo A. Donati

Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (12)Pablo A. Donati

1Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (13),

Martin R. Ceballos

Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (14)Martin R. Ceballos

1 and

Diego A. Portela

Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (15)Diego A. Portela

Diego A Portela received his veterinary degree from the School of Veterinary Sciences at the of in a[...]

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3Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (16)

1

Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires C1427CWO, Argentina

2

Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80137 Naples, Italy

3

Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0123, USA

*

Author to whom correspondence should be addressed.

Animals 2024, 14(12), 1764; https://doi.org/10.3390/ani14121764 (registeringDOI)

Submission received: 16 May 2024/Revised: 6 June 2024/Accepted: 10 June 2024/Published: 11 June 2024

(This article belongs to the Special Issue Second Edition: Loco-Regional Anaesthesia in Veterinary Medicine)

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Simple Summary

The GIN-TONIC block is an interfascial ultrasound-guided regional anesthesia technique that desensitizes the lumbosacral plexus and provides analgesia to the pelvic limb. Different methods have been attempted previously, such as blocking specific plexuses (e.g., lumbar and sacral plexuses) and nerves (e.g., femoral and sciatic). However, these approaches either resulted in excessive motor block or failed to encompass all the required areas for surgery. This study assessed the efficacy of the GIN-TONIC block in dogs premedicated with either acepromazine or dexmedetomidine for surgeries on the hip and stifles. It also checked how well the dogs could move after the surgery. The results showed that the GIN-TONIC block provided adequate perioperative analgesia, independently of the drug used in premedication. During recovery, dogs showed minimal motor block, suggesting that GIN-TONIC block provides a motor-protective analgesic effect. However, more research is needed to fully understand how effective the GIN-TONIC block is during surgery.

Abstract

This study assessed the analgesic and motor effects of the GIN-TONIC block, a combination of the greater ischiatic notch plane block and the caudal lateral quadratus lumborum block, in 24 dogs undergoing pelvic limb surgery. Dogs were randomly divided into two equal groups: GA received acepromazine [(20 µg kg–1 intravenously (IV)] as premedication, and GD received dexmedetomidine (2 µg kg–1 IV). General anesthesia was maintained with isoflurane, and both groups received a GIN-TONIC block using 2% lidocaine. Nociception during surgery and postoperative pain [assessed using the Glasgow Composite Measure Pain Score (GCMPS-SF)] were assessed. Fentanyl (2 µg kg–1 IV) was administered if nociception was noted and morphine (0.5 mg kg–1 IV) was administered during recovery if the pain scores exceeded the predefined threshold. Motor function was assessed during the recovery period using descriptors previously reported. All dogs received analgesics at the 4 h mark before being discharged. Three and two dogs in GD and GA required fentanyl once. Postoperative pain scores remained ≤4/20 for all dogs except one. Dogs achieved non-ataxic ambulation within 38.9 ± 10.3 and 35.1 ± 11.1 min after extubation in GD and GA, respectively. This study highlighted the potential of the GIN-TONIC block as a feasible regional anesthesia method for delivering perioperative analgesia in dogs undergoing pelvic limb orthopedic surgery.

Keywords: analgesia; canine; nociception; regional anesthesia

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MDPI and ACS Style

Otero, P.E.; Guerrero, J.A.; Tarragona, L.; Micieli, F.; Sanchez, M.F.; Donati, P.A.; Ceballos, M.R.; Portela, D.A.Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results. Animals 2024, 14, 1764.https://doi.org/10.3390/ani14121764

AMA Style

Otero PE, Guerrero JA, Tarragona L, Micieli F, Sanchez MF, Donati PA, Ceballos MR, Portela DA.Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results. Animals. 2024; 14(12):1764.https://doi.org/10.3390/ani14121764

Chicago/Turabian Style

Otero, Pablo E., Jorge A. Guerrero, Lisa Tarragona, Fabiana Micieli, María Fernanda Sanchez, Pablo A. Donati, Martin R. Ceballos, and Diego A. Portela.2024. "Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results" Animals 14, no. 12: 1764.https://doi.org/10.3390/ani14121764

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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MDPI and ACS Style

Otero, P.E.; Guerrero, J.A.; Tarragona, L.; Micieli, F.; Sanchez, M.F.; Donati, P.A.; Ceballos, M.R.; Portela, D.A.Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results. Animals 2024, 14, 1764.https://doi.org/10.3390/ani14121764

AMA Style

Otero PE, Guerrero JA, Tarragona L, Micieli F, Sanchez MF, Donati PA, Ceballos MR, Portela DA.Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results. Animals. 2024; 14(12):1764.https://doi.org/10.3390/ani14121764

Chicago/Turabian Style

Otero, Pablo E., Jorge A. Guerrero, Lisa Tarragona, Fabiana Micieli, María Fernanda Sanchez, Pablo A. Donati, Martin R. Ceballos, and Diego A. Portela.2024. "Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results" Animals 14, no. 12: 1764.https://doi.org/10.3390/ani14121764

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results (2024)
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