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  • Title: Femoral nerve block: a novel psoas compartment lateral pre-iliac approach in dogs.
    Author: Portela DA, Otero PE, Briganti A, Romano M, Corletto F, Breghi G.
    Journal: Vet Anaesth Analg; 2013 Mar; 40(2):194-204. PubMed ID: 22765834.
    Abstract:
    OBJECTIVE: To describe a new approach to block the femoral nerve and to evaluate the distribution of a dye injected into the psoas compartment using a new femoral nerve block approach; to assess its clinical application, when combined with a sciatic nerve block, for surgical anaesthesia/analgesia of the pelvic limb in dogs. STUDY DESIGN: Prospective anatomical, research and clinical study. ANIMALS: Two dog cadavers; two dogs that had to be euthanized for reasons unrelated to this study, and 15 dogs undergoing pelvic limb orthopaedic surgery. METHODS: Phase 1: anatomical dissections were performed to determine a simple method to approach the femoral nerve within the psoas compartment. Phase 2: 0.1 mL kg(-1) of a lidocaine-new methylene blue solution was injected bilaterally after successful electrolocation of the femoral nerve in two anaesthetized dogs. Colorant spread was evaluated through femoral nerve dissections after euthanasia. Phase 3: in 15 dogs undergoing pelvic limb orthopaedic surgery under light general anaesthesia with isoflurane, intra-operative analgesic effect (cardiovascular responses) and early post-operative pain score, of the novel femoral nerve block combined with a sciatic nerve block as the sole analgesic protocol, were evaluated. RESULTS: Phase 1: a needle inserted from the lateral aspect of the lumbar muscles, cranially to the iliac crest and with a 30-45° caudo-medial direction, reaches the femoral nerve in the caudal portion of the psoas compartment. Phase 2: Four femoral nerves were stained >2 cm. Phase 3: this novel lateral pre-iliac approach, combined with the sciatic nerve block, blunted the intra-operative cardiovascular response to surgical stimulation in 13 out of 15 anaesthetized dogs. In addition, rescue analgesia was not required in the early post-operative 2-hour period. CONCLUSION AND CLINICAL RELEVANCE: The lateral pre-iliac femoral nerve block technique may provide adequate intra- and early post-operative pain relief in dogs undergoing pelvic limb surgery.
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