DOI
https://doi.org/10.18849/ve.v11i2.736Abstract
PICO Question
In dogs undergoing stifle surgery, do locoregional nerve blocks compared with epidural anaesthesia improve perioperative antinociception and reduce residual block?
Clinical bottom line
Category of research
Treatment.
Number and type of study designs reviewed
Six studies were appraised; all were prospective, blinded, randomised, controlled clinical trials.
Strength of evidence
Moderate.
Outcomes reported
Overall, the studies suggest that locoregional nerve blocks are a viable alternative to epidural anaesthesia (EPID) for dogs undergoing stifle surgeries. All studies demonstrated consistent success with locoregional nerve blocks, while two studies reported failures with EPID. Moreover, all studies found that locoregional nerve blocks provided similar analgesic effects to EPID, with one study suggesting that EPID bupivacaine might offer better intraoperative analgesia but require more rescue analgesia compared to combined femoral and sciatic nerve block (F+S), while another study suggested that the saphenous and sciatic nerve block (SSNB) group had lower pain scores than the EPID group at 4 and 8 hours postoperatively. Additionally, one study suggested that F+S bupivacaine might lead to a lower incidence of urinary retention compared to EPID, while another study indicated that lumbar plexus and sciatic nerve block (LPS) with bupivacaine could facilitate an earlier return of motor function.
Conclusion
Despite no conclusive evidence suggesting the superiority of either locoregional nerve blocks or EPID in dogs undergoing stifle surgery, there is evidence that locoregional nerve blocks may serve as an alternative to EPID, with a similar success rate, comparable perioperative analgesia, and fewer incidences of residual block.
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