title: Evaluation of a midhumeral block of the radial, ulnar, musculocutaneous and median (RUMM block) nerves for analgesia of the distal aspect of the thoracic limb in dogs.
abstract: OBJECTIVE
  To evaluate a technique for midhumeral peripheral nerve blockade in the dog.
  
  
  METHODS
  Cadaveric technique development; in vivo placebo-controlled, prospective crossover study.
  
  
  METHODS
  Canine cadavers (n=38) and 8 clinically healthy, adult hound dogs.
  
  
  METHODS
  A technique for peripheral block of the radial, ulnar, musculocutaneous, and median nerves (RUMM block) was evaluated using cadaver limbs. Eight purpose-bred, research dogs were anesthetized; a RUMM block was performed on each thoracic limb. One limb from each dog randomly received 0.5% bupivacaine and the opposite limb was assigned to receive sterile saline solution as a control. After recovery from anesthesia, skin sensation at selected dermatomes was evaluated for 24 hours using a mechanical stimulus. Weight-bearing, conscious proprioception, and withdrawal reflex were also evaluated. One month after initial testing, each dog was reanesthetized and each limb received the opposite treatment.
  
  
  RESULTS
  Sensory thresholds were significantly increased over baseline measurements when compared with control limbs for all nerves. Complete sensory block was achieved in radial (15/16), ulnar (3/16), musculocutaneous (8/16), and median (11/16) nerves, using a mechanical stimulus of analgesia. Complete simultaneous block of all nerves was only obtained in 1 of 16 limbs.
  
  
  CONCLUSIONS
  RUMM block resulted in desensitization of the skin in the associated dermatomes for 4-10 hours. Complete sensory block of the dermatomes supplied by the radial nerve was most consistent.
  
  
  CONCLUSIONS
  RUMM block may be an effective technique to provide adjunctive analgesia for dogs undergoing surgery of the distal aspect of the thoracic limb.
authors.affiliation: Comparative Pain Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Trumpatori
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Carter
authors.forename: Jon
authors.initials: J
authors.lastname: Hash
authors.forename: Gigi S
authors.initials: GS
authors.lastname: Davidson
authors.forename: Kyle G
authors.initials: KG
authors.lastname: Mathews
authors.forename: Simon C
authors.initials: SC
authors.lastname: Roe
authors.forename: B Duncan X
authors.initials: BD
authors.lastname: Lascelles
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D001917:Brachial Plexus / Q000187:drug effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D004285:Dogs; D005552:Forelimb / Q000294:innervation* / Q000601:surgery*; D006811:Humerus; D008475:Median Nerve / Q000187:drug effects; D009138:Musculocutaneous Nerve / Q000187:drug effects; D009407:Nerve Block / Q000379:methods / Q000662:veterinary*; D011826:Radial Nerve / Q000187:drug effects; D014459:Ulnar Nerve / Q000187:drug effects
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine