title: Femoral nerve block: a novel psoas compartment lateral pre-iliac approach in dogs.
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.
  
  
  METHODS
  Prospective anatomical, research and clinical study.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  The lateral pre-iliac femoral nerve block technique may provide adequate intra- and early post-operative pain relief in dogs undergoing pelvic limb surgery.
authors: Department of Veterinary Clinics, Veterinary Teaching Hospital 'Mario Modenato', University of Pisa, Pisa, Italy. dportela@vet.unipi.it
authors: Diego A
authors: DA
authors: Portela
authors: Pablo E
authors: PE
authors: Otero
authors: Angela
authors: A
authors: Briganti
authors: Marta
authors: M
authors: Romano
authors: Federico
authors: F
authors: Corletto
authors: Gloria
authors: G
authors: Breghi
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage; D000818:Animals; D002102:Cadaver; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D005267:Femoral Nerve / Q000033:anatomy & histology*; D050723:Fractures, Bone / Q000601:surgery / Q000662:veterinary; D006614:Hindlimb / Q000033:anatomy & histology / Q000294:innervation* / Q000601:surgery; D007592:Joint Diseases / Q000601:surgery / Q000662:veterinary; D008012:Lidocaine / Q000008:administration & dosage / Q000494:pharmacology; D009407:Nerve Block / Q000379:methods / Q000662:veterinary*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine