title: Comparison of Short-Term Postoperative Analgesia by Epidural, Femoral Nerve Block, or Combination Femoral and Sciatic Nerve Block in Dogs Undergoing Tibial Plateau Leveling Osteotomy.
abstract: OBJECTIVE
  To compare early postoperative analgesia in dogs undergoing unilateral tibial plateau leveling osteotomy (TPLO) that received bupivacaine via preoperative femoral nerve block (FNB), combination femoral-sciatic nerve block (F+SNB), or lumbosacral epidural (EPI).
  
  
  METHODS
  Randomized, blinded, prospective clinical trial.
  
  
  METHODS
  Forty-five client-owned dogs undergoing unilateral TPLO.
  
  
  METHODS
  Dogs undergoing unilateral TPLO were enrolled and randomly allocated to 1 of 3 treatments: FNB, F+SNB, or EPI. Assessments were completed by an observer blinded to treatment at 0, 1, 2, 4, 6, and 8 hours after extubation using the Glasgow Composite Pain Score-Short Form (GCPS-SF). Dogs with a total score ≥ 6 or ≥ 3 in any category were given a rescue analgesic. Outcome measures analyzed for differences across treatments were the GCPS-SF at each time point, time to first rescue analgesic, and total number of rescue analgesic doses per dog.
  
  
  RESULTS
  The GCPS-SF score at extubation was significantly higher for FNB (median 3) compared to F+SNB (median 2). A significantly higher proportion of dogs receiving FNB (4/14) than F+SNB (0/17) required rescue analgesic at extubation. There was no significant difference in the proportion of dogs requiring rescue at extubation between FNB and EPI (2/14) or between F+SNB and EPI. There was no significant difference in the median time to first rescue between FNB (0 hours) and F+SNB (2 hours) or between F+SNB and EPI (1.5 hours).
  
  
  CONCLUSIONS
  In dogs undergoing unilateral TPLO, bupivacaine administered via FNB, alone or in combination with sciatic nerve block, can provide short-term postoperative analgesia not different to that with administration via lumbosacral epidural.
authors.affiliation: Department of Veterinary Medicine and Surgery.
authors.forename: Ryan E
authors.initials: RE
authors.lastname: McCally
authors.affiliation: Department of Veterinary Medicine and Surgery.
authors.forename: Alex
authors.initials: A
authors.lastname: Bukoski
authors.affiliation: Department of Veterinary Medicine and Surgery.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Branson
authors.affiliation: Department of Veterinary Medicine and Surgery.
authors.forename: Derek B
authors.initials: DB
authors.lastname: Fox
authors.affiliation: Comparative Orthopaedic Laboratory, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri.
authors.forename: James L
authors.initials: JL
authors.lastname: Cook
mesh_terms: D000700:Analgesics / Q000008:administration & dosage*; D000818:Animals; D002045:Bupivacaine / Q000008:administration & dosage*; D004285:Dogs / Q000502:physiology*; D005260:Female; D005267:Femoral Nerve / Q000502:physiology; D007268:Injections, Epidural / Q000662:veterinary*; D008297:Male; D009407:Nerve Block / Q000662:veterinary*; D010027:Osteotomy / Q000662:veterinary; D010149:Postoperative Pain / Q000188:drug therapy / Q000662:veterinary*; D011184:Postoperative Period; D012584:Sciatic Nerve / Q000502:physiology
chemical_list: D000700:Analgesics; D002045:Bupivacaine