Blind supratemporal retrobulbar block in cats: a feasibility cadaveric study and its efficacy in a group of subjects undergoing corneal or intraocular surgery
IntroductionThe supratemporal retrobulbar block (RB) has not been comprehensively described in cats.Materials and methodsCadaveric study: a modified supratemporal retrobulbar injection of 0.1 ml/kg of iomeprole and saline (1:3) was executed using a Tuohy needle in recently deceased cats. Cadavers un...
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Frontiers Media S.A.
2024-11-01
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| author | Elena Lardone Manuela Crasta Pier Carlo Ostan Paola Gherlinzoni Alessandra Landi Paolo Franci |
| author_facet | Elena Lardone Manuela Crasta Pier Carlo Ostan Paola Gherlinzoni Alessandra Landi Paolo Franci |
| author_sort | Elena Lardone |
| collection | DOAJ |
| description | IntroductionThe supratemporal retrobulbar block (RB) has not been comprehensively described in cats.Materials and methodsCadaveric study: a modified supratemporal retrobulbar injection of 0.1 ml/kg of iomeprole and saline (1:3) was executed using a Tuohy needle in recently deceased cats. Cadavers underwent computed tomography before and following injections. Injectate distribution within the intraconal space was evaluated. Extraconal injections were considered a failure. Clinical study: cats undergoing corneal/intraocular surgery were included. After intramuscular premedication with methadone 0.3 mg/kg, dexmedetomidine 3 mcg/kg and alfaxalone 2 mg/kg and induction with intravenous (IV) alfaxalone to effect, isoflurane anesthesia was maintained with a target end-expired fraction of 1.1%. Cats were randomly allocated in the retrobulbar group [RG, receiving a modified supratemporal RB with 0.1 ml/kg of a mixture of 2% lidocaine (5.5 ml) and 0.75% ropivacaine (2 ml)] or control group (CG). When heart rate or mean arterial pressure increased above 20% of the pre-incisional values, fentanyl (1 mcg/kg IV) was administered. Alfaxalone (0.5 mg/kg IV) was injected when anesthesia was deemed too light. After a total of 3 interventions regardless the type of drugs (fentanyl/alfaxalone), a constant rate infusion of fentanyl (5 mcg/kg/h IV) was started. Anesthetist interventions, quality of recovery (blindly assessed using a descriptive score scale), postoperative eye rubbing, complications were studied.ResultsIn the cadaveric study 8 eyes were included (success rate = 87%). The contrast agent spread was scored “moderate-to-large” or “large” in 85.7% of cases and a median 360° (180–360) distribution around the optic nerve was reported. In the clinical study 12 cats were included (6 in RG, 6 in CG). The median time to perform the RB was 35 s (20–50). Only the controls required anesthetist interventions [total amount of 6 (p = 0.0276): fentanyl (3/6) and alfaxalone (2/6)]. The RG had a significantly better recovery score (p = 0.0012) than CG. Only controls showed eye rubbing (3/6).ConclusionsThe modified supratemporal RB is an achievable and rapidly performed technique. In this study it reduced intraoperative drug administration and improved recovery quality in cats undergoing corneal or intraocular surgery. |
| format | Article |
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| institution | Kabale University |
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| publishDate | 2024-11-01 |
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| spelling | doaj-art-a3deeb9d46e14af48e1c86b26af9954a2024-11-22T06:17:15ZengFrontiers Media S.A.Frontiers in Veterinary Science2297-17692024-11-011110.3389/fvets.2024.14787321478732Blind supratemporal retrobulbar block in cats: a feasibility cadaveric study and its efficacy in a group of subjects undergoing corneal or intraocular surgeryElena Lardone0Manuela Crasta1Pier Carlo Ostan2Paola Gherlinzoni3Alessandra Landi4Paolo Franci5Department of Veterinary Science, University of Turin, Turin, ItalyAniCura VisionVet, San Giovanni in Persiceto, ItalyAniCura VisionVet, San Giovanni in Persiceto, ItalyDepartment of Veterinary Science, University of Turin, Turin, ItalyDepartment of Veterinary Science, University of Turin, Turin, ItalyDepartment of Veterinary Science, University of Turin, Turin, ItalyIntroductionThe supratemporal retrobulbar block (RB) has not been comprehensively described in cats.Materials and methodsCadaveric study: a modified supratemporal retrobulbar injection of 0.1 ml/kg of iomeprole and saline (1:3) was executed using a Tuohy needle in recently deceased cats. Cadavers underwent computed tomography before and following injections. Injectate distribution within the intraconal space was evaluated. Extraconal injections were considered a failure. Clinical study: cats undergoing corneal/intraocular surgery were included. After intramuscular premedication with methadone 0.3 mg/kg, dexmedetomidine 3 mcg/kg and alfaxalone 2 mg/kg and induction with intravenous (IV) alfaxalone to effect, isoflurane anesthesia was maintained with a target end-expired fraction of 1.1%. Cats were randomly allocated in the retrobulbar group [RG, receiving a modified supratemporal RB with 0.1 ml/kg of a mixture of 2% lidocaine (5.5 ml) and 0.75% ropivacaine (2 ml)] or control group (CG). When heart rate or mean arterial pressure increased above 20% of the pre-incisional values, fentanyl (1 mcg/kg IV) was administered. Alfaxalone (0.5 mg/kg IV) was injected when anesthesia was deemed too light. After a total of 3 interventions regardless the type of drugs (fentanyl/alfaxalone), a constant rate infusion of fentanyl (5 mcg/kg/h IV) was started. Anesthetist interventions, quality of recovery (blindly assessed using a descriptive score scale), postoperative eye rubbing, complications were studied.ResultsIn the cadaveric study 8 eyes were included (success rate = 87%). The contrast agent spread was scored “moderate-to-large” or “large” in 85.7% of cases and a median 360° (180–360) distribution around the optic nerve was reported. In the clinical study 12 cats were included (6 in RG, 6 in CG). The median time to perform the RB was 35 s (20–50). Only the controls required anesthetist interventions [total amount of 6 (p = 0.0276): fentanyl (3/6) and alfaxalone (2/6)]. The RG had a significantly better recovery score (p = 0.0012) than CG. Only controls showed eye rubbing (3/6).ConclusionsThe modified supratemporal RB is an achievable and rapidly performed technique. In this study it reduced intraoperative drug administration and improved recovery quality in cats undergoing corneal or intraocular surgery.https://www.frontiersin.org/articles/10.3389/fvets.2024.1478732/fullsupratemporalretrobulbar blockcatcorneal surgeryintraocular surgery |
| spellingShingle | Elena Lardone Manuela Crasta Pier Carlo Ostan Paola Gherlinzoni Alessandra Landi Paolo Franci Blind supratemporal retrobulbar block in cats: a feasibility cadaveric study and its efficacy in a group of subjects undergoing corneal or intraocular surgery Frontiers in Veterinary Science supratemporal retrobulbar block cat corneal surgery intraocular surgery |
| title | Blind supratemporal retrobulbar block in cats: a feasibility cadaveric study and its efficacy in a group of subjects undergoing corneal or intraocular surgery |
| title_full | Blind supratemporal retrobulbar block in cats: a feasibility cadaveric study and its efficacy in a group of subjects undergoing corneal or intraocular surgery |
| title_fullStr | Blind supratemporal retrobulbar block in cats: a feasibility cadaveric study and its efficacy in a group of subjects undergoing corneal or intraocular surgery |
| title_full_unstemmed | Blind supratemporal retrobulbar block in cats: a feasibility cadaveric study and its efficacy in a group of subjects undergoing corneal or intraocular surgery |
| title_short | Blind supratemporal retrobulbar block in cats: a feasibility cadaveric study and its efficacy in a group of subjects undergoing corneal or intraocular surgery |
| title_sort | blind supratemporal retrobulbar block in cats a feasibility cadaveric study and its efficacy in a group of subjects undergoing corneal or intraocular surgery |
| topic | supratemporal retrobulbar block cat corneal surgery intraocular surgery |
| url | https://www.frontiersin.org/articles/10.3389/fvets.2024.1478732/full |
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