Be the pain-attacking offensive midfielder – local anaesthetic blocks every practice can utilise

Abstract

What is the job of attacking offensive midfielder in soccer? The position will be somewhere between the midfield and the forward line, which means that they’ll be able to influence the “attack” high up in the field. Local anaesthetics (LA) are similar. LA used to be the only pain management available to veterinary practitioners, whether small or large animal practice, some 40 years ago. These blocks were used to stop any nerve impulses produced by cutting during surgery. LA are currently used to reduce peri-operative pain, procedural pain and hopefully prevent chronic pain. This article will review a “how to guide” to provide local blocks.

Keywords:

• local anaesthetics
• nerve blocks
• guide

Multiple Choice Questions

1.	Which of the following would NOT be a good reason for utilising a local anaesthetic (LA) technique? (a) LA can have anti-inflammatory effects (b) LA permits reduction of general anaesthetic requirements (c) Requirements for post-operative pain management are lowered (d) LA can have pro-inflammatory effects
2.	The 2015 edition of the AAHA/AAFP Pain Management Guidelines states: “because of their safety and significant benefit, Local Anesthetics (LA) should be utilized, insofar as possible, with every surgical procedure”. (a) True (b) False
3.	Which of the following drugs is commonly used for LA techniques? (a) Butorphanol (b) Carprofen (c) Lidocaine (d) Methadone
4.	Which LA technique would be most suitable for a patient undergoing a total ear canal ablation? (a) Epidural (b) Auriculotemporal block (c) Brachial plexus block (d) Sciatic nerve block
5.	Which of the following is a rare side effect of some LAs in cats: (a) Salivation (b) Methaemoglobinaemia (c) Excitation (d) Agression
6.	Which type of LA block placement may have reduced efficacy of the block and require a larger volume of LA compared to other techniques? (a) Blind (b) Electrolocation (c) Ultrasound guidance (d) Combined ultrasound guidance and electrolocation
7.	Which LA technique would be most suitable for a patient undergoing surgery below the elbow? (a) Epidural (b) Auriculotemporal block (c) Brachial plexus block (d) Sciatic nerve block
8.	What percentage of epidural catheter failure in cats is reported? (a) 55% (b) 38% (c) 75% (d) 27%

For the answers to the MCQs, please go to: http://www.bvna.org.uk/publications/veterinary-nursing-journal

Additional information

Notes on contributors

Mary Ellen Goldberg

Mary Ellen Goldberg BS, LVT, CVT, SRA, CCRA, CVPP, VTS-lab animal medicine (research anaesthesia), VTS-physical rehabilitation (OC)

Mary Ellen Goldberg is a graduate of Harcum College and the University of Pennsylvania in 1976. She worked at Virginia Commonwealth University (VCU) in the Division of Animal Resources and for Research Scientists advising on their choices for anaesthesia and pain management on their protocols. She was a member of VCU’s IACUC for 10 years. She has been the instructor of Anaesthesia and Pain Management at VetMedTeam, LLC since 2003. She has been the Executive Secretary for the International Veterinary Academy of Pain Management (IVAPM) since 2008. She is a Certified Veterinary Pain Practitioner through IVAPM. Mary Ellen is also a Surgical Research Anaesthetist certified through the Academy of Surgical Research. She is on the Organising Committee for APRVT (Academy of Physical Rehabilitation Veterinary Technicians). She is Exam Chair for the Academy of Laboratory Animal Veterinary Technicians and Nurses (APRVT). Currently, she is a staff member at the Canine Rehabilitation Institute, as a Certified Canine Rehabilitation Assistant (CCRA). Mary Ellen has written several books, and contributed to numerous chapters regarding anaesthesia, pain management and rehabilitation. She speaks at national meetings on these topics and gives private continuing education to organisational groups. She has worked in various aspects of veterinary medicine from small animal and equine to mixed practice, coccidiosis research for a pharmaceutical company, zoo animal medicine and laboratory animal medicine since 1976.