ANALGESIC EFFECT OF A T6-T11 BILATERAL INTERCOSTAL

NERVE BLOCK IN A DOG UNDERGOING SURGICAL EXCISION OF

AN ABDOMINAL WALL TUMOR
Diego F Echeverry,1-2 Jessica T Pelez,1-2 Diego A Ospina,1-2 Edwin F Buritic,1-2 Fabin Castaeda1-2
1

Department of Animal Health, Faculty of Veterinary Medicine and Zootechny, Universidad del Tolima,
Ibagu, Colombia.
2
Small Animal Medicine and Surgery Research Group, Tolima University, Ibagu, Colombia.

Introduction
Abdominal surgery elicits considerable nociceptive input,1 where much of the pain described seems to originated from
the incision of the abdominal wall.2 The transverse abdominal plane (TAP) block has been proposed as a suitable
alternative to traditional loco-regional techniques to improve analgesia in procedures performed on the abdominal wall; 3
nevertheless, the TAP block can be ineffective in providing analgesia in the most cranial part of the abdominal wall. 2 and
complementary intercostal nerve blocks (INB) have been indicated to cover this deficit.

Objective
To describe the intraoperative analgesic effect of an intercostal nerve block in a dog undergoing surgical excision of a
tumor located in the cranial abdominal wall.

Patient features and anesthetic protocol

Patient: an 8 years-old and 33.7 kg Golden retriever dog Diagnostic: Fibrosarcoma located dorso-caudal to the
xiphoid process. Surgical procedure: surgical tumor resection.
Premedication: acepromazine (0.01 mg kg-1 IV), tramadol (3 mg kg-1 IV), meloxicam (0.3 mg kg-1 SC) IM. Induction:
propofol (5 mg kg-1 IV). Manteinance: Isofluorane in oxygen 100%.
Locoregional block technique: A T6-T11 INB was performed bilaterally at the chondrocostal junction level using a 22
G spinal needle (Fig. 1-2). Local anesthetic: 0.5 mL of bupivacaine (0.5 %) to infiltrate close to each nerve, (0.9 mg
kg-1 total dose).

Fig 1. Position of the needle for the intercostal nerve block (INB).

Fig 2. Schematic representation of figure 1. showing the blocked

nerves (T6-L11) (red targets) and the tumor location (red circle).

Intraoperative anesthetic monitoring

The heart rate (HR), the mean arterial blood pressure (MAP), and the ETIso% were monitored throughout the procedure.
Increases over 20% in the HR and MAP were considered indicative of inadequate analgesic coverage in such a case 3
g Kg-1 of fentanyl IV would be administered.

RESULTS:
Physiological parameters
were stable during the entire
surgical procedure: mean HR
90 bpm, MAP 73 mm of Hg,
ETIso 2%. Fentanyl was not
supplemented.

Conclusion
The intercostal nerve blocks technique employed here was effective to provide an adequate analgesia to perform the
surgical resection of this fibrosarcoma, located at the craneal abdomen, in this dog.

References
1. Brunt J, Downing R, Hagedorn JE, et al. AAHA/AAFP pain management guidelines
for dogs & cats. J Am Anim Hosp Assoc 2007; 43: 235-248.
2. Wall PD, Melzack R. 1999. Pain measurements in persons in pain. In: Wall PD,
Melzack R, eds. Textbook of pain. 4th ed. Edinburgh, UK: Churchill Livingstone, p.
409426.
3. Schroeder CA, Snyder LB, Tearney CC, et al. Ultrasound-guided transversus
abdominis plane block in the dog: an anatomical evaluation. Vet Anaesth Analg
2011; 38: 267-271.