Veterinary anaesthesia and analgesia最新文献

{"title":"Comparison of two immobilisation protocols (medetomidine-midazolam and alfaxalone-midazolam) for restraint of urban red foxes (Vulpes vulpes): A pilot study.","authors":"Patricia Romero Marco, Holly M English, Barry Nolan, Simone Ciuti, Rachel C Bennett, Vilhelmiina Huuskonen","doi":"10.1016/j.vaa.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.09.004","url":null,"abstract":"<p><strong>Objective: </strong>To compare two immobilisation protocols for the restraint of urban red foxes: medetomidine-midazolam (MM) and alfaxalone-midazolam (AM).</p><p><strong>Study design: </strong>Prospective, randomised clinical trial.</p><p><strong>Animals: </strong>Fourteen urban red foxes (Vulpes vulpes) captured in the Dublin metropolitan area.</p><p><strong>Methods: </strong>Foxes were randomly assigned to receive either MM [medetomidine 0.07 mg kg^-1, midazolam 0.8 mg kg^-1 intramuscularly (IM)] or AM (alfaxalone 3 mg kg^-1, midazolam 0.8 mg kg^-1 IM). Sedation and recovery were scored. Recovery times and physiological variables [heart rate, respiratory rate (f_R), oscillometric arterial blood pressure, arterial haemoglobin oxygen saturation (SpO₂) and rectal temperature] were measured. Hair and blood samples were collected for cortisol analysis. Sedation was reversed with atipamezole (0.35 mg kg^-1 IM) and/or flumazenil (0.01 mg kg^-1 IM). Recovery ended when foxes walked with coordinated movements. Data were analysed using linear and mixed-effects models.</p><p><strong>Results: </strong>Seven foxes were given MM and seven AM. Median sedation scores were higher in MM (14.5 versus 12.5; p = 0.048), with shorter reversal times (25 versus 54 minutes; p = 0.009). Heart rate was lower (80 versus 216 beats per minute^-1; p < 0.001) and mean arterial blood pressure higher (147 versus 110 mmHg; p < 0.001) in MM. SpO₂ was higher in AM (95 versus 91%; p = 0.015). Rectal temperature was higher in MM (38.6 versus 36.5 °C; p < 0.001), with a faster decrease in AM (p = 0.006). f_R did not differ between groups (p = 0.492) but increased with higher ambient temperature (p = 0.04) and decreased with higher hair cortisol levels (p = 0.02).</p><p><strong>Conclusions and clinical relevance: </strong>Both protocols provided sufficient sedation for intended procedures. MM resulted in higher sedation scores and faster recovery after antagonist administration, while AM provided higher SpO₂ and heart rates and lower rectal temperature values.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-rater reliability, expertise and justifications for the American society of anesthesiologists physical status classification in dogs.","authors":"Henrique E de Almeida Lupiano, Erik H Hofmeister, Pen-Ting Liao","doi":"10.1016/j.vaa.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.09.003","url":null,"abstract":"<p><strong>Objective: </strong>The purposes of this study were to document intra-rater reliability in assigning American Society of Anesthesiologists Physical Status Classification System (ASA) status, to compare Cochran-Weiss-Shanteau (CWS) scores between anesthetists with varying levels of external validation, and to document the explanations given for assigning certain ASA statuses.</p><p><strong>Study design: </strong>Prospective case series.</p><p><strong>Subjects: </strong>A group of 29 anesthetists.</p><p><strong>Methods: </strong>Anesthetists were presented with 25 hypothetical cases in two stages and asked to provide an ASA status as well as an explanation. Intra-rater reliability was calculated using the single-measure averaged intraclass correlation coefficient (ICC). The CWS index was calculated and quantifies expertise by assessing discrimination and consistency, where higher scores indicate superior judgment. Explanations for assignment of ASA status were analyzed by inductive coding by two investigators.</p><p><strong>Results: </strong>The intra-rater ICC for all raters who completed Stage 1 and 2 was 0.80 (95% confidence interval 0.76-0.83, n = 17), 0.80 (0.74-0.86, n = 6) for Diplomates, 0.76 (0.68-0.82, n = 5) for residents and 0.86 (0.81-0.90, n = 6) for veterinary technicians. CWS ranged from 2.0 to 6.1, with the same median score of 3.1 for Diplomates, residents and technicians. In cases with the lowest agreement, the themes identified included disagreement on the degree of physiological compensation (e.g. tachycardia) and the effects of mild dehydration, an asymptomatic heart murmur, patients with brachycephalic airway syndrome and hypoproteinemia.</p><p><strong>Conclusions and clinical relevance: </strong>Intra-rater reliability was high and similar regardless of level of external validation (i.e. technician vs. resident versus Diplomate). Using the CWS for ASA status assignment did not differentiate technicians, residents and Diplomates, although some individuals had relatively higher CWS, suggesting greater expertise in ASA status assignment. Disagreements exist in classifying conditions like brachycephalic airway syndrome and asymptomatic heart murmurs.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic and analgesic management of cats undergoing elective neutering: Survey of practices and opinions of veterinarians in Ontario, Canada.","authors":"Carolyn L Kerr, W Emmett Swanton, Ron J Johnson, Maria D Amezcua, Terri L O'Sullivan","doi":"10.1016/j.vaa.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.09.002","url":null,"abstract":"<p><strong>Objective: </strong>To determine the anesthetic and analgesic protocols and techniques used in cats undergoing elective neutering in Ontario, Canada and to obtain veterinarians' opinions regarding their choices.</p><p><strong>Study design: </strong>Cross-sectional survey.</p><p><strong>Animals: </strong>Client-owned cats undergoing elective neutering in Ontario, Canada.</p><p><strong>Methods: </strong>A confidential mixed-mode survey about anesthetic and analgesic management practices used in client-owned cats undergoing elective neutering was distributed to veterinarians (n = 2921) working in companion animal practice in Ontario. Descriptive statistics were generated. Logistic regression was used to identify associations between demographic factors and protocols. Chi-square analysis was used to compare protocols used in cats undergoing ovariohysterectomy (OVH) versus castration.</p><p><strong>Results: </strong>Four hundred and thirty-one individuals (14.8%) completed the survey. Most respondents used a sedative before induction of anesthesia (OVH: 368/387; 95.1% and castration 360/381; 94.5%) and gave an opioid and/or a non-steroidal anti-inflammatory drug perioperatively (OVH: 379/381; 99.7% and castration: 379/382; 99.2%). Respondents placed an intravenous catheter and performed orotracheal intubation more frequently in cats undergoing OVH (catheter: 366/387; 94.6% and intubation: 379/386; 98.2%) compared with castration (catheter: 219/380; 57.6% and intubation: 166/375; 44.3%) (p < 0.001). Respondents more closely followed current anesthesia guidelines relative to their peers if they: graduated during or after 2000, were women, performed 1-10 OVHs per week, worked in an urban setting, in a companion animal practice, with three or more veterinarians or three to five registered veterinary technicians. Most respondents were very satisfied or satisfied with their current anesthetic drug protocol for cats undergoing elective OVH (396/412; 96.1%) and castration (386/413; 93.4%).</p><p><strong>Conclusions and clinical relevance: </strong>Most veterinarians in Ontario who participated in the survey follow many of the current guidelines regarding anesthetic and analgesia management practices for cats undergoing elective neutering. Anesthetic protocols varied with respondent demographics; however, most respondents were satisfied with their choices.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of positive end-expiratory pressure and end-inspiratory pause on dead space and alveolar ventilation in mechanically ventilated dogs.","authors":"Diego A Portela, Stuart R McKenzie, Raiane A Moura, Margaret Gonzalez, Pablo A Donati, Ignacio Sandez, Joaquin Araos, Ludovica Chiavaccini, Elizabeth A Maxwell, Pablo E Otero","doi":"10.1016/j.vaa.2025.08.038","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.08.038","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of 5 cmH₂O positive end-expiratory pressure (PEEP) and end-inspiratory pause (EIP) on airway dead space (V_Daw) and its resultant effects on alveolar tidal volume (V_Talv) and physiological dead space-to-tidal volume ratio (V_D/V_T) in dorsally recumbent anesthetized dogs.</p><p><strong>Study design: </strong>Prospective, controlled clinical study.</p><p><strong>Animals: </strong>Healthy adult dogs (n = 20, > 20 kg) undergoing elective surgery.</p><p><strong>Methods: </strong>Dogs were mechanically ventilated across three 5 minute phases: 1) without PEEP (PEEP_OFF); 2) with 5 cmH₂O PEEP (PEEP_ON); and 3) with PEEP_ON plus an EIP (30% of inspiratory time) (PEEP_ON+EIP), allowing 15 minutes of stabilization between phases. During each phase, expired CO₂ tension and tidal volume (V_T) were measured using volumetric capnography, and arterial blood gases assessed. V_Daw, V_Talv and V_D/V_T were calculated offline and compared between phases using mixed-effect linear models. Data are presented as mean ± standard deviation (95% confidence interval) and indexed to the predicted ideal body mass when appropriate.</p><p><strong>Results: </strong>The V_T was 16.8 ± 1.7 (16.3-17.19) mL kg^-1. PEEP_ON significantly increased V_Daw [7.9 ± 1.6 (7.1-8.6) to 8.4 ± 1.8 (7.6-9.3) mL kg^-1; p = 0.001] and V_D/V_T [0.52 ± 0.1 (0.49-0.55)% to 0.55 ± 0.1 (0.52-0.59)%; p = 0.001]. PEEP_ON decreased V_Talv [8.9 ± 0.8 (8.6-9.4) to 8.3 ± 0.8 (7.9-8.7) mL kg^-1; p = 0.001]. EIP reversed these changes, decreasing V_Daw back to baseline [7.8 ± 1.6 (7.1-8.6) mL kg^-1], resulting in V_D/V_T and V_Talv returning to baseline values. Arterial PaCO₂ remained stable across phases.</p><p><strong>Conclusions and clinical relevance: </strong>Although PEEP increased V_Daw and decreased V_Talv, the addition of a 30% EIP mitigated these effects, suggesting that incorporating an EIP may be an effective strategy to optimize dead space and ventilation in dogs receiving mechanical ventilation with PEEP.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of transdermal application site on pharmacokinetics and selected pharmacodynamics of buprenorphine in horses.","authors":"Rachael L Hoh, Khursheed R Mama, Camilo J Morales, Daniel S McKemie, Philip H Kass, H K Knych","doi":"10.1016/j.vaa.2025.08.035","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.08.035","url":null,"abstract":"<p><strong>Objective: </strong>To assess absorption after transdermal application of buprenorphine to different sites and assess behavioral, antinociceptive and adverse effects. It was hypothesized that the dose and site of transdermal buprenorphine administration would influence absorption, plasma drug concentrations, physiological, antinociceptive and behavioral effects in horses.</p><p><strong>Study design: </strong>Two-part study; prospective randomized balanced three-way crossover (study 1) and single-dose (study 2) experimental study.</p><p><strong>Animals: </strong>Six (study 1) and eight (study 2) horses, aged 3-14 years.</p><p><strong>Methods: </strong>In study 1, horses were administered a single dose of buprenorphine (45 μg kg^-1), applied to the neck, croup and stifle. Blood samples were collected at fixed time points and a skin biopsy taken at the final time point for buprenorphine concentration analysis. In study 2, horses were administered a single transdermal dose of buprenorphine (90 μg kg^-1) applied to the neck (determined in study 1). Blood samples were collected and buprenorphine concentrations determined by liquid chromatography-tandem mass spectrometry, and pharmacokinetic analysis performed. Pre- and post-drug-related behavior and physiologic responses were recorded. Response to noxious stimuli was evaluated by determining thermal threshold latency in response to the application of heat. Mixed effects analysis of variance comparisons were performed to assess differences in pharmacodynamic parameters between baseline and each time point.</p><p><strong>Results: </strong>Plasma buprenorphine concentrations were highest after application to the neck and stifle. Transdermal application of 90 μg kg^-1 to the neck significantly (p < 0.05) increased thermal nociceptive thresholds from 3 hours and up to 36 hours after application. This corresponded with plasma buprenorphine concentrations ≥ 0.1 ng mL^-1. Changes in locomotor activity, heart rate and borborygmi were minimal.</p><p><strong>Conclusions and clinical relevance: </strong>A thermal antinociceptive effect was observed after the transdermal delivery of 90 μg kg^-1 of buprenorphine, applied to the neck.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary biomarkers for early diagnosis of perioperative acute kidney injury in dogs: a narrative review.","authors":"Jennifer Davis","doi":"10.1016/j.vaa.2025.08.036","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.08.036","url":null,"abstract":"<p><strong>Objective: </strong>To provide the knowledge and context necessary for veterinary anaesthetists to appraise and design studies utilising biomarkers as outcome measures for acute kidney injury (AKI).</p><p><strong>Databases used: </strong>PubMed, Medline and CAB abstracts.</p><p><strong>Conclusions: </strong>The diagnosis of AKI in dogs currently relies upon markers of glomerular function that are delayed and not specific to the tubular structural injury present during anaesthesia-related AKI. Several urinary biomarkers of renal tubular dysfunction, notably neutrophil gelatinase-associated lipocalin, clusterin, cystatin B, cystatin C and γ-glutamyl transferase, show promise as very early markers of perioperative AKI in dogs. However, for their reliable and routine use, a larger evidence base is required in the setting of canine perioperative AKI and there is a need for standardisation of measurement and reporting methodology.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of cervical epidural injection of morphine and the combination of morphine and detomidine on recovery from anesthesia in adult horses.","authors":"Anna T Carroll, Rachel A Reed, Michael Perlini, Amara E Clough, Matheus Rocha, Valerie J Moorman","doi":"10.1016/j.vaa.2025.07.012","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.07.012","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of cervical epidural injection of morphine alone and morphine in combination with detomidine on recovery from anesthesia in horses.</p><p><strong>Study design: </strong>Blinded, randomized, crossover, Latin square design.</p><p><strong>Animals: </strong>A group of six healthy adult horses aged 9 ± 3 years and weighing 471 ± 76 kg (mean ± standard deviation).</p><p><strong>Methods: </strong>Horses were administered each of three treatments during a 1 hour general anesthetic with a 4 day washout period. Treatments were: 1) cervical epidural injection of saline 0.011 mL kg^-1 (S); 2) morphine 0.1 mg kg^-1 (M); and 3) morphine 0.1 mg kg^-1 with detomidine 0.01 mg kg^-1 (MD). Data evaluating the quality of rope-assisted anesthetic recovery included accelerometry-based recovery score, time to first movement, time to sternal recumbency, time to standing and number of attempts to stand. Data were analyzed using a generalized linear mixed model. Significance was set at p < 0.05.</p><p><strong>Results: </strong>Recovery scores were 24.4 ± 10.0, 23.9 ± 6.7 and 19.9 ± 7.7 for treatments S, M and MD, respectively (p = 0.463). Times for first movement, sternal recumbency and standing were 33 ± 16, 22 ± 18 and 45 ± 10 minutes; 48 ± 26, 57 ± 29 and 69 ± 25 minutes; and 55 ± 20, 61 ± 28 and 70 ± 23 minutes for treatments S, M and MD, respectively.</p><p><strong>Conclusions: </strong>Cervical epidural injection of morphine alone and morphine with detomidine did not negatively affect recovery compared with saline.</p><p><strong>Clinical relevance: </strong>The use of cervical epidural injection of morphine alone or morphine in combination with detomidine does not negatively affect the recovery quality of horses from general anesthesia.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor from authors Dawn Sheppard and Dr Muhammed Aslam Nasir.","authors":"José M Gómez-Silvestre, Ana García-Fernández, José Ignacio Redondo, María de Los Reyes Marti-Scharhausen, Ariel Cañón, Eva Z Hernández, Agustín Martínez, David McCallum Neilson, Jaime Viscasillas","doi":"10.1016/j.vaa.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.07.001","url":null,"abstract":"","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Misconceptions in this retrospective study: computed tomography assessment of V-Gel Advanced supraglottic airway device placement in cats.","authors":"Dawn Sheppard, Muhammed A Nasir","doi":"10.1016/j.vaa.2025.07.002","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.07.002","url":null,"abstract":"","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel extrafascial subscalene brachial plexus block in dogs: reducing hemidiaphragmatic paresis compared with the intrafascial technique.","authors":"Santiago E Fuensalida, Lisa Tarragona, Alfredo Díaz, María Fenranda Sanchez, Ceballos Martin, Pablo A Donati, Andrea S Zaccagnini, Samanta Waxman, Christina Montalbano, Vincenzo Rondelli, Diego A Portela, Pablo E Otero","doi":"10.1016/j.vaa.2025.07.011","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.07.011","url":null,"abstract":"<p><strong>Objective: </strong>To assess dye solution spread of an ultrasound-guided extrafascial subscalene approach (Esub) to the brachial plexus (BP) in canine cadavers and to compare the incidence of hemidiaphragmatic paresis between the Esub and intrafascial subscalene (Isub) approaches in Beagle dogs.</p><p><strong>Study design: </strong>Descriptive anatomical study (Phase I) and prospective, randomized, blinded, experimental crossover trial (Phase II).</p><p><strong>Animals: </strong>A total of six canine cadavers and seven adult Beagle dogs.</p><p><strong>Methods: </strong>Phase I used six adult canine cadavers for anatomical assessment of dye spread after Esub. Phase II involved seven healthy adult Beagle dogs, each receiving Esub and Isub blocks with a 14 day washout in a randomized, crossover design. Both approaches used 0.4 mL kg^-1 of 2% lidocaine. Hemidiaphragmatic paresis was defined as ≥ 25% reduction in hemidiaphragmatic excursion compared with the preprocedural value, while < 25% was classified as no paresis. For the incidence of hemidiaphragmatic paresis (a dichotomous variable), exact binomial 95% confidence intervals (CIs) were calculated for each proportion, and the McNemar test was used for paired comparison. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>In Phase I, dissection confirmed dye accumulation in the lateral layer of the deep cervical fascia along the BP, with no dye in the visceral compartment; the recurrent laryngeal nerve, vagosympathetic trunk, phrenic nerve, and its branches were unstained. In Phase II, the rate of hemidiaphragmatic paresis was 0% (95% CI: 0.3-58%) and 100% (CI 95%: 59-100%) for Esub and Isub approaches, respectively (p = 0.015).</p><p><strong>Conclusions: </strong>The ultrasound-guided Esub approach successfully confined injectate to the extrafascial plane in cadavers, avoiding spread to the phrenic nerve. In Beagle dogs, Esub significantly reduced the incidence of hemidiaphragmatic paresis compared with the Isub approach. Further studies in clinical populations are warranted to confirm these findings and assess long-term outcomes.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}