Ultrasound-guided caudal quadratus lumborum block combined with the greater ischiatic notch plane block in a goat with femoral head fracture

This report describes the case of a brown-black coloured mountain goat (Caprinae), aged 13 months and weighing 46 kg, which was presented for anaesthesia to facilitate surgical repair of a femoral head fracture in the left pelvic limb. Clinical evaluation was unremarkable except for marked lameness (5/5). After sedation, general anaesthesia was induced for open reduction and internal fixation of the fracture using pins. After aseptic preparation, a ‘GIN & TONIC’ block, comprising the combination of an ultrasound-guided greater ischiatic notch (GIN) plane block (bupivacaine 0.25%; 0.25 mL kg^–1) and a caudal quadratus lumborum block (C-QLB, bupivacaine 0.25%; 0.3 mL kg^–1), was performed. No significant changes in monitored physiologic variables were observed during the fracture repair except for a slight heart rate increase (21% above 77 beats minute^–1 at baseline) during fracture reduction, which was treated with a single dose of intravenous ketamine (0.2 mg kg^–1). Regurgitation of ruminal contents occurred just before ketamine injection. At extubation, the interior of the endotracheal tube was clear and no signs of aspiration were observed postoperatively. The goat readily accepted food 3 hours after surgery, and no pain response was elicited on palpation of the surgical site immediately after recovery or during the next 12 hours. This case suggests that the ultrasound-guided GIN plane block combined with the C-QLB (GIN & TONIC block) offers effective and reliable analgesia for surgeries at the hip joint in goats. Future studies are warranted to further validate the efficacy and safety of this technique in goats and explore its potential benefits in other ruminants undergoing orthopaedic procedures.