Page 129 - BSAVA Guide to Pain Management in Small Animal Practice

BSAVA Guide to Pain Management in Small Animal Practice

VetBooks.ir CASE EXAMPLE 2 CONTINUED

boluses were administered every 4 hours
. mg kg i.v. for 48 hours followed by
buprenorphine g kg i.v. every 8 hours
for 7 hours. eloxicam .1 mg kg orally
was continued every 4 hours and the animal
was discharged on this medication.
TIPS OM T E AUT O
When performing intercostal nerve blocks
make sure to block three consecutive
intercostal nerves cranial and caudal to the
incision. For this purpose, inject bupivacaine
caudal to each rib and near the intervertebral
foramen igure 7. . Before in ecting, aspirate
to make sure you are not in a vessel. The Intercostal nerve blocks performed prior
to port placement in a dog with recurrent
author prefers to apply intercostal nerve chylothorax. Note the needle caudal to the rib and
blocks before the incision is made rather then in a dorsal location. Pen marked numbers indicate
prior to closure of the thoracotomy wound. respective ribs.

e ex p e 3 oracic trauma

HISTORY AND PRESENTATION SIGNS OF PAIN

A 1 year old male neutered Cavapoo The dog cried when touched on the torso
presented with severe thoracic wounds after and was reluctant to stand.
being bitten by a Bullmasti .
INVESTIGATIONS AND INITIAL
CLINICAL SIGNS MANAGEMENT
On clinical examination the dog was in A bolus of methadone was given . mg kg
lateral recumbency but alert and responsive. i.v. . he a ected areas were clipped and the
Clinical signs included pink and moist wounds cleaned and covered. Thoracic
mucous membranes, a capillary re ll time of radiographs showed a moderate pneumo-
less than seconds, a heart rate of 1 8 bpm, thorax in the right hemithorax, a possible
palpable and synchronous femoral pulses, a intercostal tear at the left seventh intercostal
respiratory rate of 4 breaths per minute, space, collapse of the right lung lobes and
with mildly increased e ort but no fracture of the fourth rib at the level of the
paradoxical movement. Subcutaneous costochondral junction on the right. A
emphysema was present over the thoracic morphine .1 mg kg h continuous rate
region bilaterally. Rectal temperature infusion CRI and lidocaine CRI 4 g kg

was 8.1 C. min were initiated and the animal was
stabilized overnight.

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