02851-A: Development of Regional Anesthesia Techniques to Treat Chronic Painful Conditions of the Stifle and Elbow in Dogs

Abstract

Knee and elbow osteoarthritis (OA) is a common cause of chronic pain in dogs, significantly impacting quality of life. Traditional management mainly involves the use of oral medications such as non-steroidal anti-inflammatory drugs (NSAIDs). However, long-term use of NSAIDs may be associated with significant gastrointestinal side effects, often leading to treatment discontinuation and resulting in inadequate pain management or euthanasia. Interventional pain medicine is a medical subspecialty employing advanced techniques, such as nerve blocks, to improve the quality of life of patients suffering chronic pain. Nerve blocks apply local anesthesia close to nerves responsible for the transmission of pain sensation in different parts of the body (i.e., elbow). Some nerves are difficult to localize, especially when instruments to guide the needles are not used (i.e., blind technique). The use of ultrasound guidance allows practitioners to direct needles to precise locations where the target nerves are located. No studies are currently available describing how to selectively approach sensory nerves participating in the transmission of pain from knee and elbow in dogs. The present study aims to identify and develop a reliable technique to approach the sensory nerves of the knee and elbow using both blind and ultrasound-guided techniques. A detailed anatomical study will be performed to describe the surface and ultrasonographic landmarks necessary to perform the blocks. This project will set the basis for future clinical studies aimed to evaluate the clinical effectiveness of desensitizing the sensory innervation of elbow and knee joints to provide pain relief in dogs suffering from osteoarthritic pain. Injections of different drug combinations aimed at extending the duration of sensory blockade could be used in the future to improve the quality of life in dogs suffering from chronic and debilitating stifle and elbow OA.

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