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Effects of hyaluronidase on ropivacaine or bupivacaine regional anaesthesia of the canine pelvic limb
Authors:Travis R Gray  Brighton T Dzikiti  Gareth E Zeiler
Institution:1. Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa;2. Clinical Sciences Department, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies;3. Anaesthesia and Critical Care Services, Valley Farm Animal Hospital, Pretoria, South Africa
Abstract:

Objective

To determine the effect of hyaluronidase on time to onset and offset of anaesthesia in ropivacaine or bupivacaine femoral–ischiatic nerve blocks.

Study design

Blinded randomized crossover trial.

Animals

Eight dogs.

Methods

Each dog underwent four treatments separated into two blocks – initially, the ropivacaine treatment block: RS (ropivacaine 0.5% plus saline 0.9%) and RH (ropivacaine 0.5% plus hyaluronidase 100 IU mL–1), followed 3 weeks later by the bupivacaine treatment block: BS (bupivacaine 0.5% plus saline) and BH (bupivacaine 0.5% plus hyaluronidase). The local anaesthetics were administered at 0.1 mL kg–1 per site. Hyaluronidase and saline were administered at 0.02 mL kg–1 per site. Performance of femoral–ischiatic blocks was aided by a combined ultrasound–electrolocation technique. The mechanical nociceptive threshold was measured, until offset or 360 minutes, using an algometer to ascertain baseline, onset and offset of anaesthesia. Onset and offset of anaesthesia were defined as a 25% increase above and as a return to <25% above baseline nociceptive threshold readings, respectively.

Results

The median (range) onset of anaesthesia for RS and RH was 21 (3–60) and 12 (3–21) minutes, respectively (p = 0.141), and offset was 270 (90–360) and 180 (30–300) minutes, respectively (p = 0.361). By contrast, the median (range) onset of anaesthesia for BS and BH was 24 (3–60) and 9 (3–27) minutes, respectively (p = 0.394), and offset was 360 (240–360) and 330 (210–360) minutes, respectively (p = 0.456).

Conclusion and clinical relevance

Hyaluronidase had no effect on the onset and offset times of ropivacaine and bupivacaine femoral–ischiatic nerve blocks in dogs compared with saline. The onset and offset times were highly variable in all treatments. Clinically, the high variability of the onset and offset times of the regional anaesthesia of these local anaesthetic drugs means that clinicians must monitor the animal’s response and, if required, provide additional analgesic drugs.
Keywords:bupivacaine  femoral nerve block  hyaluronidase  ischiatic nerve block  ropivacaine
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