Effectiveness of a paraverterbral nerve block versus local portal blocks for laparoscopic closure of the nephrosplenic space: A pilot study.
Authors: Delli-Rocili Massimo M, Cribb Nicola C, Trout Donald R, Thomason Jeffrey J, Valverde Alexander
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Closure of the nephrosplenic space via standing laparoscopy requires effective analgesia to ensure patient tolerance and surgical success, yet optimal local anaesthetic techniques remain underexplored in equine practice. Researchers compared paravertebral nerve blocks targeting T18, L1, and L2 against conventional local portal infiltration in twelve standing, sedated horses undergoing nephrosplenic space closure, with both groups receiving standardised systemic analgesia (dexmedetomidine and morphine) and blinded assessment of sedation quality, analgesia, surgical behaviour, and procedural ease using visual analogue scales. Neither technique demonstrated superiority: administration time proved equivalent, VAS scores showed no significant differences between groups, and total surgical duration was comparable (paravertebral 79±16 minutes versus local portal 85±25 minutes). These findings suggest both approaches provide equally adequate conditions for standing laparoscopic surgery, offering clinicians flexibility in technique selection based on operator experience and individual horse characteristics. For practitioners performing nephrosplenic space closure, the paravertebral block presents a viable alternative to portal infiltration, potentially reducing local anaesthetic volume at surgical sites whilst maintaining operative comfort and procedural efficiency.
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Practical Takeaways
- •Paravertebral nerve blocks offer a viable alternative to local portal site blocks for standing laparoscopic nephrosplenic space closure, with no compromise to surgical conditions
- •Choose between techniques based on practitioner familiarity and horse-specific factors rather than expected efficacy differences
- •Both approaches can be readily performed in practice settings with proper sedation protocols
Key Findings
- •Paravertebral nerve block (T18, L1, L2) and local portal blocks produced similar sedation quality and analgesia scores during laparoscopic nephrosplenic space closure
- •Mean surgical time was comparable between paravertebral block (79±16 min) and local portal block (85±25 min) groups
- •Both anesthetic techniques provided equivalent surgical conditions and can be used interchangeably for this procedure