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Parker et al: Pelvic limb anesthesia and analgesia in dogs undergoing tibial plateau leveling osteotomy (TPLO): A survey of board-certified anesthesiologists
Veterinary Surgery 4, 2023

🔍 Key Findings

  • Peripheral nerve block (PNB) was preferred by 79% of anesthesiologists; lumbosacral epidural (LE) by 21%; PI <1%.
  • Time since board-certification significantly influenced preference: PNB favored by newer diplomates, LE favored by more senior ones (p < .001).
  • Employment sector mattered: PNB was preferred more in private practice, LE more in academia (p = .003).
  • PNB perceived as more effective, with 78% reporting 81–100% effectiveness; compared to 55% for LE.
  • PNB associated with fewer adverse effects (75%) than LE (4%) and PI (21%).
  • PNB required less rescue analgesia intraoperatively (57%) and postoperatively (54%) than LE or PI.
  • LE preferred for bilateral TPLOs and in smaller dogs; PNB for larger dogs, due to motor function preservation.
  • Dexmedetomidine was the most common additive to PNB; bupivacaine-only was most used for PNB.

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← Articles

Parker et al: Pelvic limb anesthesia and analgesia in dogs undergoing tibial plateau leveling osteotomy (TPLO): A survey of board-certified anesthesiologists
Veterinary Surgery 4, 2023

🔍 Key Findings

  • Peripheral nerve block (PNB) was preferred by 79% of anesthesiologists; lumbosacral epidural (LE) by 21%; PI <1%.
  • Time since board-certification significantly influenced preference: PNB favored by newer diplomates, LE favored by more senior ones (p < .001).
  • Employment sector mattered: PNB was preferred more in private practice, LE more in academia (p = .003).
  • PNB perceived as more effective, with 78% reporting 81–100% effectiveness; compared to 55% for LE.
  • PNB associated with fewer adverse effects (75%) than LE (4%) and PI (21%).
  • PNB required less rescue analgesia intraoperatively (57%) and postoperatively (54%) than LE or PI.
  • LE preferred for bilateral TPLOs and in smaller dogs; PNB for larger dogs, due to motor function preservation.
  • Dexmedetomidine was the most common additive to PNB; bupivacaine-only was most used for PNB.

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Multiple Choice Questions on this study

In Parker 2023 et al., on Locoregional analgesia in TPLO, what percentage of respondents reported that peripheral nerve blocks (PNB) were effective 81–100% of the time?

A. 45%
B. 55%
C. 78%
D. 62%
E. 91%

Answer: 78%

Explanation: Most respondents using PNB reported high confidence in its effectiveness (78% rated it 81–100% effective).
In Parker 2023 et al., on Locoregional analgesia in TPLO, which variable was significantly associated with increased preference for lumbosacral epidural (LE) over PNB?

A. Board-certification college
B. Body weight of dog
C. Time from board-certification
D. Geographic region of practice
E. Use of opioid additives

Answer: Time from board-certification

Explanation: LE was more common in diplomates >10 years post-certification, while newer diplomates preferred PNB (p < .001).
In Parker 2023 et al., on Locoregional analgesia in TPLO, what was the most frequently cited additive to bupivacaine in peripheral nerve blocks?

A. Morphine
B. Ketamine
C. Dexmedetomidine
D. Epinephrine
E. Medetomidine

Answer: Dexmedetomidine

Explanation: Dexmedetomidine was the most commonly selected additive for PNB, used by 85% of those adding any agent.
In Parker 2023 et al., on Locoregional analgesia in TPLO, what was the most commonly preferred locoregional anesthesia technique among anesthesiologists for dogs undergoing TPLO?

A. Lumbosacral epidural
B. Peri-incisional infiltration
C. Spinal block
D. Peripheral nerve block
E. No locoregional technique

Answer: Peripheral nerve block

Explanation: PNB was preferred by 79% of diplomates, making it the most frequently chosen locoregional technique for TPLO.
In Parker 2023 et al., on Locoregional analgesia in TPLO, which locoregional technique was rated as having the fewest adverse effects?

A. Lumbosacral epidural
B. Peri-incisional infiltration
C. Peripheral nerve block
D. Intrathecal morphine
E. Femoral nerve block only

Answer: Peripheral nerve block

Explanation: PNB was selected by 75% of respondents as having the lowest rate of adverse effects compared to LE and PI.

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