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By using regional anaesthesia techniques with Vygon Vet’s Plexygon nerve stimulator to provide localised pain relief, the orthopaedic referral team can reduce the levels of isoflurane and opiate drug use during a procedure. As a result, there are fewer side-effects associated with higher isoflurane levels and further opiate use.
After surgery, the team has found that a patient’s appetite recovers more quickly, and the pets are often brighter and more alert enabling them to go home with their owners that same day.
Wilbury Vets, based in Brighton and Hove, was introduced to nerve blocks using the Plexygon nerve stimulator by nurse Anna Goodall who learned about the technique during a course. The portable, compact, and easy-to-use device allows accurate nerve location through the emission of a low intensity electrical current.
As well as the Plexygon device, the kit includes a red cable to connect to the ECG electrode and a black cable to attach to the neuro stimulation needle. The screen display shows the level of current and audio tones indicate the proximity of the nerve. Once stimulation is confirmed, local anaesthetic is injected through the stimulation needle.
After her course, Anna urged her colleagues in Wilbury Vet’s orthopaedic team led by Peter Haggis to look at regional anaesthesia more closely.
A continual professional development (CPD) session was arranged with a specialist anaesthetist from Glasgow University, he was able to show the team the procedure and assist them as they worked with the equipment.
Convinced regional anaesthesia would benefit their patients, the practice arranged for the loan of a Plexygon nerve stimulator from Vygon Vet along with nurse training to further build confidence amongst the team and evaluate the benefits.
Seeing a dog up and enjoying a meal not long after the operation rather than sitting salivating in their kennel was really positive and gave us a good indication immediately that nerve blocks were beneficial for patients,” explains Peter, an Advanced Practitioner in Small Animal Orthopaedics.
“It’s an easy technique for the vets & nurses to learn, there really isn’t too much to worry about with needle placement using the nerve stimulator. It was great for the nursing teams because they found they needed lower isoflurane levels during the surgery with the beneficial effect of keeping blood pressure levels more constant, with less fewer fluctuations in isoflurane levels needed. Everything just felt a bit calmer and smoother.
“We charge a small additional cost to cover the cost of materials and small amount of extra time, but the owners are happy to pay to see the benefits for their pets.”
The most common referrals seen by the orthopaedic team have been suitable for the femoral and sciatic nerve blocks techniques. These include cruciate and patella injuries. There have been a few cases of elbow and radius fractures that have allowed the team to also perform RUMM blocks with the same success. With the team averaging at least one referral case a day they have quickly become comfortable with the nerve block techniques.
The new procedure has reduced the need for further fentanyl use during the procedure. In addition, reduced post-operative methadone has definitely led to pets eating earlier in the day and looking brighter. Reduced Isoflurane use has an environmental benefit as well.
Peter added:“Introducing the Plexygon nerve stimulator with the training and support we received from Vygon made a lot of sense when we were able to see such nice clear-cut benefits for patients. In fact, we had a direct comparison because one patient had two TPLOs carried out. One using our previous drug regime and the other with the nerve block. The owner reported their pet experienced much less discomfort with the regional anaesthesia during the first 12 hours or so at home.
“I think our experience shows how beneficial it is to empower individuals and invest in CPD.
We’re a small team and we don’t have the luxury of lots of specialists in house, so we are always keen to upskill with useful techniques. The key is keeping the momentum going. After the course we had the diplomat visit us for a day. We then had the loan of the equipment and training from Vygon that got us all involved and on board with the benefits of change.”
To find out more about Vygon Vet’s Plexygon nerve stimulator or how Vygon Vet can help your veterinary practice, get in touch with the Vygon vet team on 01793 748951 or email us on: veterinary@vygon.co.uk .
