A multimodal approach to hindlimb surgical analgesia: femoral and sciatic nerve blocks

The provision of safe and optimal analgesia is a fundamental consideration for veterinary practitioners, ensuring the welfare of patients entrusted to their care. The registered veterinary nurse's (RVN) role is often key with regards to pain scoring patients, identifying pain emergence and liaising with the veterinary surgeon (VS). Jones (2016) highlighted that although there have been large changes in pain scoring and analgesia over recent years, there is still scope for improvement.

For example, Crombie et al (1998) discovered that surgery was potentially responsible for chronic pain in 35% of human patients attending a chronic pain clinic who underwent pelvic limb surgery, suggesting potential for this to occur in veterinary patients. Pelligand and Sanchis Mora (2016) described pain as the fifth vital sign, proposing that successful recognition and management results in improved patient welfare and lower incidences of chronic refractory pain. Similarly, Vadivelu et al (2014) previously evaluated the concept of preventative analgesia for postoperative pain, concluding that pre-emptive and multimodal analgesia are important to reduce sensitisation and subsequent ‘wind up’ phenomena.