Nysora - Vet RA app, slachthuislaan, Leuven (2024)

23/06/2023

❓Have you performed an intra-articular hip injection?

Here are the -guided techniques you can find in the NYSORA VET app:
💊Needle insertion: in-plane or out-of-plane
💉Needle advancement:
1️⃣Advance the needle under ultrasound guidance until the needle tip pierces the joint capsule and is located intra-articularly
2️⃣Attach the test syringe
3️⃣Aspirate to confirm intra-articular needle position by synovia aspiration
4️⃣Detach the test syringe
5️⃣Attach the syringe preloaded with drugs and slowly inject into the joint.

👉Download the app now to see the common mistakes and how to prevent them during the procedures: https://www.nysora.com/nysora-vet-app/

21/06/2023

Clinical experience and patient observation may still be the most practical way to assess anesthetic depth. This can be done by evaluating the followings:
👁️Animal’s eye position
👀Palpebral reflexes
💊Jaw tone
❤️Heart and respiratory rates
💉Autonomic responses to surgical stimulation

❗However, if ketamine is used as an anesthetic, the stages of anesthesia do not follow the classical states.

Want to know more about ?
👉Download the NYSORA VET app to access all you need to know now: https://www.nysora.com/nysora-vet-app/

16/06/2023

Epidural catheter placement is a technique widely used in dogs. The most common approach is via a Tuohy needle inserted into the lumbosacral space (LS approach). It provides the opportunity for repeated or constant delivery of analgesics to the spinal cord and is usually accomplished by using commercial kits.

However, it is not an option when facing the following situations:
1️⃣Severe coagulation abnormalities
2️⃣Sepsis
3️⃣Increased intracranial pressure
4️⃣Preexisting central nervous system disorders
5️⃣Preexisting neurologic injury

Want to dig a little more? Download the NYSORA VET app to check patient preparation and the step-by-step procedures for Epidural Catheter Placement👉 https://www.nysora.com/nysora-vet-app/

14/06/2023

What is your first response to allergy to Local Anesthetics❓

Less than 1% of all adverse reactions where local anesthetics (LAs) are administered can be attributed to allergy to LAs. Due to the fact that it is difficult to determine the exact cause of the symptoms at the time of presentation (i.e. differentiate between LAST, vasovagal syncope, or allergic reactions), treatment should be primarily supportive.

💊Type I allergic reactions are the most severe and timely administration of epinephrine (CRI 0.05 mcg/kg/min) is crucial.
💉Epinephrine doses can be guided according to the severity of the symptoms (grades I-IV)
💊Other pharmacologic treatments (steroids, antihistaminics, β2-agonists) should be considered in severe cases in the acute phase.

👉Download NYSORA’s Vet app today to access more topnotch tips for allergy to local anesthetics: https://www.nysora.com/nysora-vet-app/

09/06/2023

The maxillary nerve block desensitizes the whole ipsilateral maxillary quadrant.

❓How would you find the landmarks for the block?

💡Here is the tip in the NYSORA VET app that may be helpful:
The puncture site is located on the rostroventral border of the zygomatic arch. For medium-sized dogs, the location corresponds roughly 0.5 cm to the lateral canthus of the eye.

👉Get the app now to find the top-class instructions for needle insertion: https://www.nysora.com/nysora-vet-app/

07/06/2023

What are your drug options for ?

The following is recommended in the NYSORA VET app:
💊Local anesthetics: for diagnostic injections and immediate pain relief
💉Corticosteroids: Particulate steroids are used to achieve long-lasting effects
💊Opioids: They are excellent for local administration (e.g. intra-articular administration) in patients with localized chronic pain

👉Download the VET app to get the complete guidance for Sacroiliac Joint Injection: https://www.nysora.com/nysora-vet-app/

02/06/2023

The intercostal nerve block (ICNB) is used to desensitize the ventrolateral aspect of the chest. The intercostal blocks can be performed blindly or with ultrasound guidance which can significantly increase the success and reduce the complication rate.

👀Take a peek at how to find the position for the transducer:
Identify the target intercostal space using ultrasound by counting from the last rib and place the transducer over the proximal third of the rib, close to the angle of the rib.

❓What’s next?
👉Download NYSORA’s VET app to check the guidance for scanning and needle insertion: https://www.nysora.com/nysora-vet-app/

31/05/2023

Pain control during and after dental procedures in dogs and cats is critically important for the animals. For most cases, the mental nerve block is the optimal option for pain control. The success of the block depends on
1️⃣Knowledge about the distribution of analgesia
2️⃣Local anesthetic
3️⃣Techniques

💡Here is a tip about the landmarks in NYSORA’s VET app: the location of the middle mental foramen varies with the breed, size, and the species of the patient. While easily palpable in larger dogs, the foramen can be hard to palpate in smaller dogs.

👉Download the app and check how to solve the problem and many other tips for blocking mental nerves: https://www.nysora.com/nysora-vet-app/

26/05/2023

Sacroiliac dysfunction is used to describe pain in or around the sacroiliac joint region. It can be the primary problem for dogs. Most provocative tests for diagnosing sacroiliac joint pain are not definitive and sacroiliac joint injections remain the gold standard in human medicine.

💡Here are the tips to identify the landmarks for transducer placement:
1️⃣Use the Tuffier’s line (green) to identify the L6/L7 interspace
2️⃣Identify the L7 spinous process which is located just caudal to the Tuffier’s line

👉Check the next steps for scanning and needle insertion in NYSORA VET app: https://www.nysora.com/nysora-vet-app/

22/05/2023

Although Serratus Plane Block is seen as the simplest block of all trunk blocks, it still can cause some complications.

Have you seen complications of this block in your practice?

In the NYSORA VET app, you can find the complete list:
💊Pneumothorax
💉Intrapleural injection
💊Local anesthetic toxicity
💉Puncture of the thoracodorsal artery when using the superficial serratus plane block
💊Incomplete block

👉In the app, you can find all the techniques you should know to increase the success of the block. Experience for free now: https://www.nysora.com/nysora-vet-app/

19/05/2023

The Thoracic Erector Spinae Plane (ESP) block can be used to provide analgesia for acute surgical or traumatic pain, as well as for neuropathic pain of the area innervated by the dorsal branches of the spinal nerves over the thoracic area.

When you use the ultrasound-guided technique to perform the block, two common problems may occur:
⚠️If the transducer is placed too medial, the thoracic laminae will be visualized as flat hyperechoic lines
⚠️When the transducer is placed too lateral, ribs will be visualized as round acoustic shadows with an intermediate hyperechoic pleural line

👉Download NYSORA’s VET app to check how to fix the problems and many more tips and techniques about : https://www.nysora.com/nysora-vet-app/

18/05/2023

📣Exciting news!

Robert Trujanovic, the author of our app, was just interviewed by about the applicability of ultrasound in animal anesthesiology, side effects of narcosis, postoperative recovery, and success rates of different types of anesthesia.

Curious to learn more? Check out the article and download Vet App now to discover the fascinating world of -guided . Don't miss out on this invaluable resource!

📜Article: https://issuu.com/gg-radmag/docs/radmag_2-2023
📱App: https://www.nysora.com/nysora-vet-app/

17/05/2023

The success of performing a Serratus Plane Block depends on the volume and distribution of the injected local anesthetic in the Serratus plane.

There are two serratus planes:
1️⃣The deep serratus plane is an interfascial plane located between the serratus ventralis and external intercostal muscles
2️⃣The superficial serratus plane is located between the serratus ventralis and latissimus dorsi muscles. Additionally, it contains the thoracodorsal and long thoracic nerves. They give off muscular branches to the latissimus dorsi muscle and serratus ventralis muscle, respectively

👉Get the full experience now on more specially-designed illustrations and tried-and-true block techniques for serratus plane block in NYSORA’s VET app: https://www.nysora.com/nysora-vet-app/

12/05/2023

During anesthesia, the depth of anesthesia should be continuously assessed and adjusted. There are 4 stages of general anesthesia:
1️⃣Analgesia
2️⃣Excitation
3️⃣Surgical anesthesia
4️⃣Overdose

💡Anesthesia administration should be tailored to quickly go through stages 1 and 2 to avoid excitation phases with vocalizations or uncontrolled movements during the induction phase.

👉Download NYSORA’s VET app now to unlock common indications and risks through all 4 stages of : https://www.nysora.com/nysora-vet-app/

10/05/2023

Local Anesthetic Systemic Toxicity ( ) is a medical emergency that must be managed differently from conventional CPR because toxic cardiomyopathy is pathophysiologically different from other causes of cardiovascular system collapse.

During LAST specific CPR,
1️⃣The initial priority is immediate airway management to prevent hypoxia and respiratory and metabolic acidosis, which potentiate and increase toxicity
2️⃣The second is applying treatment that effectively moderates or reverses the mechanisms underlying the LA toxicity, taking into account that potentiation mechanisms are related to an increased free fraction of LAs and/or worsening of the cardiac function. This means reducing the free LA concentration by using lipid emulsion, below a threshold that corresponds to ion channel-blocking concentrations
3️⃣The importance of effective CPR is then to ensure that coronary perfusion is sufficient to reduce LA tissue levels and ensure the maximum benefit of lipid infusion

👉Download NYSORA’s VET app to check the exclusive tips for drug use in LAST treatment: https://www.nysora.com/nysora-vet-app/

05/05/2023

For dentistry and oral surgery, one of the most effective ways to block a painful stimulus is to use locoregional anesthesia. It helps to create a painless transition from general anesthesia to consciousness and continues to work after the procedure to reduce patient discomfort and allow oral pain medication to begin working.

However, the vet should also pay attention to potential complications caused by the surgery.
Possible complications can be:
💊Ocular globe injury
💉Intravascular injection
💊Local hemorrhage
💉Allergic reaction to local anesthetics
💊Local Anesthetic toxicity

👉Download NYSORA’s Vet app to get tips on how to decrease the happening of potential complications: https://www.nysora.com/nysora-vet-app/

03/05/2023

As with most crisis scenarios in perioperative medicine, airway management and oxygenation are paramount in the management of Local Anesthetic Systemic Toxicity ( ).

Here is a LAST management algorithm from NYSORA’s VET app.

👉Download the app now to check the details of LAST management: https://www.nysora.com/nysora-vet-app/

28/04/2023

Saphenous Nerve Block provides analgesia for stifle surgery and/or skin of the medial aspect of the leg. This block should be performed in combination with a sciatic nerve block to ensure complete desensitization of the stifle and distal to the stifle.

❓How would you choose the equipment to perform the block?

In NYSORA’s VET app, we suggest:
💡Transducer: Linear
💉Echogenic needle: 22G, 5-10 cm
💊Local anesthetic volume: 0.05-0.1 mL/kg

Want to know more about patient preparation or the block techniques? 👉Download the app now to unlock all you need to know to perform the Saphenous Nerve Block: https://www.nysora.com/nysora-vet-app/

26/04/2023

The aim of local infiltration is to anesthetize nerve endings in a finite area of tissue by the injection of local anesthetics nearby. For superficial skin procedures such as suturing of lacerations and skin biopsies, subcutaneous or intradermal infiltration is sufficient.

Two general approaches exist for anesthetizing skin and subcutaneous tissue
1️⃣The first involves injecting local anesthetic directly into the line of incision and nearby tissues, effectively flooding the individual local nerve endings to produce anesthesia
2️⃣In contrast, field (also called ring or diamond block) encircle the site of incision with walls of local anesthetic solution through which nerve fibers runs towards the planned surgical field.

Which approach would you choose for (Local Infiltration Anesthesia)? And why?

👉Download NYSORA’s VET app to get our suggestions on : https://www.nysora.com/nysora-vet-app/

21/04/2023

Injury of the biceps tendon can be the result of acute overloading or repetitive stress and is typically seen in active, older large breed dogs. Patients that fail to respond to conservative treatment are candidates for an interventional pain procedure, such as the tendon sheath injection.

💡Here is the tip for needle insertion in NYSORA’s VET app:
1️⃣Insert the needle either in-plane or out-of-plane and advance it towards the biceps tendon until the needle tip pierces the biceps tendon sheath
2️⃣Aspirate to confirm positive needle placement, and slowly and under ultrasound visualization inject the drugs into the sheath that surrounds the biceps tendon

👉Download NYSORA’s Vet app now to see what our choices for drugs for Biceps Tendon Sheath Injection are and why: https://www.nysora.com/nysora-vet-app/

19/04/2023

What would you do to reduce the risk of Local Anesthetic Systemic Toxicity ( )?

In NYSORA’s VET app, we summarize 6 current recommendations to reduce the risk of LAST. Have a peek here:
💊Use Ultrasound guidance for regional anesthesia procedures where the equipment is available
💉The injection should be paused when the spread of the local anesthetic is not detected on ultrasound, as it may indicate an intravascular injection
💊Use the lowest effective dose of local anesthetics

👉Download NYSORA’s Vet app now to unlock the complete list and more tips on : https://www.nysora.com/nysora-vet-app/

17/04/2023

Clinicians have been using a variety of adjuvants to LAs to prolong nerve blocks. Although the risk of neurotoxicity is relatively low, the advantages of these adjuvants in clinical trials have not been consistent, posing questions of clinical benefits.

The most common additives include:
💊Epinephrine
💉Opioids
💊Dexmedetomidine
💉Dexamethasone
💊Sodium bicarbonate

What would be your choice? What do you think of using adjuvants to LAs?
⌨️Tell us in the comments.

👉Download NYSORA’s VET app now to access all you need to know about local anesthetics: https://www.nysora.com/nysora-vet-app/

10/04/2023

Do you use the traditional or modified approach for an axillary brachial plexus block in your daily practice?

The modified approach allows more precise visualization of the individual nerves that need to be blocked.

Check if we use the same protocol for patient preparation:
1️⃣Put the patient in dorsal recumbency with the thoracic limbs flexed naturally
2️⃣Clip the hair of the axillary region
3️⃣Prepare the skin with aseptic solution
4️⃣Prefill the extension line with local anesthetic
5️⃣Set the nerve stimulator at 0.4 mA if used

Download NYSORA’s VET app to see our scanning tips and needle insertion techniques for this block: https://www.nysora.com/nysora-vet-app/

31/03/2023

Hip pain is commonly seen in small animal practices. In older patients, degenerative osteoarthritis (OA) of the hip is the most common reason for hip pain. The use of intra-articular steroids, opioids, and hyaluronic acid has increased over the last years to treat patients with OA.

Here are the medications we recommend for intra-articular therapy:
📎Corticosteroids: decrease pain and inflammation
💉Local anesthetics: facilitate the identification of the pain source
💊Viscosupplementation: inject hyaluronate into the joints to improve lubrication and relieve pain. Thus, it may delay joint replacement or avoid it in old patients
🌡️ACP or PRP infiltrations represent a therapeutic tool due to their trophic properties and ability to control inflammatory processes, especially in musculoskeletal applications

Which medications are you using? Share your strategy in the comments!

👉Numerous techniques about intra-articular hip injection and are waiting for you in NYSORA’s VET app. Download and try it for free now: https://www.nysora.com/nysora-vet-app/

29/03/2023

❓How do you minimize the risk of femoral artery puncture during needle insertion?

Saphenous Nerve Block provides analgesia for stifle surgery and/or skin of the medial aspect of the leg. Here's the strategy covered in the NYSORA Vet app:

📒When inserting the needle, ensure that the needle punctures the medial femoral fascia and that the needle tip is close to the saphenous nerve or the cranial border of the femoral artery. Since the medial femoral fascia is resistant, pointing the needle in a slight medial direction, as opposed to directing it towards the femoral artery, can minimize the risk of femoral artery puncture.

👉Download NYSORA’s VET app to access instructions and tips for more block techniques: https://www.nysora.com/nysora-vet-app/

27/03/2023

Ideally, a routine physical examination should be performed within the week before anesthesia and on the day of the procedure.
The pre-anesthetic physical examination should consist of the following:
💊Body condition score
💧Hydration
🧡Cardiovascular system
💨Respiratory system
🩸Capillary refill time (CRT)
💉Mucous membrane color
🌡️Body temperature
📎 Integumentum
📜In addition, owners should be asked if the patient shows any gastrointestinal or neurological signs.

👉Download NYSORA’s VET app to access the tips and explanations for each item: https://www.nysora.com/nysora-vet-app/

24/03/2023

What would you do to reduce the risk of Local Anesthetic Systemic Toxicity ( )?

We summarized the most practical tips to deal with LAST:
1️⃣Use ultrasound guidance for regional anesthesia procedures where the equipment is available
2️⃣The injection should be paused when the spread of the local anesthetic is not detected on ultrasound, as it may indicate an intravascular injection
3️⃣Use the lowest effective volume/dose of local anesthetics
…

👉Want to know more? Download NYSORA’s VET app to master everything you should know about LAST:https://www.nysora.com/nysora-vet-app/

21/03/2023

What is your LA choice for the Serratus Plane Block?

Serratus Plane Block is the simplest block of all trunk blocks and is considered to be a thoracic fascial plane block. The success of this block depends on the volume and distribution of the injected local anesthetic in the Serratus Plane.

We recommend:
💉Bupivacaine or Ropivacaine 0.25-0.5%
💊Volume: 0.4 mL/kg per hemithorax

👉Download NYSORA’s VET app to check out the detailed explanation and many more tips on : https://www.nysora.com/nysora-vet-app/

17/03/2023

Intratesticular blocks lower inhalant anesthesia requirements during castration, thereby improving the patient’s cardiovascular and respiratory status and leading to a lower pain score after surgery.

Here are the tips for pain relief from the incision when performing a testicular block.
🐱Cats (scrotal incision site): Continue infiltrating as the needle exits the testicular body to block the skin and subcutaneous tissue
🐶Dogs (prescrotal incision site): Inject local anesthetic in the subcutaneous tissue at the incision site

👉Download NYSORA’s VET app now to get more techniques for the testicular block and tried-and-true tips on veterinary anesthesia: https://www.nysora.com/nysora-vet-app/

15/03/2023

Patients with heart failure are at increased risk for Local Anesthetic Systemic Toxicity ( ) due to:
🖊️reduced hepatic perfusion
💉reduced clearance
💊elevated LA tissue concentrations due to the slower circulation time

In this situation, we recommend choosing less-cardiotoxic LAs and reducing the dosages for repeated doses or continuous infusion by 10% to 20%.

👉Download NYSORA’s VET app now to get more tried-and-true tips on veterinary anesthesia:https://www.nysora.com/nysora-vet-app/

10/03/2023

Nerve block needles vary in the tip design, length, gauge, and the presence or absence of electrical insulation or other specialized treatment of the needles. Nerve injury can be caused by direct nerve pe*******on or forceful mechanical needle-nerve contact. Therefore, the bevel of the needle can have an impact on the extent of damage when the needle is inserted close to a nerve.

Here are some tips for nerve-block needles:

💉Short-beveled (45°) needles may have the advantage of reducing nerve damage caused by cutting or penetrating the nerve.
💉Long-beveled (14°-15°) needles have been shown to be more likely to pe*****te perineurium and cause fascicular injury than short-beveled needles, especially when oriented transversely to the nerve fibers.
💉The most commonly used needles have an intermediate bevel angle (30°), which appears to be a reasonable balance.

👉Download NYSORA’s VET app now to get the complete information on nerve block needles and other peripheral nerve block equipment:https://www.nysora.com/nysora-vet-app/