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Williams et al: Evaluation of the addition of adrenaline in a bilateral maxillary nerve block to reduce hemorrhage in dogs undergoing sharp staphylectomy for brachycephalic obstructive airway syndrome. A prospective, randomized study
Veterinary Surgery 1, 2024

🔍 Key Findings Summary

  • Design: Prospective, randomized, double-blinded controlled trial
  • Population: 32 brachycephalic dogs undergoing cut-and-sew sharp staphylectomy
  • Groups: Adrenaline + lidocaine (Group A) vs. Lidocaine only (Group NA)
  • Main Findings:
    • Total hemorrhage significantly lower in Group A (median 1.82 g) vs Group NA (7.95 g); p = .013
    • Normalized hemorrhage significantly lower in Group A; p = .021
    • Surgeon-assigned hemorrhage scores significantly lower in Group A; p = .029
    • No adverse effects (tachycardia, hypertension, arrhythmia, etc.) noted from adrenaline use
    • Breed effect: English Bulldogs bled more overall even after normalization
  • Clinical Implication: Adrenaline in nerve blocks reduces hemorrhage without added risk

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← Articles

Williams et al: Evaluation of the addition of adrenaline in a bilateral maxillary nerve block to reduce hemorrhage in dogs undergoing sharp staphylectomy for brachycephalic obstructive airway syndrome. A prospective, randomized study
Veterinary Surgery 1, 2024

🔍 Key Findings Summary

  • Design: Prospective, randomized, double-blinded controlled trial
  • Population: 32 brachycephalic dogs undergoing cut-and-sew sharp staphylectomy
  • Groups: Adrenaline + lidocaine (Group A) vs. Lidocaine only (Group NA)
  • Main Findings:
    • Total hemorrhage significantly lower in Group A (median 1.82 g) vs Group NA (7.95 g); p = .013
    • Normalized hemorrhage significantly lower in Group A; p = .021
    • Surgeon-assigned hemorrhage scores significantly lower in Group A; p = .029
    • No adverse effects (tachycardia, hypertension, arrhythmia, etc.) noted from adrenaline use
    • Breed effect: English Bulldogs bled more overall even after normalization
  • Clinical Implication: Adrenaline in nerve blocks reduces hemorrhage without added risk

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Multiple Choice Questions on this study

In Williams 2024 et al., on hemorrhage scoring, which semi-quantitative hemorrhage score was most associated with adrenaline use?

A. Score 1 (virtually none)
B. Score 3 (moderate)
C. Score 4 (substantial)
D. Score 5 (very heavy)
E. Score 2 (minimal)

Answer: Score 1 (virtually none)

Explanation: Five dogs in Group A (adrenaline) were assigned Score 1, whereas none in Group NA were. This difference was statistically significant (p = .029).
In Williams 2024 et al., on local anesthetic protocol, what was the standard volume used per side for the maxillary nerve block?

A. 0.3 mL
B. 0.4 mL
C. 0.5 mL
D. 0.7 mL
E. 1.0 mL

Answer: 0.5 mL

Explanation: Each side received 0.5 mL regardless of patient size; this standardization was applied to both groups.
In Williams 2024 et al., on breed effects, which breed exhibited significantly greater hemorrhage, even after normalization?

A. Pug
B. Cavalier King Charles Spaniel
C. Boston Terrier
D. English Bulldog
E. French Bulldog

Answer: English Bulldog

Explanation: English Bulldogs had significantly higher normalized hemorrhage than other breeds (p = .048).
In Williams 2024 et al., on cardiovascular safety, what perioperative effect was observed with adrenaline in the nerve block?

A. Marked hypertension
B. Bradyarrhythmias
C. Tachycardia in >25% of dogs
D. No significant adverse effects
E. Decreased MAP in all dogs

Answer: No significant adverse effects

Explanation: No cardiovascular instability (tachycardia, arrhythmias, hypertension) was observed with adrenaline use in the nerve block.

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