Evaluation of a Midhumeral Block of the Radial, Ulnar, Musculocutaneous and Median (RUMM Block) Nerves for Analgesia of the Distal Aspect of the Thoracic Limb in Dogs

• Published in: Veterinary surgery Vol. 39; no. 7; pp. 785 - 796
• Main Authors: Trumpatori, Brian J, Carter, Jennifer E, Hash, Jon, Davidson, Gigi S, Mathews, Kyle G, Roe, Simon C, Lascelles, B. Duncan X
• Format: Journal Article
• Language: English
• Published: Malden, USA Malden, USA : Blackwell Publishing Inc 01.10.2010; Blackwell Publishing Inc; Blackwell Publishing Ltd
• Subjects: analgesia; analgesic effect; analgesics; Anatomy & physiology; Anesthesia; Anesthetics, Local - administration & dosage; Anesthetics, Local - therapeutic use; Animals; Brachial Plexus - drug effects; Bupivacaine - administration & dosage; Bupivacaine - therapeutic use; Dogs; drug injection; Forelimb - innervation; Forelimb - surgery; Humerus; in vitro studies; in vivo studies; Legs; limbs (animal); Median Nerve - drug effects; methodology; muscles; Musculocutaneous Nerve - drug effects; Nerve Block - methods; Nerve Block - veterinary; optimization; peripheral nerves; Radial Nerve - drug effects; radius (bone); reflexes; RUMM block; skin; Surgery; ulna; Ulnar Nerve - drug effects; veterinary drugs; Veterinary medicine
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/j.1532-950X.2010.00712.x

To evaluate a technique for midhumeral peripheral nerve blockade in the dog. Cadaveric technique development; in vivo placebo-controlled, prospective crossover study. Canine cadavers (n=38) and 8 clinically healthy, adult hound dogs. A technique for peripheral block of the radial, ulnar, musculocutaneous, and median nerves (RUMM block) was evaluated using cadaver limbs. Eight purpose-bred, research dogs were anesthetized; a RUMM block was performed on each thoracic limb. One limb from each dog randomly received 0.5% bupivacaine and the opposite limb was assigned to receive sterile saline solution as a control. After recovery from anesthesia, skin sensation at selected dermatomes was evaluated for 24 hours using a mechanical stimulus. Weight-bearing, conscious proprioception, and withdrawal reflex were also evaluated. One month after initial testing, each dog was reanesthetized and each limb received the opposite treatment. Sensory thresholds were significantly increased over baseline measurements when compared with control limbs for all nerves. Complete sensory block was achieved in radial (15/16), ulnar (3/16), musculocutaneous (8/16), and median (11/16) nerves, using a mechanical stimulus of analgesia. Complete simultaneous block of all nerves was only obtained in 1 of 16 limbs. RUMM block resulted in desensitization of the skin in the associated dermatomes for 4-10 hours. Complete sensory block of the dermatomes supplied by the radial nerve was most consistent. RUMM block may be an effective technique to provide adjunctive analgesia for dogs undergoing surgery of the distal aspect of the thoracic limb.