Perioperative analgesic management using bilateral ultrasound-guided lateral quadratus lumborum block in a dog with extrahepatic biliary obstruction.

Extrahepatic bile-duct obstruction is commonly caused by pancreatitis in canines. Surgical decompression of the biliary tree is required when medical management is unsuccessful. The clinical presentation often includes severe vomiting and abdominal pain requiring targeted analgesic and anesthetic protocols. Locoregional anesthesia has been largely advocated as part of multimodal analgesic plans to reduce opioid consumption and decrease opioid-related side effects. This report describes a case where the lateral quadratus lumborum block provided effective analgesia and opioid-sparing effect in a 7-year-old mixed-breed dog with extrahepatic bile-duct obstruction undergoing common bile-duct stent placement. Key clinical message: Anesthetic stability in critically ill patients undergoing abdominal surgery is challenging. However, implementation of an ultrasound-guided locoregional technique may help blunt the sympathetic response to surgery and reduce opioid requirements, facilitating anesthetic stability and a comfortable early postoperative period. This is apparently the first report on using ultrasound-guided quadratus lumborum block in a critically ill dog with pancreatitis.