Development of a lateral ultrasound-guided approach for the radial, ulnar, median and musculocutaneous (RUMM) nerve block in a calf undergoing surgical fixation of the antebrachium

27 Nov 2020

Trujanovic, R., Otero, P. E., Larenza Menzies, M. P., Gasparik-Küls, N.

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A 26-day-old Pustertaler Sprinzer calf was referred to the ruminant clinic of the Veterinary University of Vienna for internal fixation of a suspected traumatic radius–ulnar fracture of the left forelimb. Preanaesthetic medication consisted of xylazine 0.06 mg/kg and ketamine 6 mg/kg intramuscularly, followed by induction of anaesthesia with ketamine 2.7 mg/kg intravenously. Anaesthesia was maintained with isoflurane in oxygen. A modified lateral ultrasound-guided radial, ulnar, median and musculocutaneous (RUMM) block was performed using 0.3 ml/kg bupivacaine 0.5 per cent. Total surgical time was 385 minutes. Vital parameters remained stable throughout surgery, with no rescue analgesia required at any point. Recovery from anaesthesia was uneventful. The calf received morphine 0.1 mg/kg intramuscularly every four hours for the following four days. Additionally, carprofen 1.4 mg/kg intramuscularly was administered once daily for the following seven days. Fifty-one days after surgical stabilisation, the plate was removed, and the calf was discharged home. The described modified lateral RUMM block using bupivacaine 0.5 per cent provided analgesia for at least 6.5 hours.