D'Urso / Stefanello

Elisa Silvia D’Urso, DVM, PhD student

Graduated in Veterinary Medicine in February 2014 with full marks and honor, with a dissertation concerning rabbit anaesthesia and analgesia entitled “Assessment of buprenorphine and ketorolac perioperative analgesia in desflurane anaesthetized rabbits undergoing ovariohysterectomy” (supervisor: Dr. Giuliano Ravasio, assistant supervisor: Dr. Alessandro Maria Pecile). After 5 months of post degree attendance at the Department of Veterinary Sciences and Public Health as part of the anaesthetist task group, she spent a 7-month post-degree practical training period at the veterinary hospital Gregorio VII in Rome, in order to develop a proper background in internal medicine, critical and intensive care, imaging and emergency care. During the same period, she participated to two workshops concerning general veterinary anaesthesia and hemodynamic evaluation (speakers: Dr. Enrico Stefanelli and Dr. Davide Gamba). Her main interests are veterinary anaesthesia in a variety of species and small animal critical and emergency care.

Damiano Stefanello, DVM, PhD in Comparative Veterinary Oncology, Ass. Professor DIVET, University of Milan

After graduating in Veterinary medicine with full marks and honor in 1999, he earned a PhD in Comparative Veterinary Oncology in 2004. Researcher since 2008, he carried out clinical and teaching activity as well as research at the Department of Veterinary Sciences and Public Health, focusing on clinical oncology and small animal surgery. Associate professor in veterinary clinical surgery. He founded and has been leading since 2009 the Veterinary Oncology Chemotherapy unit at the Veterinary Hospital and Experimental Animal Research and Application Centre, Lodi, Faculty of Veterinary Medicine. From 2007 to 2012, he was lecturer of the Veterinary Oncology Master at the University of Pisa. He is head chief of the Small Animal Pathology and Clinical Medicine School of Specialization at the Faculty of Veterinary Medicine, Milan. Member of SIONCOV, ESVONC and VSSO societies, he has been president of the Italian Veterinary Oncology Society (SIONCOV) from 2014 to 2017. Guest speaker at several Italian and international conventions concerning veterinary oncology, he is also author of more than 120 publications dealing with clinical oncology and small animal surgery, 42 of which on international peer-reviewed journals.

Research project: Ultrasound guided loco-regional anaesthesia in small animal practice

Peripheral and central nerve blocks play nowadays an important role in perioperative pain management both in human and in veterinary medicine; the injection of local anaesthetic around a nerve or a group of nerves determines a blockade in impulse conduction, causing temporary analgesia and loss of sensory and motor function. An effective nerve block thus allows to avoid supplementation of both general anaesthetic drugs and systemic opioids during surgery leading to a minor effect on the cardiovascular system and to a faster postoperative recovery for the veterinary and human patient. Ultrasonographic (US) guidance to perform peripheral nerve blocks is widely studied and standardized in human medicine, due to its remarkable advantages compared to the peripheral nerve stimulation (PNS) technique, while in veterinary medicine the description and validation of most US guidance nerve blocks is still scarce.
The purpose of this study is to assess and compare the efficacy of peripheral nerve stimulation technique, ultrasound guided technique and the combined technique in order to evaluate their suitability in veterinary medicine.

The study will be conducted in three years; during the first academic year, an ultrasonographic anatomical study on 20 dogs who underwent euthanasia for reasons not related to the study itself or died by natural causes will be carry out, in order to acknowledge proper ultra-sonographic landmarks for all the nerves and regions involved. Data collected should thus allow the creation of a complete database of images and landmarks, which is not currently present in veterinary medicine.

During the second academic year, a clinical study will be conducted on two groups of 40 owned dogs each, submitted to the Faculty of Veterinary Medicine in order to undergo surgeries which require loco-regional anaesthesia as part of the analgesic protocol. In group 1, nerve block will be performed under ultrasonographic guidance. In group 2, nerve block will be performed with PNS technique. During the third academic year, nerve block will be performed on a third group of 40 owned dogs with the combined technique. In all patients, heart rate and invasive arterial blood pressure will be recorded during surgery in order to allow the assessment of intra-anaesthetic analgesic efficacy of the perineural nerve block. Rescue analgesia will be provided whenever needed and the number of rescue analgesic administration will be recorded as well. Data obtained from the clinical part of the study should allow to assess which technique is more suitable in small animal surgery to perform peripheral nerve block in a clinical setting in order to reduce failure rates and to minimize risks and side effects for the patient.