ivmМеждународный вестник ветеринарииInternational Journal of Veterinary Medicine2072-2419SpbGUVM Publishing House10.52419/issn2072-2419.2025.3.520ivm-1847Research ArticleХИРУРГИЯSURGERYРазработка алгоритма выполнения высокой эпидуральной анестезии при унилатеральной мастэктомии у кошекDevelopment of an algorithm for performing high epidural anesthesia during unilateral mastectomy in catshttps://orcid.org/0009-0004-2038-6331МячиковА. Д.MyachikovA. D.

ветеринарный врач 

veterinarian

https://orcid.org/0000-0003-4050-5903ГлазуноваЛ. А.GlazunovaL. A.

д-р. ветеринар. наук, профессор каф. морфологии, физиологии и общей патологии

D.Sc. (Veterinary Medicine), Professor, Department of Morphology, Physiology and General Pathology 

glazunovala@gausz.ruВетеринарная клиника «Стравет»РоссияVeterinary clinic "Stravet"Russian FederationФГБОУ ВО ГАУ Северного ЗауральяРоссияFGBOU VO GAU of the Northern Trans-UralsRussian Federation20250701202603520531Copyright © Мячиков А.Д., Глазунова Л.А., 20252025Мячиков А.Д., Глазунова Л.А.Myachikov A.D., Glazunova L.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vetjournal.spbguvm.ru/jour/article/view/1847

При раке молочной железы у кошек проводят унилатеральную мастэктомию, которая требует качественной анальгезии. В соответствии с международными рекомендациями, мы предлагаем использовать методы регионарной анестезии, в частности, высокую эпидуральную анестезию, простую в исполнении, но требующую точного расчета объема местного анестетика. Для этого необходимо разработать метод, учитывающий длину спинномозгового канала и степень распределения по эпидуральному пространству в разных отделах позвоночника кошки. Целью исследования являлось разработка техники выполнения высокой эпидуральной анестезии при унилатеральной мастэктомии у кошек. В исследовании использовали тридцать кадаверных материалов кошек и десять живых кошек. В результате работы определена необходимая площадь блокады для выполнения унилатеральной мастэктомии у кошек. Для контроля распределения жидкости в эпидуральное пространство вводили смесь рентгено-контрастного раствора Омнипак и местного анестетика Ропивакаин, контролировали контрастирование эпидурального пространства с помощью рентгенологических снимков. Инъекции выполняли поэтапно, последовательно увеличивая суммарный объем раствора и фиксировали изменения в контрастировании на серии рентгенологических снимков. В результате разработан алгоритм для расчёта необходимого объема местного анестетика. Для подтверждения экспериментальных данных на кадаверном материале кошек были произведены клинические испытания метода на живых кошках, подвергшихся унилатеральной мастэктомии по медицинским показаниям. У живых кошек оценивали уровень боли во время и после хирургии используя шкалы оценки боли. Оценена клиническая анальгетическая способность эпидуральной анальгезии во время выполнения унилатеральной мастэктомии кошек, и доказана ее эффективность для анальгезии во время хирургии.

In cats with mammary gland cancer, unilateral mastectomy is performed, which requires high-quality analgesia. In accordance with international recommendations, we propose using regional anesthesia methods, in particular, high epidural anesthesia, which is easy to perform, but requires accurate calculation of the volume of local anesthetic. For this, it is necessary to develop a method that takes into account the length of the spinal canal and the degree of distribution along the epidural space in different parts of the cat's spine. The aim of the study was to develop a technique for performing high epidural anesthesia for unilateral mastectomy in cats. Thirty cat cadaver materials and ten live cats were used in the study. As a result of the work, the required blockade area for performing unilateral mastectomy in cats was determined. To control the distribution of fluid, a mixture of Omnipaque radiopaque solution and Ropivacaine local anesthetic were injected into the epidural space, and the contrasting of the epidural space was controlled using X-ray images. The injections were performed stepwise, consistently increasing the total volume of the solution, and changes in contrast were recorded on a series of radiographic images. As a result, an algorithm was developed for calculating the required volume of local anesthetic. To confirm the experimental data on cat cadaver material, clinical trials of the method were conducted on live cats that underwent unilateral mastectomy for medical reasons. In live cats, pain levels were assessed during and after surgery using pain assessment scales. The clinical analgesic capacity of epidural analgesia during unilateral mastectomy in cats was assessed, and its effectiveness for analgesia during surgery was proven.

кошкиунилатеральная мастэктомияэпидуральная анестезиядлина спинномозгового каналаконтроль рентгеноcatsunilateral mastectomyepidural anesthesiaspinal canal lengthXray controlradiopaque agentscadaver materialanesthetic volume calculationReferencesFrantz L.A.F., Bradley, D.G., Larson, G. et al. Animal domestication in the era of ancient genomics. Nat Rev Genet 21, 449–460 (2020). https://doi.org/10.1038/s41576-020-0225-0.Frantz L.A.F., Bradley, D.G., Larson, G. et al. Animal domestication in the era of ancient genomics. Nat Rev Genet 21, 449–460 (2020). https://doi.org/10.1038/s41576-020-0225-0.De la Flor M, Delgado C, Martínez S, Arenas M, Gómez M, Reig R. Rate of effect of surgical margins after breast conserving surgery and estimation of direct costs. Cir Esp (Engl Ed). 2022 Nov;100(11):702-708. doi: 10.1016/j.cireng.2021.07.016.De la Flor M, Delgado C, Martínez S, Arenas M, Gómez M, Reig R. Rate of effect of surgical margins after breast conserving surgery and estimation of direct costs. Cir Esp (Engl Ed). 2022 Nov;100(11):702-708. doi: 10.1016/j.cireng.2021.07.016.Amorim FV, Souza HJ, Ferreira AM, Fonseca AB. Clinical, cytological and histopathological evaluation of mammary masses in cats from Rio de Janeiro, Brazil. J Feline Med Surg. 2006 Dec;8(6):379-88. https://doi.org/10.1016/j.jfms.2006.04.004.Amorim FV, Souza HJ, Ferreira AM, Fonseca AB. Clinical, cytological and histopathological evaluation of mammary masses in cats from Rio de Janeiro, Brazil. J Feline Med Surg. 2006 Dec;8(6):379-88. https://doi.org/10.1016/j.jfms.2006.04.004.Gemignani F, Mayhew PD, Giuffrida MA, Palaigos J, Runge JJ, Holt DE, Robertson NA, Seguin B, Walker M, Singh A, Liptak JM, Romanelli G, Martano M, Boston SE, Lux C, Busetto R, Culp WTN, Skorupski KA, Burton JH. Association of surgical approach with complication rate, progression-free survival time, and disease-specific survival time in cats with mammary adenocarcinoma: 107 cases (1991-2014). J Am Vet Med Assoc. 2018 Jun 1;252(11):1393-1402. https://doi.org/10.2460/javma.252.11.1393.Gemignani F, Mayhew PD, Giuffrida MA, Palaigos J, Runge JJ, Holt DE, Robertson NA, Seguin B, Walker M, Singh A, Liptak JM, Romanelli G, Martano M, Boston SE, Lux C, Busetto R, Culp WTN, Skorupski KA, Burton JH. Association of surgical approach with complication rate, progressionfree survival time, and disease-specific survival time in cats with mammary adenocarcinoma: 107 cases (1991-2014). J Am Vet Med Assoc. 2018 Jun 1;252(11):1393-1402. https://doi.org/10.2460/javma.252.11.1393.MacEwen EG, Hayes AA, Harvey HJ, Patnaik AK, Mooney S, Passe S. Prognostic factors for feline mammary tumors. J Am Vet Med Assoc. 1984 Jul 15;185(2):201-4.MacEwen EG, Hayes AA, Harvey HJ, Patnaik AK, Mooney S, Passe S. Prognostic factors for feline mammary tumors. J Am Vet Med Assoc. 1984 Jul 15;185(2):201-4. 6. Murphy S. Mammary tumours in dogs and cats. In Practice. 2008;30(6):334–339.Murphy S. Mammary tumours in dogs and cats. In Practice. 2008;30(6):334–339.Petrucci GN, Henriques J, Lobo L, Vilhena H, Figueira AC, Canadas-Sousa A, Dias-Pereira P, Prada J, Pires I, Queiroga FL. Adjuvant doxorubicin vs metronomic cyclophosphamide and meloxicam vs surgery alone for cats with mammary carcinomas: A retrospective study of 137 cases. Vet Comp Oncol. 2021 Dec;19(4):714-723. https://doi.org/10.1111/vco.12660.Petrucci GN, Henriques J, Lobo L, Vilhena H, Figueira AC, Canadas-Sousa A, Dias-Pereira P, Prada J, Pires I, Queiroga FL. Adjuvant doxorubicin vs metronomic cyclophosphamide and meloxicam vs surgery alone for cats with mammary carcinomas: A retrospective study of 137 cases. Vet Comp Oncol. 2021 Dec;19(4):714-723. https://doi.org/10.1111/vco.12660.Stratmann N, Failing K, Richter A, Wehrend A. Mammary tumor recurrence in bitches after regional mastectomy. Vet Surg. 2008 Jan;37(1):82-6. https://doi.org/10.1111/j.1532-950X.2007.00351.x.Stratmann N, Failing K, Richter A, Wehrend A. Mammary tumor recurrence in bitches after regional mastectomy. Vet Surg. 2008 Jan;37(1):82-6. https://doi.org/10.1111/j.1532-950X.2007.00351.x.Moreira CM, Oliveira RL, Costa GA, Corgozinho KB, Luna SP, Souza HJ. Evaluation of tumescent local anesthesia in cats undergoing unilateral mastectomy. Vet Anaesth Analg. 2021 Jan;48(1):134-141. https://doi.org/10.1016/j.vaa.2020.08.006.Moreira CM, Oliveira RL, Costa GA, Corgozinho KB, Luna SP, Souza HJ. Evaluation of tumescent local anesthesia in cats undergoing unilateral mastectomy. Vet Anaesth Analg. 2021 Jan;48(1):134-141. https://doi.org/10.1016/j.vaa.2020.08.006.Luciana G. Teixeira, Diego M. Pujol and Aline F. Pazzim et al. Combination of Transversus abdominis plane block and Serratus plane block anesthesia in dogs submitted to masctetomy. Pesq. Vet. Bras.. 2018. Vol. 38 (2):315-319. https://doi.org/10.1590/1678-5150-pvb-5007.Luciana G. Teixeira, Diego M. Pujol and Aline F. Pazzim et al. Combination of Transversus abdominis plane block and Serratus plane block anesthesia in dogs submitted to masctetomy. Pesq. Vet. Bras.. 2018. Vol. 38(2):315-319. https://doi.org/10.1590/1678-5150-pvb-5007.Kornyushenkov, E.A. Recommendations for anesthesia protocols for elective castrations of dogs and cats (orchifuniculectomy, ovariohysterectomy, and ovariectomy) / E.A. Kornyushenkov, E.V. Turovnikova, E.V. Zakharov, Yu.S. Dorodnykh, A.N. Maltseva, E.S. Vasechkina, V.V. Solovyova, T.B. Krasnova, S.G. Atanasova, E.A. Lezhneva, A.Yu. Pavlyuchenko // Russian Veterinary Journal. - 2023. - No. 2. - P. 5–13. https://doi.org/10.32416/2500-4379-2023-2-5-13. (In Russ.)Корнюшенков, Е.А. Рекомендации протоколов анестезии для проведения плановых кастраций собак и кошек (орхифуникулэктомии, овариогистерэктомии и овариоэктомии) / Е.А. Корнюшенков, Е.В. Туровникова, Е.В. Захаров, Ю.С. Дородных, А.Н. Мальцева, Е.С. Васечкина, В.В. Соловьева, Т.Б. Краснова, С.Г. Атанасова, Е.А. Лежнева, А.Ю. Павлюченко // Российский ветеринарный журнал. — 2023. — № 2. — С. 5–13. https://doi.org/10.32416/2500-4379-2023-2- 5-13.Albrecht E, Chin KJ. Advances in regional anesthesia and acute pain management: a narrative review. Anaesthesia. 2020 Jan;75 Suppl 1:e101-e110. https://doi.org/10.1111/anae.14868.Albrecht E, Chin KJ. Advances in regional anaesthesia and acute pain management: a narrative review. Anaesthesia. 2020 Jan;75 Suppl 1:e101-e110. https://doi.org/10.1111/anae.14868.Bednarski R, Grimm K, Harvey R, Lukasik VM, Penn WS, Sargent B, Spelts K; American Animal Hospital Association. AAHA anesthesia guidelines for dogs and cats. J Am Anim Hosp Assoc. 2011 NovDec;47(6):377-85. https://doi.org/10.5326/JAAHA-MS-5846.Bednarski R, Grimm K, Harvey R, Lukasik VM, Penn WS, Sargent B, Spelts K; American Animal Hospital Association. AAHA anesthesia guidelines for dogs and cats. J Am Anim Hosp Assoc. 2011 NovDec;47(6):377-85. https://doi.org/10.5326/JAAHA-MS-5846.DeRossi R, Hermeto LC, Jardim PHA, de Andrade Bicudo N, de Assis KT. Postoperative pain control in cats: clinical trials with pre-emptive lidocaine epidural coadministered with morphine or methadone. J Feline Med Surg. 2016 Nov;18(11):882-888. https://doi.org/10.1177/1098612X15602738.DeRossi R, Hermeto LC, Jardim PHA, de Andrade Bicudo N, de Assis KT. Postoperative pain control in cats: clinical trials with pre-emptive lidocaine epidural coadministered with morphine or methadone. J Feline Med Surg. 2016 Nov;18(11):882-888. https://doi.org/10.1177/1098612X15602738.Fundamentals of anesthesiology and resuscitation in clinical veterinary medicine of small mammals: a textbook for universities / I. I. Kalyuzhny, P. R. Pulnyashenko, A. V. Yashin [et al.]; edited by I. I. Kalyuzhny, P. R. Pulnyashenko. - 3rd ed., reprinted - St. Petersburg: Lan, 2024. - 236 p.Основы анестезиологии и реаниматологии в клинической ветеринарии мелких млекопитающих животных: учебное пособие для вузов / И. И. Калюжный, П. Р. Пульняшенко, А. В. Яшин [и др.]; под редакцией И. И. Калюжный, П. Р. Пульняшенко. — 3-е изд., стер. — Санкт-Петербург: Лань, 2024. — 236 с.Plemyashov, K. V. Veterinary anesthesiology. General and local anesthesia: a textbook for universities / K. V. Plemyashov, A. A. Stekolnikov, A. Yu. - St. Petersburg: Lan, 2025. - 236 p. Access mode: https://e.lanbook.com/book/439943?category=939&publisher=0.17.Campoy L., Read M. R. (ed.). Small animal regional anesthesia and analgesia. – John Wiley & Sons, 2013 – 304 p. (In Russ.)Племяшов, К. В. Ветеринарная анестезиология. Общая и местная анестезия: учебное пособие для вузов / К. В. Племяшов, А. А. Стекольников, А. Ю. Нечаев. — Санкт-Петербург: Лань, 2025. — 236 с. Режим доступа: https://e.lanbook.com/book/439943?category=939&publisher=0.Jones RS. Epidural analgesia in the dog and cat. Vet J. 2001 Mar;161(2):123-31. https://doi.org/10.1053/tvjl.2000.0528. PMID: 11243684.Campoy L., Read M. R. (ed.). Small animal regional anesthesia and analgesia. – John Wiley & Sons, 2013 – 304 p. 18. Jones RS. Epidural analgesia in the dog and cat. Vet J. 2001 Mar;161(2):123-31. https://doi.org/10.1053/tvjl.2000.0528. PMID: 11243684.Klide AM, Soma LR. Epidural analgesia in the dog and cat. J Am Vet Med Assoc. 1968 Jul 15;153(2):165-73. 20. Machin H, Merlin T, Viscasillas J. Use of ultrasonography to confirm epidural catheter position in a cat. Vet Anaesth Analg. 2018 Sep;45(5):711-713. https://doi.org/10.1016/j.vaa.2018.03.012.Klide AM, Soma LR. Epidural analgesia in the dog and cat. J Am Vet Med Assoc. 1968 Jul 15;153(2):165-73.Lawal FM, Adetunji A. A comparison of epidural anaesthesia with lignocaine, bupivacaine and a lignocaine-bupivacaine mixture in cats. J S Afr Vet Assoc. 2009 Dec;80 (4):243-6. https://doi.org/10.4102/jsava.v80i4.220.Machin H, Merlin T, Viscasillas J. Use of ultrasonography to confirm epidural catheter position in a cat. Vet Anaesth Analg. 2018 Sep;45(5):711-713. https://doi.org/10.1016/j.vaa.2018.03.012.Mariscal Martínez A, Vives Roselló I, Salazar Gómez A, Catanese A, Pérez Molina M, Solà Suarez M, Pascual Miguel I, Blay Aulina L, Ríos Gozálvez C, Julián Ibáñez JF, Rodríguez Martínez P, Martínez Román S, Margelí Vila M, Luna Tomás MA. Advantages of preoperative localization and surgical resection of metastatic axillary lymph nodes using magnetic seeds after neoadjuvant chemotherapy in breast cancer. Surg Oncol. 2021 Mar;36:28-33. https://doi.org/10.1016/j.suronc.2020.11.013.Lawal FM, Adetunji A. A comparison of epidural anaesthesia with lignocaine, bupivacaine and a lignocaine-bupivacaine mixture in cats. J S Afr Vet Assoc. 2009 Dec;80 (4):243-6. https://doi.org/10.4102/jsava.v80i4.220.Couceiro TC, Menezes TC, Valênça MM. Post-mastectomy pain syndrome: the magnitude of the problem. Rev Bras Anestesiol. 2009 May-Jun;59(3):358-65. English, Portuguese. https://doi.org/10.1590/s0034-70942009000300012.Mariscal Martínez A, Vives Roselló I, Salazar Gómez A, Catanese A, Pérez Molina M, Solà Suarez M, Pascual Miguel I, Blay Aulina L, Ríos Gozálvez C, Julián Ibáñez JF, Rodríguez Martínez P, Martínez Román S, Margelí Vila M, Luna Tomás MA. Advantages of preoperative localization and surgical resection of metastatic axillary lymph nodes using magnetic seeds after neoadjuvant chemotherapy in breast cancer. Surg Oncol. 2021 Mar;36:28-33. https://doi.org/10.1016/j.suronc.2020.11.013.Tayari H, Otero PE, D'Agostino M, Bartolini F, Briganti A. Epidural Volume of Injectate Using a Dose Regimen Based on Occipito-Coccygeal Spinal Length (OCL): Randomized Clinical Study Comparing Different Ropivacaine Concentrations, with or without Morphine, in Bitches Undergoing Total Unilateral Mastectomy. Animals (Basel). 2022 Feb 25;12(5):587. https://doi.org/10.3390/ani12050587.Couceiro TC, Menezes TC, Valênça MM. Post-mastectomy pain syndrome: the magnitude of the problem. Rev Bras Anestesiol. 2009 May-Jun;59(3):358-65. English, Portuguese. https://doi.org/10.1590/s0034-70942009000300012.Couceiro TC, Menezes TC, Valênça MM. Post-mastectomy pain syndrome: the magnitude of the problem. Rev Bras Anestesiol. 2009 May-Jun;59(3):358-65. English, Portuguese. https://doi.org/10.1590/s0034-70942009000300012.Tayari H, Otero PE, D'Agostino M, Bartolini F, Briganti A. Epidural Volume of Injectate Using a Dose Regimen Based on Occipito-Coccygeal Spinal Length (OCL): Randomized Clinical Study Comparing Different Ropivacaine Concentrations, with or without Morphine, in Bitches Undergoing Total Unilateral Mastectomy. Animals (Basel). 2022 Feb 25;12(5):587. https://doi.org/10.3390/ani12050587.Tayari H, Otero PE, D'Agostino M, Bartolini F, Briganti A. Epidural Volume of Injectate Using a Dose Regimen Based on Occipito-Coccygeal Spinal Length (OCL): Randomized Clinical Study Comparing Different Ropivacaine Concentrations, with or without Morphine, in Bitches Undergoing Total Unilateral Mastectomy. Animals (Basel). 2022 Feb 25;12(5):587. https://doi.org/10.3390/ani12050587.

The authors declare that there are no conflicts of interest present.