Comparison of ultrasound-guided sciatic nerve block with inFiLtration Around Genicular Structures (FLAGS) in dogs undergoing cranial cruciate ligament repair.

FLAGS block provides superior motor preservation compared to sciatic nerve block for canine stifle surgery.

This randomized prospective clinical trial compared two regional anesthetic techniques for dogs undergoing cranial cruciate ligament repair: ultrasound-guided sciatic nerve block (caudal approach) versus local anesthetic infiltration around genicular structures (FLAGS). Twenty-eight dogs were randomly allocated to receive either sciatic nerve block or FLAGS block, with both groups also receiving saphenous nerve blocks under general anesthesia. Bupivacaine 0.5% at 0.1 ml/kg was used for all blocks. Intraoperative rescue analgesia was provided if hemodynamic parameters increased more than 20% from baseline for over 2 minutes. Postoperative motor function was assessed at 2 hours by evaluating patellar, sciatic, gastrocnemius, cranial tibial, and withdrawal reflexes. The FLAGS group demonstrated significantly lower total motor scores (0, range 0-5) compared to the sciatic nerve block group (3, range 0-8), indicating less motor function impairment. No animals in either group required intraoperative rescue analgesia. These findings suggest FLAGS provides superior motor-sparing properties while maintaining adequate analgesia for stifle surgery in dogs.

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