Combined inter‐transversospinalis and erector spinae plane blocks for perioperative analgesia in a cat undergoing cervical injection‐site sarcoma excision

Abstract
An 11‐year‐old, 5.8‐kg, neutered, male European shorthair cat was presented for surgical excision of an extensive injection‐site sarcoma affecting the thoraco‐cervical region. Premedication consisted of methadone, dexmedetomidine and alfaxalone, followed by induction with alfaxalone and maintenance with isoflurane. Perioperative analgesia was provided through a combination of ultrasound‐guided erector spinae (ESP) and inter‐transversospinalis plane (ITP) blocks, using ropivacaine 0.25% at a total dose of 2 mg/kg. The anaesthetic course was stable, and a single bolus of fentanyl (2 µg/kg intravenously) was administered during partial left scapulectomy. Postoperative analgesia was provided by intermittent administration of ropivacaine 0.5% (2 mg/kg every 8 hours) through a wound‐soaker catheter. Pain scores remained low during the 48‐hour monitoring period, and no rescue analgesia was required. This case highlights the feasibility and potential benefits of combining ESP and ITP blocks to achieve effective thoraco‐cervical analgesia in cats undergoing extensive dorsal soft‐tissue surgery.