Artificial Intelligence in Veterinary Neurology: Comparative Insights From Human Medicine and Cross-Species Technology Transfer.

Video-assisted thoracoscopic surgery (VATS) has become a widely adopted alternative to open thoracotomy because it is associated with less surgical trauma and faster recovery [,]. However, despite its minimally invasive nature, multiport VATS is still associated with considerable postoperative pain, particularly during early mobilization [,]. Effective perioperative pain management is therefore essential to facilitate recovery, reduce opioid consumption and its associated adverse effects, and improve postoperative outcomes. Regional nerve blocks provide rapid, long-lasting analgesia and have become an integral component of multimodal analgesic strategies for thoracic surgery. Thoracic epidural anesthesia (TEA) has long been regarded as the gold standard for analgesia after thoracic surgery. However, its relatively high incidence of adverse effects, including hypotension and urinary retention, limits its compatibility with enhanced recovery after surgery (ERAS) protocols. Thoracic paravertebral block (TPVB) offers effective postoperative analgesia after thoracoscopic surgery and has emerged as a suitable alternative to TEA for managing post-thoracoscopic pain []. Despite its clinical effectiveness, TPVB presents technical challenges because the needle is advanced close to the pleura, increasing the risk of complications such as hypotension, chest wall hematoma, pneumothorax, and inadvertent epidural spread []. The rhomboid intercostal block (RIB) is a relatively novel fascial plane block for chest wall analgesia that provides sensory coverage of the surgical incision while positioning the injection site away from the thoracic cavity and major vascular structures []. Our previous study demonstrated that a single-shot RIB provided postoperative recovery outcomes that were non-inferior to those achieved with a single-shot TPVB following thoracoscopic surgery []. However, three-port thoracoscopic surgery involves multiple incisions across different thoracic dermatomes, and it remains uncertain whether a single injection can provide adequate analgesic coverage. Previous studies have shown that local anesthetic injected into the fascial plane between the rhomboid major and intercostal muscles can spread from T2 to T9 [], and a two-point injection technique may further improve anesthetic distribution across the three-port surgical field.