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Douglas S. Castro Fernando Garcia-Pereira Robson F. Giglio 《Veterinary anaesthesia and analgesia》2018,45(4):566-574
Objective
To evaluate an ultrasound-guided technique for adductor canal (AC) block by describing the distribution of methylene blue around the AC, popliteal fossa, saphenous, tibial and common fibular nerves in dog cadavers.Study design
Prospective experimental trial.Animals
Ten mixed breed canine cadavers weighing 28.55 ± 3.94 kg.Methods
Ultrasound scans of the AC were performed bilaterally in 10 canine cadavers. A high-frequency linear transducer was placed on the long axis of the pectineus muscle and using an in-plane technique, an insulated needle was introduced at a proximal to distal direction into the AC. Methylene blue 0.1% (0.3 mL kg?1) was administered followed by dissection. The presence of dye over the target nerves for ≥2 cm was considered successful distribution. Three of 10 cadavers were submitted to computed tomography (CT) and one of them to magnetic resonance (MR) evaluation.Results
Methylene blue reached the AC in 20 (100%) and the popliteal fossa in 17 (85%) pelvic limbs. Staining was successful in the saphenous nerve (4.0 ± 1.57 cm) in 11 (55%) limbs, tibial nerve (2.65 ± 0.8 cm) in six (30%) and common fibular nerve (2.7 ± 0.9 cm) in four (20%). There was no evidence of staining around the motor branches of the femoral nerve. No intraneural or intravascular dye spread was found during dissections. Contrast distribution to the popliteal fossa was observed in three limbs (50%) in CT and in one (50%) MR image.Conclusions and clinical relevance
Although the tibial and common fibular nerves were not stained as often as the saphenous nerve, dye was encountered throughout the popliteal fossa near the nerves. The AC block may be useful for intra and postoperative analgesia in stifle surgery with minimal femoral motor dysfunction. However, further study is required to confirm its efficacy and safety in vivo. 相似文献3.
Fernando L. Garcia-Pereira Daniel Boruta Sharon Tenenbaum Vaidehi Paranjape 《Veterinary anaesthesia and analgesia》2018,45(5):703-706
Objective
To investigate the utility of identifying the superficial circumflex iliac artery (SCIA) via ultrasound as an anatomical landmark for ultrasound-guided femoral nerve block.Study design
Observational study.Animals
A group of six canine cadavers weighing >20 kg.Methods
Pelvic limbs from six canine cadavers were examined to study the relationship between the SCIA and the femoral nerve. Ultrasonographic imaging of the SCIA in each limb was obtained with the transducer placed transversely in the medial aspect of the pelvic limb at the inguinal area. Subsequently, a needle was inserted in close proximity to the femoral nerve using an in-plane technique based on the anatomical relationship between the SCIA and femoral nerve. A total of 0.1 mL of colored latex was then injected at the location where the femoral nerve was expected to be in relationship to the SCIA. Gross dissection of the inguinal region in each pelvic limb was performed after injection. Positive nerve location was defined when the colored latex was in contact with the femoral nerve.Results
A total of eleven pelvic limbs were injected because the SCIA could not be successfully visualized in one limb. Upon dissection, colored latex was found to be in direct contact with the femoral nerve in all 11 injected limbs.Conclusions and clinical relevance
We concluded that the ultrasonographic visualization of the SCIA assisted in the accurate deposition of dye in proximity to the femoral nerve of canine cadavers. Further investigation will determine the efficacy of this technique for performing femoral nerve blocks. 相似文献4.
Tatiana H. Ferreira Leandro B.C. Teixeira Carrie A. Schroeder Cristina de Miguel Garcia Kristopher M. Schroeder 《Veterinary anaesthesia and analgesia》2018,45(6):811-819
Objectives
To describe an ultrasound-guided thoracic paravertebral block and determine the distribution after injection of two volumes of methylene blue in dog cadavers.Study design
Prospective experimental cadaveric study.Animals
Twelve dog cadavers weighing 11 ± 3 kg.Methods
Ultrasound-guided injections aimed at the fifth thoracic (T5) paravertebral space were performed in randomized order using 0.1 or 0.3 mL kg–1 dye solution (six dogs for each volume). Anatomic dissections determined dye spread characteristics, including the presence and degree of staining of spinal nerves, and the presence of intercostal and sympathetic trunk spread. Staining of mediastinum, epidural, intrapleural and contralateral thoracic paravertebral space was recorded.Results
There was no significant difference in dye distribution between groups. The use of anatomic landmarks resulted in the inaccurate identification of the T5 paravertebral space. The T4, T5 and T6 paravertebral spaces were injected in four, five and three of 12 dogs, respectively. Complete staining of the spinal nerve of the thoracic paravertebral space injected was observed in 11 of 12 dogs, and partial staining in one dog in the low-volume group. Multisegmental distribution was demonstrated with staining of contiguous spinal nerves in one dog in the high-volume group, and multiple segments of intercostal (three dogs) and sympathetic trunk (four dogs) spread in both groups. No mediastinal, epidural, intrapleural or contralateral thoracic paravertebral space staining was observed.Conclusions and clinical relevance
Ultrasound-guided injection at the thoracic paravertebral space resulted in staining of the spinal nerve in all dogs. However, T5 paravertebral space was not accurately identified using anatomic landmarks. Dye distribution was not significantly different between the two groups; therefore, the use of the lower-volume and multiple-site injections would be potentially necessary in clinical cases to achieve ipsilateral blockade of the thoracic wall. 相似文献5.
Vincent Marolf Helene Rohrbach Géraldine Bolen Anne-Sophie Van Wijnsberghe Charlotte Sandersen 《Veterinary anaesthesia and analgesia》2019,46(1):106-115
Objective
To develop a modified ultrasound-guided parasacral approach to the sciatic nerve and compare the effects of a volume of 0.2 mL kg–1 of 0.5% levobupivacaine with an equivalent volume of 0.9% saline injected near the sciatic nerve.Study design
Cadaveric and experimental, blinded, randomized study.Animals
Seven canine cadavers and seven experimental Beagle dogs.Methods
Both sciatic nerves of seven cadavers were identified using a modified in-plane ultrasound-guided approach. Methylene blue solution (0.2 mL) was injected perineurally, and success was evaluated through dissection. The same approach was repeated in seven Beagle dogs sedated with dexmedetomidine (50 μg kg–1) injected intramuscularly (IM). After randomization, 0.2 mL kg–1 of 0.5% levobupivacaine (limb L) and 0.2 mL kg–1 of 0.9% saline (limb C) were injected perineurally on either right or left limb. Block success was determined by sensory deficits every hour for 8 hours after an atipamezole injection (0.2 mg kg–1) IM. Reaction to pinprick (binary score) over the course of the sciatic nerve (four locations) and locomotion were assessed.Results
The overall sciatic nerve block success was 93% in cadavers and 86% in sedated dogs. It was impossible to localize the sciatic nerves in one obese sedated dog. Significant differences between limb L and limb C were observed for pinprick at great trochanter, caudal thigh and lateral tarsal joint (p < 0.0001). Reaction to pinprick was absent in all dogs at great trochanter and caudal thigh up to at least 3 hours on limb L. Locomotion was impaired in all but one dog for 60 (30–210) minutes (median; interquartile range). No complications were observed.Conclusions and clinical relevance
A volume of ≥0.2 mL kg–1 and a concentration of 0.5% levobupivacaine can be recommended when using a modified ultrasound-guided parasacral approach to the sciatic nerve in dogs. 相似文献6.
Objective
To describe a transorbital approach to the maxillary nerve block in dogs and compare it with a traditional approach.Study design
Prospective, randomized controlled study.Animals
Heads from 17 euthanized dogs (10 Greyhounds, three Border Collies and four of mixed breed).Methods
A volume of 1 mL of methylene blue dye was injected by each of two techniques, a traditional percutaneous approach and a transorbital approach to the maxillary nerve block. Both techniques were used on each head, alternating the left and right sides after random assignment to the first head. The heads were dissected to reveal the maxillary nerve and the length of nerve stained was measured.Results
There was no significant difference (p = 0.67) in the proportion of nerves stained for a length >6 mm by either technique (88.2% transorbital versus 82.3% percutaneous). The mean length of nerve stained did not differ significantly between the techniques (p = 0.26).Conclusions and clinical relevance
The transorbital approach to the maxillary nerve block described here presents a viable alternative to the traditional percutaneous approach. Further study is required to confirm its efficacy and safety under clinical conditions. 相似文献7.
Two-point ultrasound-guided transversus abdominis plane injection in canine cadavers – a pilot study
Emma K. Johnson Sébastien H. Bauquier Jennifer E. Carter Ted Whittem Thierry Beths 《Veterinary anaesthesia and analgesia》2018,45(6):871-875
Objective
This study evaluated the spread of a two-point transversus abdominis plane (TAP) injection in canine cadavers. Compared with previous techniques, the two-point TAP injection was developed to increase the consistency of local anaesthetic spread to the nerve segments T11, T12, L1, L2 and L3.Study design
Prospective experimental trial.Animals
Five fresh canine cadavers.Methods
Two-point TAP injections were performed under ultrasound guidance by a single trained individual in canine cadavers (15.7–43.0 kg). Each hemi-abdomen was infiltrated and evaluated independently for a total of 10 evaluations of the technique. The first injection was performed at the level of the costo-chondral junction of the thirteenth rib, and the second injection was performed cranial to the tuber coxae. Each injection comprised 0.3 mL kg–1 methylene blue solution (0.0015 mg mL–1). Ten minutes after the injections, abdominal wall dissection was performed, and any nerves stained for a minimum of 10 mm along their long axis were identified and recorded.Results
During all injections, separation of the internal oblique and transversus abdominis muscles was observed on ultrasound. On dissection, branches of T12, T13, L1, L2 and L3 were adequately stained in 30%, 100%, 100%, 90% and 90% of injections, respectively. No staining of branches of T11 occurred in any of the cadavers. In one hemi-abdomen, branches of L1 and L3, but not L2, were stained.Conclusions and clinical relevance
This study indicates that the two-point TAP injection delivers consistent dye dispersion to adequately stain branches of T13, L1, L2 and L3, with no coverage of T11 and poor coverage of T12, in fresh canine cadavers. An in vivo study using local anaesthetic should be performed to evaluate the analgesic efficacy of this technique in mid to caudal abdominal surgeries. 相似文献8.
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Diego A. Portela Luis Campoy Pablo E. Otero Manuel Martin-Flores Robin D. Gleed 《Veterinary anaesthesia and analgesia》2017,44(3):636-645
Objective
To describe ultrasound-visualized anatomy and the spread characteristics of a dye injected in the thoracic paravertebral (TPV) space under ultrasound guidance.Study design
Anatomic cadaver study.Animals
Seven dog cadavers.Methods
One cadaver was used to observe, identify, and describe the relevant TPV anatomy. In the remaining six, the left fifth TPV space was randomly assigned to be injected with either a low volume (LV; 0.05 mL kg?1) or high volume (HV; 0.15 mL kg?1) of dye. Subsequently, the contralateral side was injected with the alternative volume. Anatomic dissections were conducted to determine the incidence of complete spinal nerve staining (>1 cm circumferential coverage), number of contiguous spinal nerves dyed and the absence or presence of solution in particular locations.Results
The ultrasound-visualized anatomy of the TPV space was defined as the intercostal space abaxial to the vertebral body, delimited by the parietal pleura ventrally and the internal intercostal membrane dorsally. The endothoracic fascia divides the paravertebral space into dorsal and ventral compartments. The target nerve was completely dyed in five of six and six of six injections in the LV and HV conditions, respectively. In one LV injection, the nerve was partially dyed. No multisegmental spread affecting contiguous spinal nerves was found in either treatment. Multisegmental spread was found in the ventral compartment of the TPV space, affecting the sympathetic trunk on 3 (0–3) and 3.5 (1–6) vertebral spinal levels in the LV and HV conditions, respectively, but differences between volumes were not significant. No intrapleural, ventral mediastinal or epidural migration was observed.Conclusions and clinical relevance
Ultrasound-guided TPV block is a potentially reliable technique. The LV appeared sufficient to dye a single spinal nerve and multiple sympathetic trunk vertebral levels. Multiple TPV injections may be needed to provide adequate thoracic analgesia in dogs undergoing thoracic surgery. 相似文献10.
Paolo Monticelli Ian Jones Jaime Viscasillas 《Veterinary anaesthesia and analgesia》2017,44(4):968-972
Objective
To describe an ultrasound-guided thoracic paravertebral block in canidae.Study design
Prospective, experimental, cadaveric study.Animals
Twelve thawed fox cadavers.Methods
A 15 MHz linear transducer was used to visualize the paravertebral space at the level of the fifth thoracic vertebrae. Iohexol (300 mg mL?1) at 0.2 mL kg?1 was injected into the right and left paravertebral spaces under ultrasound guidance using a Tuohy needle. The needle was advanced in a lateral to medial direction using an in-plane technique. Injections were performed by two operators, each performing 12 injections in six fox cadavers. A thoracic computed tomography was then performed and evaluated by a single operator. The following features were recorded: paravertebral contrast location (yes/no), length of contrast column (number of intercostal spaces), location of contrast relative to the fifth thoracic vertebrae (cranial/caudal/mixed), epidural contrast contamination (yes/no), pleural contrast contamination (yes/no) and mediastinal contrast contamination (yes/no).Results
All injections resulted in paravertebral contrast distribution (24/24). The mean length of the contrast column was five intercostal spaces. Contrast spread was caudal to the injection site in 54% (7/24), cranial in 29% (4/24) and mixed in 17% (3/24). Pleural contamination was observed in 50% (12/24) of injections; 42% (10/24) and 4% (1/24) of the injections resulted in mediastinal and epidural contamination, respectively.Conclusions and clinical relevance
Injection of the paravertebral space in canidae is possible using the technique described. Possible complications include epidural, pleural and mediastinal contamination. To establish clinical efficacy and safety of this technique, further studies are required. 相似文献11.
Luciano C.B.A. da Silva Fábio P. Sellera Ronaldo G. Gargano Thais C. Rossetto Giancarlo B. Gomes Fabiano T. Miyahira Fábio Futema Silvia R.G. Cortopassi 《Veterinary anaesthesia and analgesia》2017,44(3):684-687
Objective
To evaluate the use of an experimental colloid model for teaching veterinary anesthesia residents ultrasound-guided technique for nerve blockade.Study design
Prospective, blinded and randomized.Methods
Colloid models were constructed for practice in ultrasound-guided needle location. Nine veterinary anesthesia residents with no prior experience of ultrasound-guided technique for nerve blocks were randomly divided into three groups. Each group received theoretical orientation. Two groups were assigned to practical training using the experimental model: group 1 (G1) received 2 hours of training and group 2 (G2) received 1 hour of training prior to testing with specific tasks. Group 3 (G3) received no practical training. During testing, the time required for task completion (e.g., display of structures and positioning a needle) and the number of failures were recorded.Results
The average times to completion of the tasks and the number of technical failures were: G1, 47 seconds and 1 failure; G2, 68 seconds and 2 failures; G3, 187 seconds and 7 failures.Conclusions and clinical relevance
In residents with no prior experience of ultrasound-guided needle placement, using an experimental colloid model and a longer training period was associated with increased accuracy and decreased time to task completion. Based on the results of this study, training with an experimental model can be recommended to improve the speed and accuracy of needle manipulation using ultrasound in clinicians with no prior experience of ultrasound-guided technique. 相似文献12.
Stephanie Stauffer Beckie Cordner Jonathon Dixon Thomas Witte 《Veterinary anaesthesia and analgesia》2017,44(4):951-958
Objective
The aim of this preliminary proof-of-concept study was to evaluate and compare the success and complication rate of infiltration of the maxillary nerve of cadaver heads using previously described surface landmarks, standard ultrasound and a novel needle guidance positioning ultrasound system (SonixGPS).Study design
Prospective, anatomical, method-comparison study.Animals
Thirty-eight equine cadaver heads.Methods
Twenty-six veterinary students performed the three methods consecutively on cadaver heads using an 18 gauge, 8.9 cm spinal needle and 0.5 mL iodinated contrast medium. Computed tomography was used to quantify success (deposition of contrast in contact with the maxillary nerve) and complication rate (contrast identified within surrounding vasculature or periorbital structures) associated with each method.Results
Perineural injection of the maxillary nerve was attempted 76 times, with an overall success rate of 65.8% (50/76) and complication rate of 53.9% (41/76). Success rates were 50% (13/26) with surface landmark, 65.4% (17/26) with standard ultrasound guidance and 83.3% (20/24) with SonixGPS guidance approaches (Fisher's exact test, p = 0.046). No significant difference in complication rate was found between the three methods.Conclusions
Ultrasound-guided maxillary nerve blocks were significantly more successful than surface landmark approaches when performed by inexperienced operators, and the highest success rate was achieved with guidance positioning system (GPS) needle guidance.Clinical relevance
Local anaesthesia of the equine maxillary nerve in the fossa pterygopalatina is frequently used for diagnostic and surgical procedures in the standing sedated horse. Due to vague superficial landmarks with various approaches and the need for experience via ultrasound guidance, this block remains challenging. GPS guidance may improve reliability of maxillary and other nerve blocks, and allow a smaller volume of local anaesthetic solution to be used, thereby improving specificity and reducing the potential for side effects. 相似文献13.
Description of a regional anaesthesia technique for the dorsal cranium in the dog: a cadaveric study
Yishai Kushnir Gal S. Marwitz Yael Shilo-Benjamini Joshua Milgram 《Veterinary anaesthesia and analgesia》2018,45(5):684-694
Objective
To identify landmarks and to describe a technique for nerve blockade of the dorsal cranium in dogs.Study design
Anatomic cadaveric study.Animals
A total of 39 dog cadavers, weighing 18.0 ± 9.7 kg (mean ± standard deviation).Methods
The study was performed in three parts. In the initial part, cadavers were dissected to determine the location of the frontal, zygomaticotemporal, and major occipital nerves, and to identify prominent landmarks for their blockade. In the second part, one technique was developed to block each of the frontal and zygomaticotemporal nerves, and two techniques, rostral and caudal, were developed to block the major occipital nerve. Injection solution was 0.05% methylene blue in 0.5% bupivacaine. In the third part, cadavers were used to test the techniques developed in the second part with 0.04 mL kg?1 of the same injectate administered at each site (maximal volume 0.5 mL per site). The length of nerve stained was measured, with a length ≥6 mm considered successful. Confidence intervals were calculated using Fisher’s exact test.Results
Success rates (95% confidence interval) for the frontal, zygomaticotemporal, and rostral and caudal locations for the major occipital nerve were 94% (80–99%), 91% (76–98%), 74% (58–86%) and 77% (59–89%), respectively. With a combination of both locations, the success rate for the major occipital nerve was 100% (90–100%).Conclusion and clinical relevance
This study describes a simple regional anaesthesia technique using palpable anatomical landmarks that may provide analgesia for dogs undergoing craniotomy. 相似文献14.
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Ignacio Lizarraga Fernanda Castillo-Alcala Lauren S. Robinson 《Veterinary anaesthesia and analgesia》2017,44(3):509-517
Objective
To assess and compare the sedative and antinociceptive effects of four dosages of dexmedetomidine in donkeys.Study design
Randomized, controlled, crossover, Latin-square, blinded study.Animals
Six healthy, castrated, adult, standard donkeys.Methods
Dexmedetomidine (2, 3, 4 and 5 μg kg?1; D2, D3, D4 and D5), acepromazine (0.1 mg kg?1) and saline were administered intravenously to each donkey and a 1 week interval was allowed between successive trials on each animal. Sedation scores (SS) and head heights above ground (HHAG) were used to assess sedation and mechanical nociceptive threshold (MNT) testing to assess antinociception over 120 minutes post-treatment. Areas under the curve (AUC) for 0–30, 30–60 and 60–120 minutes were computed to compare the effect of treatments.Results
SS-AUC0–30 values were larger for D4 and D5, and SS-AUC30–60 values were larger for D5 than for saline. All dexmedetomidine treatments produced lower HHAG-AUC0–30 and HHAG-AUC30–60 values, and acepromazine produced lower HHAG AUC60–120 values than did saline. For MNT, D3, D4 and D5 increased AUC0–30 and AUC30–60 values compared with saline and also AUC0–30 values compared with D2 and acepromazine. Smaller MNT-AUC30–60 values were obtained with D2 than with D4 and D5, with D3 than with D5, and with acepromazine than with D4 and D5.Conclusions and clinical relevance
Dexmedetomidine induced sedation and dosage-dependent mechanical antinociception. Larger dexmedetomidine dose rates were required to induce antinociception than sedation. Furthermore, the antinociception induced by dexmedetomidine was of shorter duration than its sedation. For minor painful procedures on standing donkeys, D5 may be clinically useful to provide sedation and analgesia. 相似文献16.
Jenelle Izer Ronald Wilson Krista Hernon Akif Ündar 《Veterinary anaesthesia and analgesia》2017,44(1):133-137
Objective
To describe an ultrasound-guided approach for venous and arterial vascular access and catheterization in anesthetized adult Yorkshire cross-bred pigs.Study design
Prospective experimental study.Animals
Ten adult female Yorkshire cross-bred pigs, weighing 78.4 ± 5.6 kg (mean ± standard deviation).Methods
Using ultrasound guidance and the Seldinger technique, a 7 Fr, 20 cm triple-lumen central venous catheter was placed in the external jugular vein and an 18 gauge, 16 cm catheter was placed in the femoral artery. The success rate of catheterization and the incidence of catheter patency over 24 hours of general anesthesia were recorded.Results
Catheterization of the external jugular vein was successful in 10 out of 10 pigs and catheterization of the femoral artery was successful in eight out of 10 pigs. A surgical dissection technique on the femoral artery was performed in two pigs. Venous and arterial catheter patency was maintained in all pigs over the 24 hour study period.Conclusions and clinical relevance
Ultrasound guidance resulted in success rates of 100% for catheterization of the external jugular vein and 80% for catheterization of the femoral artery in anesthetized adult Yorkshire cross-bred pigs. This technique is a noninvasive, easily performed alternative to surgical exposure of the vessels in large pigs undergoing surgical instrumentation for biomedical device testing. 相似文献17.
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Alicia Skelding Alexander Valverde Melissa Sinclair Jeffrey Thomason Noel Moens 《Veterinary anaesthesia and analgesia》2018,45(2):203-211
Objectives
To describe the ventral spinal nerve rami contribution to the formation of the brachial plexus (BP), and to compare ease of performing and nerve staining between three blind techniques for BP blockade in dogs.Study design
Prospective, randomized, blind study.Animals
A total of 18 dog cadavers weighing 28.2 ± 9.7 kg (mean ± standard deviation).Methods
Dogs were randomly assigned to two of three BP treatments: traditional approach (TA), perpendicular approach (PA), and axillary approach (AA). Dye (0.2 mL kg?1) was injected in the left BP using a spinal needle; another BP treatment was used in the right BP. Landmarks (L) included: L1, midpoint between point of the shoulder and sixth cervical (C6) transverse process; L2, scapulohumeral joint; and L3, first rib. For TA, the needle was introduced craniocaudally through L1, medial to the limb and cranial to L3. For PA, the needle was directed perpendicular and caudal to L2, aligned with L1, until cranial to L3. For AA, the needle was directed ventrodorsally, parallel and cranial to L3 until at L1. All BPs were scored for dyeing quality [0 (poor) to 5 (excellent)]. The left BP was dissected for nerve origins. Durbin test was used to compare scores (p < 0.05).Results
In all dogs, the musculocutaneous nerve originated from C7 and C8; the radial nerve from C8, the first thoracic vertebra (T1) (16/18 dogs) and C7 (2/18); and the median and ulnar nerves from C8, T1 (17/18) and C7 (1/18). Respective raw scores and adjusted scores for the incomplete block design were not significantly different (p = 0.72; ranks TA 16.5, PA 19.0, AA 18.5).Conclusions and clinical relevance
The musculocutaneous, median, ulnar and radial nerves originate from C7, C8 and T1. Regardless of the technique, knowledge of anatomy and precise landmarks are relevant for correct dye dispersion. 相似文献19.
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Yael Shilo-Benjamini Peter J. Pascoe Erik R. Wisner Nili Kahane Philip H. Kass David J. Maggs 《Veterinary anaesthesia and analgesia》2017,44(4):925-932