利多卡因-亚甲蓝溶液在犬臂丛、腰丛和坐骨神经阻滞中的染色分布。
Distribution of a lidocaine-methylene blue solution staining in brachial plexus, lumbar plexus and sciatic nerve blocks in the dog.
作者信息
Campoy Luis, Martin-Flores Manuel, Looney Andrea L, Erb Hollis N, Ludders John W, Stewart Jennifer E, Gleed Robin D, Asakawa Makoto
机构信息
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853-6401, USA.
出版信息
Vet Anaesth Analg. 2008 Jul;35(4):348-54. doi: 10.1111/j.1467-2995.2007.00390.x. Epub 2008 Mar 19.
OBJECTIVE
To determine the influence on the distribution of the volume of a local anaesthetic-methylene blue solution at three different nerve block sites in the dog.
STUDY DESIGN
Randomized, controlled, blinded experimental trial.
ANIMALS
23 hound-cross dogs weighing 16-40 kg and aged 2 +/- 0 years (mean +/- SD).
METHODS
Dogs were anaesthetized and randomly assigned to three groups of seven or eight dogs each, based on volume administered: low, medium and high volume (L, M and H). Using electrolocation, the injection was performed after a positive response was elicited (flexion of the elbow for the brachial plexus block, quadriceps contractions for the lumbar plexus and dorsiflexion/plantar extension of the foot for the sciatic nerve block). At the brachial plexus site, groups L, M and H received 0.075, 0.15 and 0.3 mL kg(-1), respectively. At the lumbar plexus site, groups L, M and H received 0.1, 0.2 and 0.4 mL kg(-1), respectively. At the proximal sciatic nerve site, groups L, M and H received 0.05, 0.1 and 0.25 mL kg(-1), respectively. Necropsies were performed immediately following euthanasia. Staining of > or =2 cm along the nerve was considered sufficient; the proportions sufficient were compared with Fisher's exact test. The volume was recommended when all the relevant nerves were stained sufficiently in all or all but one of the dogs within the group.
RESULTS
In the brachial plexus, only in group H were all the nerves stained sufficiently. In the lumbar plexus site, no statistical difference was found, but we suggest the H group volume to balance sufficient and excessive staining. At the sciatic nerve site, all volumes tested produced sufficient staining in all (or all but one) dogs.
CONCLUSIONS AND CLINICAL RELEVANCE
Volumes of 0.3 and 0.05 mL kg(-1) produced sufficient distribution for performing brachial plexus, and sciatic nerve blocks, respectively. Additionally, a volume of 0.4 mL kg(-1) might also be adequate for a lumbar plexus block (no statistical significance was reached).
目的
确定局部麻醉药-亚甲蓝溶液在犬的三个不同神经阻滞部位的体积分布情况。
研究设计
随机、对照、盲法实验性试验。
动物
23只杂种猎犬,体重16 - 40千克,年龄2±0岁(平均±标准差)。
方法
对犬进行麻醉,并根据给药体积随机分为三组,每组七或八只犬:低、中、高剂量组(L、M和H)。使用电定位法,在引出阳性反应(臂丛神经阻滞时肘部屈曲、腰丛神经阻滞时股四头肌收缩、坐骨神经阻滞时足部背屈/跖屈)后进行注射。在臂丛神经阻滞部位,L、M和H组分别接受0.075、0.15和0.3 mL·kg⁻¹。在腰丛神经阻滞部位,L、M和H组分别接受0.1、0.2和0.4 mL·kg⁻¹。在坐骨神经近端阻滞部位,L、M和H组分别接受0.05、0.1和0.25 mL·kg⁻¹。安乐死后立即进行尸检。沿神经染色≥2厘米被认为是足够的;将足够染色的比例用Fisher精确检验进行比较。当组内所有或除一只外的所有犬的所有相关神经都充分染色时,推荐该体积。
结果
在臂丛神经阻滞中,仅H组所有神经均充分染色。在腰丛神经阻滞部位,未发现统计学差异,但我们建议H组的体积以平衡充分染色和过度染色。在坐骨神经阻滞部位,所有测试体积在所有(或除一只外的所有)犬中均产生了足够的染色。
结论及临床意义
0.3和0.05 mL·kg⁻¹的体积分别为臂丛神经阻滞和坐骨神经阻滞产生了足够的分布。此外,0.4 mL·kg⁻¹的体积也可能适用于腰丛神经阻滞(未达到统计学显著性)。