Zhang Di, Nishimura Ryohei, Nagahama Shotaro, Iseri Toshie, Mochizuki Manabu, Nakagawa Takayuki, Sasaki Nobuo
Laboratory of Veterinary Emergency Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Japan.
J Vet Med Sci. 2011 Dec;73(12):1573-7. doi: 10.1292/jvms.11-0165. Epub 2011 Jul 29.
To compare the technical difficulty and safety of epidural catheterization between cranial and caudal lumbar region, thirteen dogs were randomly assigned to a cranial lumbar group (group CraL, n=6) or a caudal lumbar group (group CauL, n=6) depending on different epidural sites, and one dog was used as a negative control without catheterization. After general anesthesia, an epidural catheter was advanced 10 cm cranially from the interspace of L1-L2 in group CraL or from lumbosacral space in group CauL. Dogs were euthanized and catheter position and tip location were confirmed by laminectomy. Spinal cord samples were examined by macro- and microscopic observations. Success rate, time taken for epidural space confirmation and catheter insertion were compared, and overall technical difficulty was evaluated subjectively. Epidural catheter was inserted successfully in all dogs. Time needed from needle skin puncture to catheter placement and saline injection was 226 ± 63 and 229 ± 26 sec in groups CraL and CauL without significant differences. Three dogs in group CraL suffered subcutaneous blood, but no spinal cord injuries were found. Subjective evaluation score of the overall technical difficulty was slightly but significantly higher in group CraL than in group CauL (P=0.009). Epidural catheterization in cranial lumbar region could be performed as feasible and safe as that at the caudal lumbar vertebral region in medium or large dogs.
为比较颅侧腰椎区域和尾侧腰椎区域硬膜外导管置入术的技术难度和安全性，根据不同的硬膜外穿刺部位，将13只犬随机分为颅侧腰椎组（CraL组，n = 6）或尾侧腰椎组（CauL组，n = 6），1只犬作为未进行导管置入的阴性对照。全身麻醉后，在CraL组从L1-L2间隙向颅侧推进硬膜外导管10 cm，在CauL组从腰骶间隙推进。对犬实施安乐死后，通过椎板切除术确认导管位置和尖端位置。对脊髓样本进行大体和显微镜观察。比较成功率、确认硬膜外间隙和插入导管所需时间，并主观评估总体技术难度。所有犬均成功插入硬膜外导管。CraL组和CauL组从针刺皮肤到放置导管和注射生理盐水所需时间分别为226±63秒和229±26秒，无显著差异。CraL组有3只犬出现皮下出血，但未发现脊髓损伤。CraL组总体技术难度的主观评估得分略高于CauL组，但差异有统计学意义（P = 0.009）。在中大型犬中，颅侧腰椎区域的硬膜外导管置入术与尾侧腰椎区域的硬膜外导管置入术一样可行且安全。
