Department of Clinical Sciences, Auburn University, JT Vaughan Teaching Hospital, Alabama, USA.
Equine Vet J. 2013 Jan;45(1):31-5. doi: 10.1111/j.2042-3306.2012.00579.x. Epub 2012 May 6.
The role of the communicating branch between the medial and lateral palmar nerves of horses (i.e. the ramus communicans) in conveying sensory impulses proximally should be determined to avoid errors in interpreting diagnostic anaesthesia of the palmar nerves.
Sensory nerve fibres in the ramus communicans of horses pass proximally from the lateral palmar nerve to merge with the medial palmar nerve, but not vice versa.
To determine the direction of sensory impulses through the ramus communicans between lateral and medial palmar nerves.
Pain in a thoracic foot was created with set-screw pressure applied to either the medial or lateral aspect of the sole of each forelimb of 6 horses. The palmar nerve on the side of the sole in which pain was created was anaesthetised proximal to the ramus communicans with local anaesthetic. Lameness was evaluated objectively by using a wireless, inertial, sensor-based, motion analysis system (Lameness Locator). Lameness was also evaluated subjectively by using a graded scoring system. Local anaesthetic was then administered adjacent to the ramus communicans to determine the effect of anaesthesia of the ramus communicans on residual lameness.
When pain originated from the medial or the lateral aspect of the sole, anaesthesia of the ipsilateral palmar nerve proximal to the ramus communicans did not entirely resolve lameness. Anaesthesia of the ramus communicans further attenuated or resolved lameness.
Sensory fibres pass in both directions in the ramus communicans to connect the medial and lateral palmar nerves.
When administering a low palmar nerve block, both palmar nerves should be anaesthetised distal to the ramus communicans to avoid leaving nondesensitised sensory nerve fibres passing through this neural connection. Alternatively, local anaesthetic could also be deposited adjacent to the ramus communicans when anaesthetising the palmar nerves.
确定马掌中部和侧掌皮神经之间的交通支(即交通支)在近端传递感觉冲动的作用,以避免在解读掌皮神经诊断麻醉时出现错误。
马掌交通支中的感觉神经纤维从侧掌皮神经向近端传递,与掌皮神经合并,但反之则不然。
确定侧掌皮神经和中掌皮神经之间交通支中感觉冲动的传递方向。
通过在每匹马前肢脚掌的内侧或外侧施加螺丝压力来在胸部脚部产生疼痛。在脚掌疼痛产生的一侧,在交通支近端用局部麻醉剂对掌皮神经进行麻醉。使用无线、惯性、基于传感器的运动分析系统(跛行定位器)客观评估跛行。也使用分级评分系统对跛行进行主观评估。然后在交通支附近给予局部麻醉剂,以确定交通支麻醉对残余跛行的影响。
当疼痛源自脚掌的内侧或外侧时,在交通支近端对同侧掌皮神经进行麻醉并不能完全缓解跛行。交通支麻醉进一步减轻或消除了跛行。
感觉纤维在交通支中双向传递,连接中掌皮神经和侧掌皮神经。
当进行低掌皮神经阻滞时,应在交通支远端对掌皮神经进行麻醉,以避免留下未感觉的感觉神经纤维通过这种神经连接。或者,在麻醉掌皮神经时,也可以在交通支附近放置局部麻醉剂。