Viscasillas Jaime, Seymour Christopher J, Brodbelt David C
Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, UK.
Vet Anaesth Analg. 2013 Mar;40(2):212-9. doi: 10.1111/j.1467-2995.2012.00781.x. Epub 2012 Sep 27.
To compare the success by inexperienced anaesthetists of using a modified infraorbital approach to the maxillary nerve with the traditional percutaneous approach.
Prospective, randomized, blinded controlled study.
Heads from 37 euthanized Beagle and Beagle cross dogs.
Four anaesthetists were recruited to perform two different approaches to block the maxillary nerve of the cadavers. The infraorbital (I) approach advanced an intravenous catheter along the infraorbital canal. Earlier measurements from scans of similar heads were used to assess suitable catheter size. The percutaneous (P) approach introduced a needle percutaneously just below the ventral border of the zygomatic arch. The side of the head where the technique was to be performed was randomized. A total volume of 0.5 mL methylene blue was injected in each approach. After completion of injections, head dissections were performed by an investigator unaware of the approach used and staining of the maxillary and pterygopalatine nerves was evaluated. Chi squared analysis examined the relationship between the methods (p < 0.05). Complications related to the techniques, such as intravascular/intraneural injection and location of the dye, were evaluated macroscopically.
Maxillary nerve staining >6 mm was found in 64.9% (I) versus 21.6% (P) attempts; staining <6 mm was found in 27% (I) versus 21.6% (P); and no nerve staining 8.1% (I) versus 56.8% (M). Pterygopalatine nerve staining was found in 70% (I) versus 21% (P). The infraorbital approach demonstrated significantly higher maxillary and pterygopalatine nerve staining compared to the percutaneous approach (p = 0.001 for both nerves). No evidence of intravascular/intraneural injections was found.
The infraorbital approach was more successful than the percutaneous approach when performed by inexperienced anaesthetists. No macroscopic complications were observed.
比较经验不足的麻醉医生采用改良眶下途径阻滞上颌神经与传统经皮途径的成功率。
前瞻性、随机、双盲对照研究。
37只安乐死的比格犬和比格杂交犬的头部。
招募4名麻醉医生对尸体的上颌神经进行两种不同的阻滞方法。眶下（I）途径是沿眶下管推进一根静脉导管。利用之前对类似头部扫描的测量结果来评估合适的导管尺寸。经皮（P）途径是在颧弓腹侧缘下方经皮插入一根针。将进行操作的头部一侧随机分配。每种途径均注射0.5 mL亚甲蓝。注射完成后，由一名不了解所采用途径的研究人员进行头部解剖，并评估上颌神经和翼腭神经的染色情况。采用卡方分析检验两种方法之间的关系（p < 0.05）。宏观评估与技术相关的并发症，如血管内/神经内注射及染料的位置。
上颌神经染色>6 mm的情况在眶下途径（I）的尝试中占64.9%，而经皮途径（P）为21.6%；染色<6 mm的情况在眶下途径（I）为27%，经皮途径（P）为21.6%；无神经染色的情况在眶下途径（I）为8.1%，经皮途径（P）为56.8%。翼腭神经染色在眶下途径（I）为70%，经皮途径（P）为21%。与经皮途径相比，眶下途径的上颌神经和翼腭神经染色明显更高（两种神经的p值均为0.001）。未发现血管内/神经内注射的证据。
经验不足的麻醉医生采用眶下途径比经皮途径更成功。未观察到宏观并发症。
