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超声引导下犊牛盆腔肢体的麻醉阻滞

Ultrasound-guided anaesthetic blockade of the pelvic limb in calves.

作者信息

Re Michela, Blanco-Murcia Javier, Villaescusa Fernández Alejandra, De Gaspar Simón Ignacio, Gómez de Segura Ignacio A

机构信息

Department of Animal Medicine and Surgery, Veterinary Faculty, University Complutense, Avda, Puerta de Hierro s/n. 28040, Madrid, Spain.

Department of Anatomy and Embryology, Veterinary Faculty, University Complutense, Avda, Puerta de Hierro s/n. 28040, Madrid, Spain.

出版信息

Vet J. 2014 Jun;200(3):434-9. doi: 10.1016/j.tvjl.2014.04.010. Epub 2014 Apr 18.

Abstract

This study aimed to describe a suitable acoustic window to facilitate access to the sciatic and femoral nerves in calves and to study the effects of their blockade with local anaesthetics. The neuroanatomical and ultrasound (US) study was performed on the cadavers of 10 calves, and the effects of 2% lidocaine with epinephrine (0.2 mL/kg) were determined in five healthy calves. The sciatic nerve in the cadavers was easily visualised as a hyperechoic band distal to the femoral greater trochanter and caudal to the femoral shaft. The femoral nerve in the cadavers was not easily identified, and was visualised as a hyperechoic oval structure situated immediately medial to the psoas major muscle and lateral to the femoral artery. The sciatic nerve was stained by methylene blue, injected under US guidance, in 9/10 cases, and the femoral nerve was stained in 6/10 cases. Sciatic nerve blockade under US guidance produced adduction of the limb with metatarsophalangeal joint flexion, while the femoral nerve blockade produced reduced weight bearing. The sciatic nerve blockade produced a reduced response to the noxious stimulus, mainly in the phalanges, proximal and distal metatarsus, tarsus and tibia and, following the femoral nerve blockade, in the medial subarea of the femur. However, femoral nerve blockade produced a more variable degree of blockade. In conclusion, US -guided anaesthetic blockade of the sciatic nerve in calves may be considered for surgery in the distal pelvic limb, although further studies are necessary to determine its clinical application.

摘要

本研究旨在描述一个合适的声学窗口,以利于在犊牛中触及坐骨神经和股神经,并研究局部麻醉药对其进行阻滞的效果。对10头犊牛的尸体进行了神经解剖学和超声(US)研究,并在5头健康犊牛中测定了2%利多卡因加肾上腺素(0.2 mL/kg)的效果。尸体中的坐骨神经很容易被看作是股骨大转子远端、股骨干后方的高回声带。尸体中的股神经不容易识别,被看作是紧位于腰大肌内侧、股动脉外侧的高回声椭圆形结构。在超声引导下,10例中有9例坐骨神经被亚甲蓝染色并注射,10例中有6例股神经被染色。超声引导下的坐骨神经阻滞导致肢体内收并伴有跖趾关节屈曲,而股神经阻滞导致负重减轻。坐骨神经阻滞使对伤害性刺激的反应减弱,主要在趾骨、近侧和远侧跖骨、跗骨和胫骨,股神经阻滞后,在股骨内侧分区也有反应减弱。然而,股神经阻滞产生的阻滞程度变化更大。总之,尽管需要进一步研究以确定其临床应用,但对于犊牛远端盆腔肢体的手术,可考虑超声引导下对坐骨神经进行麻醉阻滞。

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