Sarwal Aarti, Cartwright Michael S, Mitchell Erin, Williams Koudy, Walker Francis O, Childers Martin K
Section on Critical Care Medicine, Department of Anesthesiology Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, 27157-1009, USA; Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Muscle Nerve. 2015 Feb;51(2):287-9. doi: 10.1002/mus.24493.
We describe a unique method that combines ultrasound and electromyography to guide intramuscular diaphragm injections in anesthetized large animals.
Ultrasound was used to visualize the diaphragm on each side of spontaneously breathing, anesthetized beagle dogs and cynomolgus macaques. An electromyography (EMG) needle was introduced and directed by ultrasound to confirm that the needle entered the muscular portion of the diaphragm, and methylene blue was injected. Injection accuracy was confirmed upon necropsy by tracking the spread of methylene blue.
All methylene blue injections were confirmed to have been placed appropriately into the diaphragm.
This study demonstrates the feasibility and accuracy of using ultrasound and EMG to guide injections and to reduce complications associated with conventional blind techniques. Ultrasound guidance can be used for clinical EMG of the diaphragm. Future applications may include targeted diaphragm injections with gene replacement therapy in neuromuscular diseases.
我们描述了一种独特的方法，该方法结合超声和肌电图来指导在麻醉的大型动物中进行膈肌内注射。
在自主呼吸的麻醉比格犬和食蟹猕猴中，使用超声可视化双侧膈肌。引入肌电图（EMG）针并通过超声引导，以确认针进入膈肌的肌肉部分，然后注射亚甲蓝。尸检时通过追踪亚甲蓝的扩散来确认注射准确性。
所有亚甲蓝注射均被证实已正确注入膈肌。
本研究证明了使用超声和EMG指导注射并减少与传统盲目技术相关并发症的可行性和准确性。超声引导可用于膈肌的临床肌电图检查。未来的应用可能包括在神经肌肉疾病中进行基因替代疗法的靶向膈肌注射。
