Malton R, Nagy A
Dubai Stable Veterinary Clinic, Dubai, United Arab Emirates.
Old Town, Dubai, United Arab Emirates.
Equine Vet J. 2015 Sep;47 Suppl 48:15. doi: 10.1111/evj.12486_33.
Diffusion of local anaesthetic solution after a mid-pastern ring block has not been investigated.
To demonstrate potential distribution of local anaesthetic solution following injection of radiodense contrast medium as performed for a mid-pastern ring block.
Experimental.
Twelve mature horses were used. One and a half ml radiodense contrast medium was injected over the medial or lateral palmar digital nerve at the level of the proximal aspect of the ungular cartilages. A dorsal ring block was performed on the ipsilateral side, 1.5 cm proximal to the palpable palmar aspect of the proximal eminence of the middle phalanx, using 2 or 5 ml contrast medium. Both forelimbs were injected on 2 days (48 injections). Four standard radiographic views of the pastern were obtained immediately, 10 and 20 min after injections. Images were analysed subjectively and objectively.
After dorsal injections the contrast medium was distributed in a diffuse patch over the ipsilateral half of the proximal phalanx (PP), extending proximally over the half of the length of PP in all limbs (greatest proximal extension: 89.0% of the length of PP [from distal] after 2 ml, 94.2% after 5 ml). There was significant proximal diffusion in the first 10 min after injection and significant dorsal diffusion between all time points (P<0.01). There was significant positive association between injected volume and the proximal extension of the dorsal contrast patch (P = 0.01). The median dorsal diffusion was to the dorsal midline of PP; 5 ml contrast medium resulted in significantly greater dorsal diffusion than 2 ml (P<0.01). The dorsal and the palmar contrast patches did not merge.
Diffusion to the proximal aspect of P1 occurred even after injection of only 2 ml contrast medium. Fetlock region pain may be influenced by a mid-pastern ring block. Ethical animal research: Written consent had been obtained from a representative of the horses' owner prior to starting the study.
None. Competing interests: None declared.
尚未对掌中部环形阻滞术后局部麻醉溶液的扩散情况进行研究。
展示在进行掌中部环形阻滞时注射放射性造影剂后局部麻醉溶液的潜在分布情况。
实验性研究。
使用12匹成年马。在蹄软骨近端水平,于掌内侧或外侧指神经处注射1.5毫升放射性造影剂。在同侧距中节指骨近端隆起可触及的掌侧1.5厘米处进行背侧环形阻滞,使用2或5毫升造影剂。在两天内对两前肢进行注射(共48次注射)。在注射后即刻、10分钟和20分钟获取掌部的四张标准X线片。对图像进行主观和客观分析。
背侧注射后,造影剂在近节指骨(P1)同侧半部呈弥漫性片状分布,在所有肢体中向近端延伸至P1长度的一半(最大近端延伸:2毫升注射后为P1长度的89.0%[从远端起],5毫升注射后为94.2%)。注射后前10分钟有显著的近端扩散,且在所有时间点之间存在显著的背侧扩散(P<0.01)。注射量与背侧造影剂片状分布的近端延伸之间存在显著正相关(P = 0.01)。背侧扩散的中位数至P1的背侧中线;5毫升造影剂导致的背侧扩散显著大于2毫升(P<0.01)。背侧和掌侧造影剂片状分布未融合。
即使仅注射2毫升造影剂,也会扩散至P1近端。掌中部环形阻滞可能会影响系关节区域疼痛。动物伦理研究:在研究开始前已获得马主代表的书面同意。
无。利益冲突:未声明。