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犬类尸体超声引导下肋下斜行腹横肌平面阻滞

Ultrasound-guided subcostal oblique transversus abdominis plane block in canine cadavers.

作者信息

Drożdżyńska Maja, Monticelli Paolo, Neilson David, Viscasillas Jaime

机构信息

Clinical Sciences and Services, Royal Veterinary College, Queen Mother Hospital for Animals, Hatfield, UK.

Clinical Sciences and Services, Royal Veterinary College, Queen Mother Hospital for Animals, Hatfield, UK.

出版信息

Vet Anaesth Analg. 2017 Jan;44(1):183-186. doi: 10.1111/vaa.12391. Epub 2017 Feb 23.

Abstract

OBJECTIVES

To describe the ultrasound-guided transversus abdominis plane (TAP) block using a subcostal oblique approach in dog cadavers and to evaluate the spread of a methylene blue solution using a multiple-injection technique.

STUDY DESIGN

Prospective, descriptive, experimental anatomic study.

ANIMALS

Nine adult Beagle cadavers weighing a mean ± standard deviation of 13 ± 2 kg.

METHODS

Methylene blue solution (10.0 mL) was injected bilaterally within the fascia that overlies the transversus abdominis muscle in dog cadavers under ultrasound guidance. A total of three injections (3.3 mL each) were administered on each side by the same operator. Dissection was performed by a second operator 20 minutes later. Successful nerve staining was defined as the presence of dye on the nerve for a length of >1 cm.

RESULTS

Ventral branches of the T9, T10, T11, T12 and T13 nerves innervating the cranial abdominal wall were stained in 72%, 95%, 100%, 95% and 61% of cases, respectively. Ventral branches of L1 and L2 innervating the caudal abdominal wall were stained in only 33% and 11% of cases, respectively. The dye was found only in the fascia between the transversus abdominis and the internal oblique muscles.

CONCLUSIONS AND CLINICAL RELEVANCE

The ultrasound-guided subcostal oblique TAP block provided adequate staining of the sensory innervation of the cranial abdominal wall. Further studies are required to evaluate the efficacy of this technique in blocking the nociceptive response in clinical procedures.

摘要

目的

描述在犬类尸体中使用肋下斜入路的超声引导下腹横肌平面(TAP)阻滞,并使用多次注射技术评估亚甲蓝溶液的扩散情况。

研究设计

前瞻性、描述性、实验解剖学研究。

动物

9只成年比格犬尸体,平均体重±标准差为13±2千克。

方法

在超声引导下,向犬类尸体腹横肌上方的筋膜内双侧注射亚甲蓝溶液(10.0毫升)。由同一名操作者在每侧总共进行三次注射(每次3.3毫升)。20分钟后由第二名操作者进行解剖。成功的神经染色定义为神经上存在长度>1厘米的染料。

结果

支配腹壁前部的T9、T10、T11、T12和T13神经的腹侧支染色率分别为72%、95%、100%、95%和61%。支配腹壁后部的L1和L2神经的腹侧支染色率分别仅为33%和11%。染料仅在腹横肌和腹内斜肌之间的筋膜中发现。

结论及临床意义

超声引导下肋下斜入路TAP阻滞对腹壁前部的感觉神经支配提供了充分的染色。需要进一步研究来评估该技术在临床操作中阻断伤害性反应的疗效。

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