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在犊牛中比较有超声引导和无超声引导的椎旁阻滞技术。

Comparison of paravertebral blockade techniques with and without ultrasound guidance in calves.

作者信息

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

出版信息

Am J Vet Res. 2016 Nov;77(11):1187-1193. doi: 10.2460/ajvr.77.11.1187.

Abstract

OBJECTIVE To compare the effectiveness of an ultrasound-guided paravertebral nerve blockade technique (UGPNB) with distal and proximal paravertebral nerve blockade techniques without ultrasound guidance (DPNB and PPNB, respectively) in calves. ANIMALS 4 calf cadavers and 7 healthy calves. PROCEDURES A suitable acoustic window was identified to facilitate access to the T13, L1, and L2 spinal nerves in cadavers and live calves. In cadavers, nerves were injected with dye under ultrasound guidance. In calves, the UGPNB, DPNB, and PPNB were performed in random order at 10-day intervals by injection of an anesthetic solution containing 2% lidocaine hydrochloride. Nociceptive withdrawal responses were assessed to determine the effects of the blockades. RESULTS In cadavers, nerve staining success rates (ie, ≥ 2-cm-long dye path) achieved with ultrasound guidance were 88% (T13 [ventral branch]), 75% (T13 and L1 [dorsal branches] and L1 and L2 [ventral branches]), and 38% (L2 [dorsal branch]). The nerves were each identified as a hyperechoic band in a longitudinal plane. In calves, the UGPNB, DPNB, and PPNB reduced the withdrawal response to the noxious stimulus, mainly in the dorsal-cranial, dorsal-caudal, and ventral-cranial areas of the flank. Overall, the UGPNB resulted in a better nociceptive cumulative score, administering only one half of the local anaesthetic dose, compared with findings for the DPNB and PPNB. However, time to perform the UGPNB was longer. CONCLUSIONS AND CLINICAL RELEVANCE The UGPNB evaluated may be an improved alternative to the DPNB and PPNB for provision of anesthesia for flank surgery in calves. However, effectiveness of the UGPNB should be evaluated in a clinical setting and in adult cattle.

摘要

目的 比较超声引导下椎旁神经阻滞技术(UGPNB)与非超声引导下远端和近端椎旁神经阻滞技术(分别为DPNB和PPNB)在犊牛中的有效性。

动物 4头犊牛尸体和7头健康犊牛。

方法 在尸体和活体犊牛中确定合适的声学窗口,以利于接近T13、L1和L2脊神经。在尸体中,在超声引导下向神经注射染料。在犊牛中,以随机顺序每隔10天进行UGPNB、DPNB和PPNB,注射含2%盐酸利多卡因的麻醉溶液。评估伤害性退缩反应以确定阻滞效果。

结果 在尸体中,超声引导下神经染色成功率(即染料路径长度≥2 cm)分别为88%(T13[腹侧支])、75%(T13和L1[背侧支]以及L1和L2[腹侧支])和38%(L2[背侧支])。在纵切面中,每条神经均被识别为高回声带。在犊牛中,UGPNB、DPNB和PPNB均降低了对有害刺激的退缩反应,主要在胁腹的背颅侧、背尾侧和腹颅侧区域。总体而言,与DPNB和PPNB相比,UGPNB导致更好的伤害性累积评分,且仅使用了一半的局部麻醉剂剂量。然而,进行UGPNB的时间更长。

结论及临床意义 所评估的UGPNB可能是为犊牛胁腹手术提供麻醉的一种优于DPNB和PPNB的替代方法。然而,UGPNB的有效性应在临床环境和成年牛中进行评估。

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