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犬臂丛神经超声引导与电刺激引导神经阻滞的比较。

Comparison of ultrasound- and electrostimulation-guided nerve blocks of brachial plexus in dogs.

作者信息

Akasaka Minori, Shimizu Miki

机构信息

Department of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan.

Department of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan.

出版信息

Vet Anaesth Analg. 2017 May;44(3):625-635. doi: 10.1016/j.vaa.2016.08.001. Epub 2017 Jan 11.

Abstract

OBJECTIVE

To compare the effectiveness of ultrasound- and electrostimulation-guided nerve blocks of the brachial plexus and to determine whether ultrasound guidance is feasible in conscious dogs.

STUDY DESIGN

Blinded, crossover, experimental study.

ANIMALS

Six clinically healthy adult Beagle dogs.

METHODS

The nerves of the brachial plexus of the right thoracic limb were blocked under ultrasound guidance (UNB) in conscious dogs and under electrostimulation guidance (ENB) in anesthetized dogs with bupivacaine (0.4 mL kg, 0.25%). Saline (0.4 mL kg) was injected in control animals. Sensory nerve blockade was evaluated by scoring cutaneous sensation in targeted nerves. Motor nerve blockade was evaluated based on weight bearing, conscious proprioception and withdrawal reflex scores. Times to execute the technique in UNB and ENB were compared using t tests (p < 0.05). Scores for sensory and motor nerve blockades in each treatment were compared with scores before treatment and with control treatment scores using nonparametric repeated-measures two-way analysis of variance. Time to onset and duration of sensory nerve block were assessed using scores for four sensory nerve functions. A successful sensory nerve block was defined by decreases in scores for these functions. Success rates of nerve blocks were compared among treatments using McNemar's test.

RESULTS

In UNB and ENB, onset times of sensory nerve blocks were 1 hour and 1.5 hours, respectively. Onset times of motor nerve blocks were 0.5 hour in both treatments. In UNB and ENB, durations of sensory nerve block were 3 hours and 0.5 hour, respectively, and durations of motor nerve block were 7.5 hours and 6.5 hours, respectively. Success rates did not differ between the techniques.

CONCLUSIONS AND CLINICAL RELEVANCE

The UNB brachial plexus block had a shorter onset time and longer duration than ENB. UNB can be performed in conscious dogs or those under mild sedation.

摘要

目的

比较超声引导和电刺激引导下臂丛神经阻滞的效果,并确定超声引导在清醒犬中是否可行。

研究设计

盲法、交叉、实验研究。

动物

6只临床健康的成年比格犬。

方法

在清醒犬中,于超声引导(超声引导下神经阻滞,UNB)下对右胸肢的臂丛神经进行阻滞;在麻醉犬中,于电刺激引导(电刺激引导下神经阻滞,ENB)下用布比卡因(0.4 mL/kg,0.25%)进行阻滞。对照动物注射生理盐水(0.4 mL/kg)。通过对目标神经的皮肤感觉进行评分来评估感觉神经阻滞。基于负重、意识本体感觉和退缩反射评分来评估运动神经阻滞。使用t检验比较在UNB和ENB中执行该技术的时间(p < 0.05)。使用非参数重复测量双向方差分析比较每种治疗中感觉和运动神经阻滞的评分与治疗前评分以及对照治疗评分。使用四种感觉神经功能的评分评估感觉神经阻滞的起效时间和持续时间。这些功能评分降低定义为成功的感觉神经阻滞。使用McNemar检验比较各治疗组间神经阻滞的成功率。

结果

在UNB和ENB中,感觉神经阻滞的起效时间分别为1小时和1.5小时。两种治疗中运动神经阻滞的起效时间均为0.5小时。在UNB和ENB中,感觉神经阻滞的持续时间分别为3小时和0.5小时,运动神经阻滞的持续时间分别为7.5小时和6.5小时。两种技术的成功率无差异。

结论及临床意义

与ENB相比,UNB臂丛神经阻滞的起效时间更短,持续时间更长。UNB可在清醒犬或轻度镇静的犬中进行。

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