Ferreira Tatiana H, St James Mariko, Schroeder Carrie A, Hershberger-Braker Karen L, Teixeira Leandro B C, Schroeder Kristopher M
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.
Vet Anaesth Analg. 2019 Jul;46(4):516-522. doi: 10.1016/j.vaa.2019.03.002. Epub 2019 Mar 27.
To describe a technique to perform an ultrasound-guided erector spinae plane (ESP) block and determine the distribution and potential complications after injection of two volumes of methylene blue in dog cadavers.
Prospective experimental cadaveric study.
A total of eight dog cadavers weighing 9.3 ± 1.9 kg.
Ultrasound-guided injections dorsal to the transverse process and ventral to the erector spinae muscles aimed at the fifth thoracic transverse process were performed bilaterally in each dog using 0.5 and 1.0 mL kg dye solution [low volume (LV) and high volume (HV) treatments, respectively]. Treatments were randomly assigned to the right or left side of each dog, resulting in a total of 16 injections. Anatomical dissections determined dye spread characteristics, including epaxial muscles spread, staining of spinal nerves, dorsal rami, ventral rami (intercostal nerves) and sympathetic trunk spread. Staining indicating potential complications (epidural, mediastinal and intrapleural spread) was recorded.
There was complete staining of at least one dorsal ramus following all injections. A more extensive spread was observed along the muscles in the HV compared with LV (p = 0.036). No significant difference between multisegmental dorsal rami spread (six out of eight injections in each treatment) was noted. Out of 16 injections, one in LV treatment resulted in multisegmental spinal nerve staining and one in HV treatment resulted in ventral ramus (intercostal nerve) staining. Use of anatomic landmarks resulted in inaccurate identification of the fifth transverse process in at least six out of 16 injections (38%). No sympathetic trunk, epidural, mediastinal or intrapleural staining was observed.
Ultrasound-guided ESP injections resulted in extensive staining along the epaxial muscles, as well as staining of the dorsal rami in all dogs. The incidence of dorsal rami mutisegmental spread was the same in both treatments.
描述一种进行超声引导下竖脊肌平面（ESP）阻滞的技术，并确定在犬尸体中注射两体积亚甲蓝后的分布及潜在并发症。
前瞻性实验性尸体研究。
总共8只体重为9.3±1.9千克的犬尸体。
在每只犬双侧进行超声引导下注射，注射部位在横突背侧和竖脊肌腹侧，目标为第五胸椎横突，分别使用0.5和1.0 mL/kg的染料溶液[分别为低容量（LV）和高容量（HV）治疗]。治疗随机分配至每只犬的右侧或左侧，共进行16次注射。解剖确定染料扩散特征，包括轴上肌扩散、脊神经、背支、腹支（肋间神经）染色及交感干扩散情况。记录表明潜在并发症（硬膜外、纵隔和胸膜内扩散）的染色情况。
所有注射后至少有一支背支完全染色。与LV相比，HV组沿肌肉的扩散更广泛（p = 0.036）。各治疗组多节段背支扩散情况无显著差异（每组8次注射中有6次）。在16次注射中，LV治疗组有1次导致多节段脊神经染色，HV治疗组有1次导致腹支（肋间神经）染色。使用解剖标志导致在16次注射中至少6次（38%）对第五横突的识别不准确。未观察到交感干、硬膜外、纵隔或胸膜内染色。
超声引导下ESP注射导致所有犬的轴上肌广泛染色以及背支染色。两种治疗中背支多节段扩散的发生率相同。
