Freitag Flavio Av, Gaio Thalise S, Dos Santos Amanda Am, Muehlbauer Eloisa, Machado Marcello, Duque Juan Cm
Veterinary Sciences Graduate Program, Department of Veterinary Medicine, Federal University of Paraná, Curitiba, PR, Brazil.
Anatomy Department, Biological Science Sector, Federal University of Paraná, Curitiba, PR, Brazil.
Vet Anaesth Analg. 2020 Jan;47(1):88-94. doi: 10.1016/j.vaa.2019.08.003. Epub 2019 Aug 27.
To evaluate the anatomy of the serratus plane in dogs to establish the optimal landmarks for a superficial serratus plane (SSP) block and evaluate ropivacaine-methylene blue solution dispersion with three volumes of injection.
Prospective experimental cadaveric study.
A formaldehyde solution-preserved dog cadaver and 15 frozen/thawed adult dog cadavers.
The thoracic wall of the formaldehyde-preserved cadaver was dissected. An SSP injection was performed on each hemithorax of the cadavers, with the ultrasound transducer placed over the fourth and fifth ribs, at the level of the shoulder joint. A needle was inserted in-plane in a caudocranial direction until it could be visualized between the serratus ventralis thoracis and latissimus dorsi muscles. Dog cadavers were injected with a ropivacaine-methylene blue solution at 0.3, 0.6 and 1.0 mL kg and were dissected to determine the spread of the dye.
The thoracic wall muscles identified in the formalinized cadaver were the cutaneous trunci, latissimus dorsi, external abdominal oblique, serratus ventralis thoracis, scalenus, serratus dorsalis cranialis and external intercostal. The nerves identified in the SSP included the lateral cutaneous branches of intercostal nerves, intercostobrachial nerves and long thoracic nerve. The solution was successfully injected at the SSP in 26 of 29 (89.7%) attempts. Dermatomal dye spread, median (range), was 4 (3-6), 4 (2-5) and 5 (4-8) for 0.3, 0.6 and 1.0 mL kg, respectively, with no significant difference among them.
Injections for an SSP block were easily performed under ultrasound guidance, using the fourth and fifth ribs at the level of the shoulder joint as reference landmarks. An injected volume of 0.3 mL kg may be sufficient for hemithorax analgesia in dogs. Further studies in dogs are required to determine the utility of this technique.
评估犬锯齿肌平面的解剖结构，以确定浅表锯齿肌平面（SSP）阻滞的最佳标志，并评估三种注射体积的罗哌卡因 - 亚甲蓝溶液的扩散情况。
前瞻性实验尸体研究。
一具用甲醛溶液保存的犬尸体和15具冷冻/解冻的成年犬尸体。
解剖用甲醛保存的尸体的胸壁。在尸体的每个半胸进行SSP注射，超声探头置于肩关节水平的第四和第五肋骨上方。沿尾颅方向平面内插入一根针，直到在胸外侧锯肌和背阔肌之间可见。给犬尸体分别注射0.3、0.6和1.0 mL/kg的罗哌卡因 - 亚甲蓝溶液，然后解剖以确定染料的扩散情况。
在福尔马林固定的尸体中识别出的胸壁肌肉有躯干皮肌、背阔肌、腹外斜肌、胸外侧锯肌、斜角肌、颅背侧锯肌和肋间外肌。在SSP中识别出的神经有肋间神经的外侧皮支、肋间臂神经和胸长神经。29次尝试中有26次（89.7%）成功在SSP注射溶液。0.3、0.6和1.0 mL/kg时皮节染料扩散的中位数（范围）分别为4（3 - 6）、4（2 - 5）和5（4 - 8），它们之间无显著差异。
在超声引导下，以肩关节水平的第四和第五肋骨作为参考标志，SSP阻滞注射操作简便。0.3 mL/kg的注射量可能足以用于犬的半胸镇痛。需要在犬身上进行进一步研究以确定该技术效用。
