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超声在肥胖犬硬膜外注射中的应用。

The use of ultrasound to assist epidural injection in obese dogs.

作者信息

da Silva Luciano Cba, Pacheco Paula F, Sellera Fábio P, Futema Fábio, Cortopassi Silvia Rg

机构信息

Department of Surgery, School of Veterinary Medicine, Metropolitan University of Santos, São Paulo, SP, Brazil; Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.

Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.

出版信息

Vet Anaesth Analg. 2020 Jan;47(1):137-140. doi: 10.1016/j.vaa.2019.10.003. Epub 2019 Oct 22.

Abstract

OBJECTIVE

To evaluate the use of ultrasound for identifying the site for needle puncture and to determine the depth to the epidural space in obese dogs.

STUDY DESIGN

Prospective study in dogs undergoing elective orthopedic surgery.

ANIMALS

A group of seven obese Labrador male dogs aged 6.93 ± 2.56 years and weighing 46.5 ± 4.1 kg (mean ± standard deviation).

METHODS

The anesthetic protocol for these dogs included epidural anesthesia. With the dogs anesthetized and positioned in sternal recumbency with the pelvic limbs flexed forward, ultrasound imaging was used to locate the lumbosacral intervertebral space. Intersection of dorsal and transverse lines about the probe identified the point of needle insertion. A 17 gauge, 8.9 cm Tuohy needle was inserted perpendicularly through the skin and advanced to the lumbosacral intervertebral space. The number of puncture attempts was recorded and needle depth was compared with skin to ligamentum flavum distance.

RESULTS

Epidural injection was performed in all dogs at the first attempt of needle insertion. The distance from skin to epidural space was 5.95 ± 0.62 cm measured by ultrasound and 5.89 ± 0.64 cm measured with the Tuohy needle. These measurements were not different (p = 0.26). A highly significant correlation coefficient of 0.966 between measurement techniques was obtained (p < 0.001).

CONCLUSIONS AND CLINICAL RELEVANCE

Ultrasound imaging identified the point of needle insertion for lumbosacral epidural injection in seven obese dogs. The results indicate that ultrasound can be used to locate the lumbosacral intervertebral space and identify an appropriate point for needle insertion to perform epidural injection.

摘要

目的

评估超声在确定肥胖犬穿刺部位及测定至硬膜外腔深度方面的应用。

研究设计

对接受择期骨科手术的犬进行前瞻性研究。

动物

一组7只肥胖雄性拉布拉多犬,年龄6.93±2.56岁,体重46.5±4.1千克(均值±标准差)。

方法

这些犬的麻醉方案包括硬膜外麻醉。犬麻醉后呈胸骨卧位,后肢向前屈曲,使用超声成像定位腰骶椎间隙。探头周围背侧线与横线的交点确定进针点。将一根17号、8.9厘米的Tuohy针垂直穿过皮肤,推进至腰骶椎间隙。记录穿刺尝试次数,并将针的深度与皮肤至黄韧带的距离进行比较。

结果

所有犬在首次进针时均成功进行了硬膜外注射。超声测量皮肤至硬膜外腔的距离为5.95±0.62厘米,Tuohy针测量为5.89±0.64厘米。这些测量结果无差异(p = 0.26)。两种测量技术之间的相关系数为0.966,具有高度显著性(p < 0.001)。

结论及临床意义

超声成像确定了7只肥胖犬腰骶部硬膜外注射的进针点。结果表明,超声可用于定位腰骶椎间隙,并确定进行硬膜外注射的合适进针点。

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