Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
Vet Anaesth Analg. 2020 Mar;47(2):249-258. doi: 10.1016/j.vaa.2019.12.005. Epub 2019 Dec 31.
To describe a quadratus lumborum (QL) block technique in canine cadavers and the spread of injectate.
Prospective, randomized, descriptive, experimental anatomic study.
A group of 12 adult canine cadavers.
Gross and ultrasound anatomy of the sublumbar musculature and the relationship with the spinal nerves was studied in two cadavers. Bilateral ultrasound-guided injections were performed in eight cadavers in the fascial plane between the QL and psoas muscle using a dye-lidocaine solution [low volume (LV) 0.15 mL kg or high volume (HV) 0.3 mL kg]. The ultrasound transducer was positioned caudal and parallel to the proximal aspect of the last rib, and an insulated needle was introduced in-plane using a ventrolateral to dorsomedial approach. Dissections were performed to determine the number of spinal nerves successfully stained (>1 cm) and the presence of injectate in the epidural space or abdominal cavity. Additionally, two cadavers were transversally cryosectioned after QL injection.
Ventral branches of the last thoracic and first three lumbar spinal nerves ran between the bundles of the QL muscle and between the QL and psoas muscles. The target fascial plane was ultrasonographically identified and filled with the dye solution following all injections. Ventral branches of the thirteenth thoracic and first, second and third lumbar nerves were stained by 0.0%, 71.4%, 100%, 100%, and 25%, 100%, 100%, 100% using LV and HV, respectively. Multisegmental spread stained the lumbar sympathetic trunk on 0 (0-3) and 3 (0-4) vertebral levels with LV and HV, respectively. No abdominal or epidural spread was identified.
Although no significant differences were found, HV resulted in a higher percentage of stain on spinal nerves and sympathetic trunk than LV. Further studies are warranted to determine if the QL block provides somatic and visceral abdominal analgesia in dogs.
描述犬 cadaver 中的 quadratus lumborum (QL) 阻滞技术和注射剂的扩散。
前瞻性、随机、描述性、实验解剖研究。
一组 12 只成年犬 cadaver。
在两具 cadaver 中研究了 sublumbar 肌肉的大体和超声解剖结构以及与脊神经的关系。在 8 具 cadaver 中，使用染料-利多卡因溶液[低容量 (LV) 0.15 mL/kg 或高容量 (HV) 0.3 mL/kg]在 QL 和腰大肌之间的筋膜平面进行双侧超声引导注射。超声换能器放置在最后一根肋骨近端的尾侧和平行位置，使用从腹外侧到背内侧的入路引入绝缘针进行平面内进针。进行解剖以确定成功染色 (>1 cm)的脊神经数量以及硬膜外腔或腹腔内是否存在注射剂。此外，在 QL 注射后，对两具 cadaver 进行了横断 cryosectioning。
最后胸神经和第一至第三腰神经的腹侧分支在 QL 肌肉束之间以及 QL 和腰大肌之间运行。目标筋膜平面在所有注射后均通过超声识别并充满染料溶液。LV 和 HV 分别用 0.0%、71.4%、100%、100%和 25%、100%、100%、100%染色第 13 胸神经和第 1、2、3 腰神经的腹侧分支。LV 和 HV 分别在 0（0-3）和 3（0-4）个椎骨水平上对多节段扩散染色，使腰交感干染色。未发现腹部或硬膜外扩散。
尽管没有发现显著差异，但 HV 使脊神经和交感干的染色百分比高于 LV。需要进一步的研究来确定 QL 阻滞是否能为犬提供躯体和内脏腹部镇痛。
