Touzot-Jourde Gwenola, Geffroy Olivier, Tallaj Amélie, Gauthier Olivier, Denoix Jean-Marie
INSERM, UMR 1229, Regenerative Medecine and Skeleton, University of Nantes, ONIRIS, Department of Veterinary Clinical Sciences, Nantes, France.
INRA/ENVA, UMR 957, Biomechanics and Equine Locomotor Pathology Research Unit, Centre for Imaging and Research in Equine Locomotor Disorders (CIRALE), National Veterinary School of Alfort, Maisons-Alfort, France.
Front Vet Sci. 2020 Feb 25;7:102. doi: 10.3389/fvets.2020.00102. eCollection 2020.
To describe the feasibility and dye diffusion of selective perineural injection of the 7 and 8th cervical nerve (C7 and C8) under ultrasonographic guidance in horses. Prospective experimental pilot cadaver study. Four equine cadavers of similar body weight (420-480 kg) and neck conformation. Five C7 and five C8 were perineurally injected with a dye solution. Anatomic dissections including vertebral canal opening were conducted to confirm nerve dye staining and describe the extent of color diffusion. The of the spinal cervical nerves was visualized in all cadavers. All the injections were successful in staining a portion of the nerve trunk. Eight had a uniform transversal staining of the nerve trunk that longitudinally covered a distance >2 cm. One C7 and one C8 nerve trunk showed incomplete transversal staining with a more concentrated color on its half cranial aspect and a longitudinal coverage of <2 cm. Five injections resulted in dye extending proximally and medially into the epidural space. Volume had no appreciable effect on the extent of nerve staining. A greater proportion of epidural diffusion was found with injections done within less than one cm distally to the articular processes. All injections were considered to be selective for the targeted nerve. Ultrasonography-guided perineural injection of C7 and C8 is a feasible technique that may have multiple applications in multimodal analgesia in horses. Further clinical study will be necessary to determine the appropriate drug, dosage, and volume to inject and to confirm its usefulness.
描述超声引导下对马的第7和第8颈神经（C7和C8）进行选择性神经周围注射的可行性及染料扩散情况。前瞻性实验性尸体研究。选用4匹体重相近（420 - 480千克）且颈部形态相似的马的尸体。对5条C7和5条C8神经进行神经周围染料溶液注射。进行包括椎管开放在内的解剖以确认神经染料染色情况并描述颜色扩散范围。在所有尸体中均能观察到颈脊髓神经。所有注射均成功使部分神经干染色。8条神经干有均匀的横向染色，纵向覆盖距离>2厘米。1条C7和1条C8神经干横向染色不完全，在其颅侧半部颜色更浓，纵向覆盖<2厘米。5次注射导致染料向近端和内侧延伸至硬膜外间隙。注射量对神经染色范围无明显影响。在关节突远端不到1厘米处进行注射时，发现硬膜外扩散比例更高。所有注射均被认为对目标神经具有选择性。超声引导下对C7和C8进行神经周围注射是一种可行的技术，可能在马的多模式镇痛中有多种应用。需要进一步的临床研究来确定合适的药物、剂量和注射量，并确认其有效性。
