Department of Surgery and Anaesthesia of domestic animals, Faculty of Veterinary Medicine, University of Ghent, Merelbeke, Belgium; Clinique Equine Acy-Romance, Acy-Romance, France.
Clinical Sciences and Services, Royal Veterinary College, Queen Mother Hospital for Animals, Hatfield, UK.
Vet Anaesth Analg. 2021 May;48(3):470-477. doi: 10.1016/j.vaa.2020.10.012. Epub 2021 Feb 18.
To develop an ultrasound (US)-guided transversus abdominis plane (TAP) block in pigs.
Prospective, descriptive, experimental study.
A total of 26 hemi-abdomens belonging to 13 Seghers Hybrid cadavers.
The study consisted of two parts. In part 1, a preliminary anatomical understanding of the abdominal wall innervation in pigs was established (two hemi-abdomens of one pig). Part 2 was divided into three phases, and a US-guided TAP technique using methylene blue dye (0.3 mL kg for each hemi-abdomen) was developed. In chronological order, a pilot study (phase I) was conducted to establish good injection points (four hemi-abdomens). In phase II a two-point injection technique (10 hemi-abdomens) was performed. A cranial injection was made at two-thirds of the distance between the xyphoid process and the iliac crest, immediately ventral to the rib arch. A caudal injection was performed ventral to the last rib. In phase III a three-point injection technique was performed (10 hemi-abdomens) with an extra injection point halfway between the cranial and caudal injection point. Staining of the different nerves was recorded during dissection.
In part 1 the nerves innervating the pig's abdominal wall, thoracic vertebrae 12-16 (T12-16) and lumbar vertebrae 1-3 (L1-3), were identified. In part 2, data from the pilot study, adequate nerve staining with the two- or three-point injection technique, were obtained in T12 (29 versus 45% respectively), T13 (29 versus 100%), T14 (73 versus 45%), T15 (75 versus 78%), T16 (58 versus 78%), L1 (100 versus 75%), L2 (88 versus 84%) and L3 (23 versus 0%).
US-guided TAP block can be used in swine but only a moderate success rate for adequate nerve staining was achieved in this study. Further studies are necessary to determine a correct injection volume and assess clinical intra- and postoperative efficacy.
在猪身上建立超声（US）引导的腹横肌平面（TAP）阻滞。
前瞻性、描述性、实验研究。
共 26 个半腹部，来自 13 个 Seghers 杂种尸体。
该研究包括两个部分。在第一部分中，建立了对猪腹壁神经支配的初步解剖学理解（一头猪的两个半腹部）。第二部分分为三个阶段，并开发了一种使用亚甲蓝染料的 US 引导 TAP 技术（每个半腹部 0.3 毫升/公斤）。按时间顺序，进行了一项初步研究（第一阶段）以确定良好的注射点（4 个半腹部）。在第二阶段，进行了两点注射技术（10 个半腹部）。在胸骨柄和髂嵴之间的三分之二处，肋骨弓的正下方进行颅侧注射。在最后一根肋骨的正下方进行尾侧注射。在第三阶段，进行了三点注射技术（10 个半腹部），在颅侧和尾侧注射点之间的中点增加了一个注射点。在解剖过程中记录了不同神经的染色情况。
在第一部分中，确定了猪腹壁、胸椎 12-16（T12-16）和腰椎 1-3（L1-3）的神经支配。在第二部分中，从初步研究中获得了数据，两种或三点注射技术均可获得足够的神经染色，在 T12（分别为 29%和 45%）、T13（分别为 29%和 100%）、T14（分别为 73%和 45%）、T15（分别为 75%和 78%）、T16（分别为 58%和 78%）、L1（100%和 75%）、L2（分别为 88%和 84%）和 L3（分别为 23%和 0%）。
US 引导的 TAP 阻滞可用于猪，但在这项研究中仅获得了适度的神经染色成功率。需要进一步研究以确定正确的注射量并评估临床围手术期效果。
