Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.
Vet Anaesth Analg. 2021 Sep;48(5):767-774. doi: 10.1016/j.vaa.2021.06.005. Epub 2021 Jun 18.
To evaluate a direct intra-abdominal approach to injection of the ventral transversus abdominis plane (TAP) and compare the dispersion of two volumes of injectate.
Prospective anatomic and feasibility study.
A total of 10 canine cadavers weighing 9 ± 4 kg.
A ventral incision was made extending through the linea alba, from the umbilicus and extending 5 cm caudally. A single injection of an isovolumic mixture of iopamidol and new methylene blue was performed with a hypodermic needle placed within the TAP of each hemiabdomen, alternating between 0.5 mL kg in low-volume group (LV) and 1 mL kg in high-volume group (HV). Surgical staples marked the incision. Computed tomography and three-dimensional reconstruction of the tomographic images evaluated the dimensions, cranial and caudal spread beyond the incision and the total area of the injectate. Dissection determined the extent of nerve staining within the TAP adjacent to the abdominal incision. Wilcoxon signed rank (stain) or paired t test was used to compare variables between groups. Data are reported as mean ± standard deviation or median (range).
Injectate spread was within the ventral TAP. Length of spread was 2.5 ± 1.6 cm greater in group HV than in group LV. There was a strong positive correlation between the surface area (p = 0.02, r = 0.71) and cranial-caudal spread of injectate (p = 0.041, r = 0.65) with volume. All but two LV injections were associated with staining of all nerves adjacent to the incision. Additional nerves caudal to the incision were stained in group HV (p = 0.02).
This approach to the TAP was easily performed, with volume of injectate positively influencing distribution.
This technique is easily applied and future prospective studies are warranted to determine its analgesic efficacy.
评估一种直接经腹腔内注射腹横肌平面（TAP）的方法，并比较两种容量注射剂的扩散情况。
前瞻性解剖学和可行性研究。
10 只体重 9 ± 4 kg 的犬尸体。
在 TAP 内放置皮下注射针，从脐部延伸至白线，向头侧和尾侧各延伸 5 cm，做一个腹侧切口，每个半侧腹部注射等容量的异戊碘和新亚甲蓝混合物。低容量组（LV）注射 0.5 mL/kg，高容量组（HV）注射 1 mL/kg。手术钉标记切口。对断层图像进行 CT 扫描和三维重建，评估切口处的尺寸、头侧和尾侧扩散范围以及注射剂的总面积。解剖确定了腹部切口附近 TAP 内神经染色的范围。采用 Wilcoxon 符号秩（染色）或配对 t 检验比较组间变量。数据以平均值 ± 标准差或中位数（范围）表示。
注射剂的扩散范围在腹侧 TAP 内。HV 组的扩散长度比 LV 组长 2.5 ± 1.6 cm。注射量与注射剂的表面积（p=0.02，r=0.71）和头侧-尾侧扩散（p=0.041，r=0.65）呈强正相关。LV 组的所有注射剂都与切口附近所有神经的染色有关，而 HV 组的注射剂则在切口以下的神经染色（p=0.02）。
这种 TAP 入路易于实施，注射量与分布呈正相关。
该技术易于应用，需要进一步前瞻性研究来确定其镇痛效果。
