Alaman Manuel, González-Marrón Adrián, Lorente Cristina, Bonastre Cristina, Laborda Alicia
Department of Animal Pathology, Faculty of Veterinary Medicine, University of Zaragoza, C/Miguel Servet 177, 50013 Zaragoza, Spain.
Hospital Veterinario Anicura Valencia Sur, Avda. Picassent, 28, 46460 Silla, Spain.
Animals (Basel). 2021 Sep 10;11(9):2657. doi: 10.3390/ani11092657.
Transversus thoracis plane (TTP) block has demonstrated to produce analgesia in humans undergoing median sternotomy. The objectives of the study were to describe an ultrasound-guided transverse approach to the transversus thoracis plane (t-TTP) and to evaluate the spread of two injectable volumes in canine cadavers. Two cadavers were used to describe relevant gross anatomy of the ventral thoracic area and sonoanatomy between the fifth and sixth costal cartilages. Then, eight cadavers were used to describe the ultrasound-guided injection into the TTP and were dissected to evaluate the injectate spread and the intercostal nerves staining with two different dye-lidocaine volumes: low volume (LV) 0.5 mL kg and high volume (HV) 1 mL kg. To compare the spread between both volumes the Fisher's exact test and Wilcoxon signed-rank test were used. The solution spread along the TTP after all injections, staining a median number (range) of 3 (2-4) and 4 (3-5) nerves with LV and HV, respectively ( = 0.014). The injection of HV versus LV increases the number of stained nerves. Ultrasound-guided t-TTP is a feasible technique that provides staining of several intercostal nerves with a single injection site, so it could be useful to provide analgesia to the ventral chest wall.
胸横肌平面（TTP）阻滞已被证明能为接受正中开胸手术的患者产生镇痛效果。本研究的目的是描述一种超声引导下经胸横肌平面的横向入路（t-TTP），并评估两种注射容量在犬类尸体中的扩散情况。使用两具尸体描述胸腹部区域的相关大体解剖结构以及第五和第六肋软骨之间的超声解剖结构。然后，使用八具尸体描述超声引导下向TTP内注射的情况，并进行解剖以评估注射剂的扩散以及两种不同染料-利多卡因容量（低容量（LV）0.5 mL/kg和高容量（HV）1 mL/kg）对肋间神经的染色情况。为比较两种容量之间的扩散情况，使用了Fisher精确检验和Wilcoxon符号秩检验。所有注射后，溶液沿TTP扩散，LV和HV分别使3（2 - 4）条和4（3 - 5）条神经染色（P = 0.014）。与LV相比，注射HV增加了染色神经的数量。超声引导下的t-TTP是一种可行的技术，通过单一注射部位可使多条肋间神经染色，因此可为前胸壁提供镇痛，可能具有实用价值。
