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在犬类尸体中使用改良的腰方肌背侧阻滞方法评估大容量注射

Evaluation of High-Volume Injections Using a Modified Dorsal Quadratus Lumborum Block Approach in Canine Cadavers.

作者信息

Marchina-Gonçalves André, Gil Francisco, Laredo Francisco G, Soler Marta, Agut Amalia, Belda Eliseo

机构信息

Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain.

Departamento de Anatomía y Embriología Veterinaria, Facultad de Veterinaria, Universidad de Murcia, 30100 Murcia, Spain.

出版信息

Animals (Basel). 2021 Dec 22;12(1):18. doi: 10.3390/ani12010018.

Abstract

The quadratus lumborum (QL) block targets the fascial plane surrounding the QL muscle providing abdominal somatic and visceral analgesia. The extension of its analgesic effects is a subject of research, as it could not cover areas of the cranial abdomen in dogs. This study assesses in eight thawed canine cadavers, the distribution of high-volume injections (0.6 mL kg of a mixture of methylene blue and iopromide) injected between the psoas minor muscle and the vertebral body of L1. Anatomical features of the area of interest were studied in two cadavers. In another six dogs, QL blocks were performed bilaterally under ultrasound-guidance. The distribution of contrast was evaluated by computed tomography (CT). Hypaxial abdominal muscles were dissected to visualize the dye spread (spinal nerves and sympathetic trunk) in 5 cadavers. The remaining cadaver was refrozen and cross-sectioned. CT studies showed a maximum distribution of contrast from T10 to L7. The methylene blue stained T13 (10%), L1 (100%), L2 (100%), L3 (100%), L4 (60%) and the sympathetic trunk T10 (10%), T11 (20%), T12 (30%), T13 (70%), L1 (80%), L2 (80%), L3 (60%) and L4 (30%). These findings may suggest that despite the high volume of injectate administered, this modified QL block could not produce somatic analgesia of the cranial abdomen, although it could provide visceral analgesia in dogs.

摘要

腰方肌(QL)阻滞的目标是腰方肌周围的筋膜平面,可提供腹部躯体和内脏镇痛。其镇痛效果的扩展范围是一个研究课题,因为在犬类中它无法覆盖腹部上半部分区域。本研究在八具解冻的犬类尸体中,评估了在腰小肌和L1椎体之间注射大容量注射液(0.6 mL/kg的亚甲蓝和碘普罗胺混合物)的分布情况。在两具尸体中研究了感兴趣区域的解剖特征。在另外六只犬中,在超声引导下双侧进行QL阻滞。通过计算机断层扫描(CT)评估造影剂的分布。解剖5具尸体的椎前腹部肌肉以观察染料扩散情况(脊神经和交感干)。将剩余的尸体重新冷冻并进行横断面切片。CT研究显示造影剂的最大分布范围从T10到L7。亚甲蓝染色显示T13(10%)、L1(100%)、L2(100%)、L3(100%)、L4(60%)以及交感干T10(10%)、T11(20%)、T12(30%)、T13(70%)、L1(80%)、L2(80%)、L3(60%)和L4(30%)。这些发现可能表明,尽管注射量很大,但这种改良的QL阻滞不能产生腹部上半部分的躯体镇痛效果,不过它可以为犬类提供内脏镇痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e78/8749509/9385f794a573/animals-12-00018-g001.jpg

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