Medical School, Sao Paulo State University (Unesp), Department of Anaesthesiology, Professor Mario Rubens Guimarães Montenegro Avenue, n/n, Botucatu, Sao Paulo, 18618-687, Brazil.
School of Veterinary Medicine and Animal Science, Sao Paulo State University (Unesp), Department of Veterinary Surgery and Anaesthesiology, Rua Prof. Doutor Walter Mauricio Correa, s/n, Unesp Campus de Botucatu, Botucatu, Sao Paulo, 18618-681, Brazil.
Vet J. 2022 Feb;280:105791. doi: 10.1016/j.tvjl.2022.105791. Epub 2022 Jan 25.
Correctly identifying the puncture site and needle position in obese dogs can be challenging to achieve epidural anaesthesia. The current study aimed to evaluate a real-time ultrasound-guided technique, to perform epidural anaesthesia in obese or appropriate body condition score dogs, based on visualization of local anaesthetic flow during its injection, compared to the traditional method of palpation of anatomical landmarks. Seventy-two client-owned dogs were evaluated in a prospective, comparative, randomized clinical trial, allocated into four groups of 18 dogs. For the Palpation-guided 1 (PG1) and 2 (PG2) groups, epidural anaesthesia was based on palpating anatomical landmarks. Dogs with a body condition score (BCS) 1-5/9 were included in the PG1 (non-obese), and those with a BCS 6-9/9 in PG2 (obese) groups. In the Ultrasound-guided 1 (USG1 - BCS 1-5/9) and 2 (USG2 - BCS 6-9/9) groups, epidural anaesthesia was guided by ultrasound (US). The flow of anaesthetic through the epidural canal was observed in all dogs by US. There were fewer needle-to-bone contacts in the US-guided groups when performing epidural anaesthesia; this only occurred on the vertebral laminae, never in the vertebral canal. Ultrasound guidance enabled local anaesthetic injection into the epidural space without the need for palpation of anatomical landmarks to guide needle placement. Blood reflux occurred in 11.1% (PG1), 22.2% (PG2), 5.5% (USG1), and 0% (USG2) of the dogs. Ultrasound-guided punctures led to fewer vascular punctures. Epidural anaesthesia was effective in all animals, and no complications were observed.
在肥胖犬中正确识别穿刺部位和针头位置可能难以实现硬膜外麻醉。本研究旨在评估一种实时超声引导技术，通过在注射局部麻醉剂时观察其流动情况，在肥胖或适当身体状况评分犬中进行硬膜外麻醉，与传统的解剖标志触诊方法进行比较。72 只患犬参与了一项前瞻性、对照、随机临床试验，分为 4 组，每组 18 只。对于触诊引导 1 组（PG1）和 2 组（PG2），硬膜外麻醉是基于触诊解剖标志。体况评分（BCS）为 1-5/9 的犬被纳入 PG1（非肥胖）组，BCS 为 6-9/9 的犬被纳入 PG2（肥胖）组。在超声引导 1 组（USG1-BCS 1-5/9）和 2 组（USG2-BCS 6-9/9）中，硬膜外麻醉由超声（US）引导。所有犬均通过 US 观察到麻醉剂在硬膜外管内的流动。在进行硬膜外麻醉时，US 引导组的针骨接触次数较少；这种情况仅发生在椎板上，从未发生在椎管内。超声引导可在无需触诊解剖标志引导针头放置的情况下，将局部麻醉剂注入硬膜外腔。11.1%（PG1）、22.2%（PG2）、5.5%（USG1）和 0%（USG2）的犬出现血液反流。US 引导穿刺导致较少的血管穿刺。所有动物的硬膜外麻醉均有效，未观察到并发症。
