Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina.
Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
Vet Anaesth Analg. 2022 Nov;49(6):664-673. doi: 10.1016/j.vaa.2022.08.001. Epub 2022 Aug 11.
To develop and assess the efficacy of an ultrasound (US)-guided pericapsular hip desensitization (PHD) technique in dogs.
Prospective, randomized, anatomical study and a case series.
A total of 30 healthy dogs, eight canine cadavers and seven dogs with hip osteoarthritis.
After studying the US anatomy of the medial aspect of the coxofemoral joint and determining an acoustic window to perform an US-guided PHD in healthy dogs, the US-guided PHD was performed bilaterally in canine cadavers. A low [(LV) 0.1 mL kg] and high [(HV) 0.2 mL kg] volume of dye was injected per hip on each cadaver. The staining of the pericapsular nerves was assessed by anatomical dissection, and comparison between LV and HV was assessed using Fisher's exact test. Then, the US-guided PHD was performed using a triamcinolone-bupivacaine solution in dogs with hip osteoarthritis. Dynamic pain response was assessed before and after injection. The canine brief pain inventory (CBPI) questionnaire was used to assess treatment efficacy and duration.
The US-guided PHD could be performed by inserting the needle between the iliopsoas muscle and the periosteum of the ilium. The articular branches of the femoral and obturator nerves were stained in all cadavers using both volumes. The main femoral nerve was never stained, but the main obturator nerve was stained in 37.5% and 100% of injections using LV and HV, respectively (p = 0.026). Treated animals showed decreased dynamic pain response after the injection. Compared with baseline, CBPI scores were reduced by ≥ 50% for ≥ 12 weeks in all but one dog.
The US-guided PHD with both 0.1 and 0.2 mL kg volumes stained the articular branches of the femoral and obturator nerves in canine cadavers and was associated with clinical improvement in dogs with hip osteoarthritis.
开发并评估一种超声（US）引导髋关节囊周围去敏（PHD）技术在犬中的疗效。
前瞻性、随机、解剖学研究和病例系列研究。
共 30 只健康犬、8 只犬尸体和 7 只患有髋关节骨关节炎的犬。
在研究了股髋关节内侧的 US 解剖结构并确定了一个可进行 US 引导 PHD 的声窗后，在健康犬的双侧髋关节进行了 US 引导 PHD。每只犬尸体的每只髋关节注射低（LV）[0.1 毫升/千克]和高（HV）[0.2 毫升/千克]两种容量的染料。通过解剖学解剖评估了囊周神经的染色情况，并使用 Fisher 精确检验比较了 LV 和 HV 之间的差异。然后，在患有髋关节骨关节炎的犬中使用曲安奈德-布比卡因溶液进行 US 引导 PHD。在注射前后评估动态疼痛反应。使用犬简明疼痛量表（CBPI）问卷评估治疗效果和持续时间。
US 引导 PHD 可通过将针插入腰大肌和髂骨骨膜之间进行。在所有尸体中，使用两种容量均能染色股神经和闭孔神经的关节支。主股神经从未染色，但在 LV 和 HV 注射中，主闭孔神经分别在 37.5%和 100%的注射中染色（p=0.026）。治疗动物在注射后动态疼痛反应降低。与基线相比，所有犬除一只外，CBPI 评分均降低≥50%，持续时间≥12 周。
两种容量（0.1 和 0.2 毫升/千克）的 US 引导 PHD 均可染色犬尸体的关节支股神经和闭孔神经，并可改善髋关节骨关节炎犬的临床症状。
