D'Anselme Olivia, Hartnack Amanda, Andrade Jose Suarez Sanchez, Alfaro Rojas Christian, Ringer Simone Katja, de Carvalho Papa Paula
Department of Clinical Diagnostics and Services, Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland.
Department of Farm Animal, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland.
Animals (Basel). 2022 Aug 25;12(17):2191. doi: 10.3390/ani12172191.
The proximal paravertebral nerve block is commonly used to provide anaesthesia to the flank during standing surgical procedures in adult cattle. It has been reported that additional anaesthetic infiltration may be necessary to provide complete anaesthesia. In humans as well as animal species, another technique-the ultrasound (US)-guided erector spinae plane block (ESPB)-has been described. The goal of the present study was to develop and investigate an US-guided ESPB in comparison to a blind proximal paravertebral nerve block (PPNB) in cow cadavers. In 10 cadaver specimens, injections of methylene blue-lidocaine (1:1) were performed at the level of T13, L1 and L2 vertebras, on one side doing an ESPB block and, on the other side, a PPNB. Five cadavers were injected with high (40 mL per injection for PPNB and 20 mL for ESPB) and five with low (20 and 15 mL, respectively) volumes of injectate. For the ESPB, the ultrasound probe was oriented craniocaudally, and the ventral-cranial aspect of the articular processes (T13, L1 and L2) was targeted for injection. The dye spreading was evaluated by dissection. The landmarks for US-guided injection were easily visualized; however, injections were accidentally performed at T12, T13 and L1. Nevertheless, L2 was stained in 60% of ESPBs. Epidural spreading was observed with both techniques and all volumes. Viscera puncture was reported in two PPNBs. The ESPB resulted in similar nerve staining compared to the PPNB while using a lower volume of injectate. Even better staining is expected with a T13-L2 instead of a T12-L1 ESPB approach. Further studies are warranted to evaluate the clinical efficacy.
椎旁近端神经阻滞常用于成年牛站立式外科手术期间为胁腹提供麻醉。据报道，可能需要额外的麻醉剂浸润才能实现完全麻醉。在人类和动物中，另一种技术——超声（US）引导的竖脊肌平面阻滞（ESPB）已被描述。本研究的目的是在牛尸体中开发并研究超声引导的ESPB，并与盲法椎旁近端神经阻滞（PPNB）进行比较。在10个尸体标本中，于T13、L1和L2椎体水平进行亚甲蓝-利多卡因（1:1）注射，一侧进行ESPB阻滞，另一侧进行PPNB阻滞。5具尸体注射高容量注射液（PPNB每次注射40 mL，ESPB每次注射20 mL），另外5具注射低容量注射液（分别为20 mL和15 mL）。对于ESPB，将超声探头沿头尾方向放置，以关节突（T13、L1和L2）的腹侧-头侧为注射靶点。通过解剖评估染料扩散情况。超声引导注射的标志点很容易看清；然而，注射操作意外地在T12、T13和L1处进行。尽管如此，在60%的ESPB中L2被染色。两种技术和所有容量的注射液均观察到硬膜外扩散。在两次PPNB中报告了内脏穿刺情况。与PPNB相比，ESPB在使用较低容量注射液时导致相似的神经染色。采用T13-L2而非T12-L1的ESPB方法预计染色效果会更好。有必要进行进一步研究以评估其临床疗效。
