Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina.
Vet Anaesth Analg. 2023 Sep;50(5):439-445. doi: 10.1016/j.vaa.2023.05.003. Epub 2023 May 24.
To describe the gross and ultrasound anatomy of the parasacral region and an ultrasound-guided greater ischiatic notch (GIN) plane approach aimed at staining the lumbosacral trunk (LST) in canine cadavers. To evaluate if the ultrasound-guided GIN plane approach is non-inferior to the previously described ultrasound-guided parasacral approach at staining the LST.
Prospective, randomized, non-inferiority experimental anatomic study.
A total of 17 (23.9 ± 5.2 kg) mesocephalic canine cadavers.
Anatomic and echographic landmarks, and the feasibility of performing a GIN plane technique were evaluated using two canine cadavers. The remaining 15 cadavers had each hemipelvis randomly assigned to be administered either parasacral or GIN plane injection of 0.15 mL kg dye solution. The parasacral region was dissected after injections to assess the staining of LST, cranial gluteal nerve, pararectal fossa and pelvic cavity. The stained LST were removed and processed for histological evaluation of intraneural injections. A one-sided z-test for non-inferiority (non-inferiority margin -14%) was used to statistically evaluate the success of the GIN plane versus the parasacral approach. Data were considered statistically significant when p < 0.05.
The GIN plane and parasacral approach stained the LST in 100% and 93.3% of the injections, respectively. The success rate difference between treatments was 6.7% [95% confidence interval, -0.6 to 19.0%; p < 0.001 for non-inferiority]. The GIN plane and parasacral injections stained the LST for 32.7 ± 16.8 mm and 43.1 ± 24.3 mm, respectively (p = 0.18). No evidence of intraneural injection was found.
The ultrasound-guided GIN plane technique resulted in nerve staining that was non-inferior to the parasacral technique and may be considered an alternative to the parasacral approach to block the LST in dogs.
描述荐旁区的大体和超声解剖结构，并介绍一种经超声引导坐骨大切迹（GIN）平面入路，以对犬尸体的腰骶干（LST）进行染色。评估经超声引导 GIN 平面入路是否在对 LST 进行染色方面不劣于先前描述的超声引导荐旁入路。
前瞻性、随机、非劣效性实验解剖研究。
共 17 只（23.9 ± 5.2 kg）中头颅犬尸体。
使用 2 只犬尸体评估解剖和超声学标志以及进行 GIN 平面技术的可行性。剩余的 15 只 cadaver 每只半骨盆随机分配接受荐旁或 GIN 平面注射 0.15 mL/kg 染色溶液。注射后解剖荐旁区，评估 LST、臀上神经、直肠旁窝和盆腔的染色情况。取出染色的 LST 并进行组织学评估，以检查神经内注射情况。使用单侧 z 检验进行非劣效性（非劣效性边界 -14%）统计评估 GIN 平面与荐旁入路的成功率。当 p < 0.05 时，认为数据具有统计学意义。
GIN 平面和荐旁入路分别使 100%和 93.3%的注射染色 LST。两种处理方法的成功率差异为 6.7% [95%置信区间，-0.6 至 19.0%；非劣效性 p < 0.001]。GIN 平面和荐旁注射使 LST 染色分别为 32.7 ± 16.8 mm 和 43.1 ± 24.3 mm（p = 0.18）。未发现神经内注射的证据。
超声引导 GIN 平面技术可导致神经染色，其不劣于荐旁技术，可作为犬 LST 阻滞的荐旁入路替代方法。
