Swanton William Emmett, Christensen Neil, Schroeder Carrie
Am J Vet Res. 2024 Jul 30;85(10). doi: 10.2460/ajvr.24.04.0106. Print 2024 Oct 1.
To evaluate the in vivo spread of iodinated contrast following injections in the transversus abdominis plane (TAP) and rectus sheath in anesthetized dogs via computed tomography. Secondarily, the time of performing each block was compared.
6 adult, purpose-bred Beagles.
In a prospective crossover study, dogs were administered injections either in the rectus sheath or transversus abdominis fascial plane in the same manner as a rectus sheath block (RSB) or TAP block using dilute iodinated contrast. Computed tomography scans were performed immediately following injection (time [T]-0) and at 3, 9, 18, and 30 minutes postinjection. Data regarding the spread in the cranial-caudal and lateral directions and time to perform the injections were compared between the 2 techniques using paired or 2-sample t tests.
There was significantly greater spread in the cranial-caudal direction in the RSB group (62.9 ± 6.4 mm vs 54.8 ± 6.8 mm at T30; P = .009), whereas spread in the lateral direction was greater in the TAP group (37.3 ± 3.0 mm vs 48.6 ± 6.1 mm at T30; P < .0001). The RSB injection was performed in a more time-efficient manner than TAP injection (48.2 ± 3.2 seconds vs 82.3 ± 8.7 seconds; P = .03).
In living subjects, RSB injections resulted in greater cranial-caudal spread while TAP injections resulted in greater lateral spread. Rectus sheath block injections were performed in a more time efficient manner compared to a single point TAP injection in anesthetized dogs.
The RSB was performed in a more time-efficient manner and would likely result in greater coverage of the ventral midline. The TAP block would likely result in more significant regional anesthetic coverage of the lateral abdominal wall. Further studies are required to determine the degree of the clinical significance of these results.
通过计算机断层扫描评估碘化造影剂在麻醉犬的腹横肌平面（TAP）和腹直肌鞘注射后的体内扩散情况。其次，比较进行每个阻滞操作的时间。
6只成年、专门繁育的比格犬。
在一项前瞻性交叉研究中，使用稀释的碘化造影剂，按照腹直肌鞘阻滞（RSB）或TAP阻滞的相同方式，在犬的腹直肌鞘或腹横肌筋膜平面进行注射。注射后立即（时间[T]-0）以及注射后3、9、18和30分钟进行计算机断层扫描。使用配对或双样本t检验比较两种技术在头-尾方向和侧向的扩散数据以及注射操作时间。
RSB组在头-尾方向的扩散明显更大（T30时为62.9±6.4毫米，而TAP组为54.8±6.8毫米；P = 0.009），而TAP组在侧向的扩散更大（T30时为37.3±3.0毫米，而RSB组为48.6±6.1毫米；P < 0.0001）。RSB注射比TAP注射更具时间效率（48.2±3.2秒对82.3±8.7秒；P = 0.03）。
在活体受试者中，RSB注射导致更大的头-尾方向扩散，而TAP注射导致更大的侧向扩散。与麻醉犬的单点TAP注射相比，腹直肌鞘阻滞注射的时间效率更高。
RSB操作更具时间效率，可能会导致腹中线的覆盖范围更大。TAP阻滞可能会导致腹外侧壁更显著的区域麻醉覆盖。需要进一步研究以确定这些结果的临床意义程度。
