Sredenšek Jerneja, Brankovič Jana, Lampreht Tratar Urša, Čemažar Maja, Đokić Mihajlo, Seliškar Alenka
Small Animal Clinic, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia.
Institute of Preclinical Sciences, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia.
Front Vet Sci. 2025 Apr 16;12:1574833. doi: 10.3389/fvets.2025.1574833. eCollection 2025.
This prospective pilot anatomical study aimed to develop an ultrasound-guided transversus abdominis plane (TAP) block technique that desensitises cranial and mid-abdominal wall in grower pigs. We hypothesised that a four-point TAP approach would be more efficient than a three-point TAP in staining relevant nerves of the cranial and mid-abdominal wall.
In phase I, the ultrasound anatomy of the abdominal wall musculature was examined on three pig cadavers (two piglets and one fattening pig) and the ultrasound localization of the needle in the corresponding interfascial plane was practised. In phase II, a three-point TAP injection was performed in three freshly euthanized cadavers of grower pigs. A 1% methylene blue solution (0.3 mL/kg per injection point) was injected between the transversus abdominis and internal oblique muscle. In phase III, methylene blue solution was injected at four points (0.2 mL/kg per injection point) in four anaesthetized grower pigs prior to euthanasia. Positive nerve staining was defined as continuous staining of at least 1 cm of the nerve length. Binary variables (positive/negative) were used for nerve staining assessment.
The four-point TAP technique with a lower injection volume stained more nerves than the three-point technique with a higher injection volume, i.e., 69% of the observed nerves from the eighth-last thoracic to the third lumbar nerve were stained with the four-point TAP technique. The nerves in the centre were stained with a higher success rate, while the eighth-last thoracic and the second lumbar nerve were stained with less success (1/8 and 3/8, respectively). The third lumbar nerve was not stained.
The four-point TAP technique could be used as part of a multimodal analgesia approach for cranial and mid-abdominal surgery in pigs, but live animal studies are needed to evaluate the clinical applicability and efficacy of desensitisation.
本前瞻性解剖学试点研究旨在开发一种超声引导下的腹横肌平面（TAP）阻滞技术，该技术可使生长猪的颅部和腹壁中部脱敏。我们假设四点TAP方法在对颅部和腹壁中部相关神经进行染色方面比三点TAP更有效。
在第一阶段，对三只猪尸体（两只仔猪和一头育肥猪）的腹壁肌肉组织进行超声解剖检查，并在相应的筋膜间平面进行针的超声定位练习。在第二阶段，对三头刚安乐死的生长猪尸体进行三点TAP注射。在腹横肌和腹内斜肌之间注射1%的亚甲蓝溶液（每个注射点0.3 mL/kg）。在第三阶段，在四只麻醉的生长猪安乐死之前，在四个点注射亚甲蓝溶液（每个注射点0.2 mL/kg）。阳性神经染色定义为神经长度至少1 cm的连续染色。二元变量（阳性/阴性）用于神经染色评估。
注射量较低的四点TAP技术比注射量较高的三点技术染色的神经更多，即使用四点TAP技术染色了从倒数第八胸椎到第三腰椎神经的69%的观察神经。中心部位的神经染色成功率较高，而倒数第八胸椎和第二腰椎神经染色成功率较低（分别为1/8和3/8）。第三腰椎神经未被染色。
四点TAP技术可作为猪颅部和腹部中部手术多模式镇痛方法的一部分，但需要进行活体动物研究以评估脱敏的临床适用性和疗效。
