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The use of a nerve stimulation test to confirm sacrococcygeal epidural needle placement in cats
Authors:Pablo E Otero  Natali Verdier  Andrea S Zaccagnini  Santiago E Fuensalida  Lisa Tarragona  Diego A Portela
Affiliation:1. Department of Anesthesiology, College of Veterinary Medicine, University of Buenos, Aires, Argentina;2. Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
Abstract:ObjectiveTo determine if a nerve stimulation test (NST) could act as a monitoring technique to confirm sacrococcygeal epidural needle placement in cats.Study designProspective experimental trial in a clinical setting.AnimalsTwenty-four adult cats, scheduled for a therapeutic procedure where epidural anesthesia was indicated.MethodsUnder general anesthesia, an insulated needle was inserted through the S3-Cd1 intervertebral space guided by the application of a fixed electrical current (0.7 mA) until a motor response was obtained. The NST was considered positive when the epidural nerve stimulation produced a motor response of the muscles of the tail, whereas it was considered negative when no motor response was evoked. In the NST positive cases, 0.3 mL kg?1 of 0.5% bupivacaine was administrated before needle withdrawal. Ten minutes after injection, epidural blockade was confirmed by the loss of perineal (anal), and pelvic limbs reflexes (patellar and withdrawal).ResultsThe use of a fixed electrical stimulation current of 0.7 mA resulted in correct prediction of sacrococcygeal epidural injection, corroborated by post bupivacaine loss of perineal and pelvic limb reflexes, in 95.8% of the cases.Conclusion and clinical relevanceThis study demonstrates the feasibility of using, in a clinical setting, an electrical stimulation test as an objective and in real-time method to confirm sacrococcygeal epidural needle placement in cats.
Keywords:cat  epidural  nerve stimulation  sacrococcygeal
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