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1.
ObjectiveTo determine the influence on the distribution of the volume of a local anaesthetic-methylene blue solution at three different nerve block sites in the dog.Study designRandomized, controlled, blinded experimental trial.Animals23 hound-cross dogs weighing 16–40 kg and aged 2 ± 0 years (mean ± SD).MethodsDogs were anaesthetized and randomly assigned to three groups of seven or eight dogs each, based on volume administered: low, medium and high volume (L, M and H). Using electrolocation, the injection was performed after a positive response was elicited (flexion of the elbow for the brachial plexus block, quadriceps contractions for the lumbar plexus and dorsiflexion/plantar extension of the foot for the sciatic nerve block). At the brachial plexus site, groups L, M and H received 0.075, 0.15 and 0.3 mL kg−1, respectively. At the lumbar plexus site, groups L, M and H received 0.1, 0.2 and 0.4 mL kg−1, respectively. At the proximal sciatic nerve site, groups L, M and H received 0.05, 0.1 and 0.25 mL kg−1, respectively. Necropsies were performed immediately following euthanasia. Staining of ≥2 cm along the nerve was considered sufficient; the proportions sufficient were compared with Fisher's exact test. The volume was recommended when all the relevant nerves were stained sufficiently in all or all but one of the dogs within the group.ResultsIn the brachial plexus, only in group H were all the nerves stained sufficiently. In the lumbar plexus site, no statistical difference was found, but we suggest the H group volume to balance sufficient and excessive staining. At the sciatic nerve site, all volumes tested produced sufficient staining in all (or all but one) dogs.Conclusions and clinical relevanceVolumes of 0.3 and 0.05 mL kg−1 produced sufficient distribution for performing brachial plexus, and sciatic nerve blocks, respectively. Additionally, a volume of 0.4 mL kg−1 might also be adequate for a lumbar plexus block (no statistical significance was reached).  相似文献   

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3.
ObjectiveTo describe a novel in-plane ultrasound (U/S)-guided temporal approach to peribulbar block in dogs.Study DesignProspective experimental cadaver study.AnimalsA group of 10 Beagle cadavers.MethodsAfter describing the U/S anatomy, peribulbar injection was performed bilaterally in 10 thawed Beagle cadavers by two randomly assigned operators. A 5–8 MHz microconvex U/S probe was positioned caudal to the orbital ligament in the longitudinal plane. Using an in-plane technique, methylene blue dye was injected in five dogs (10 eyes total), while methylene blue dye and iohexol contrast mixture (50:50) were injected in the remaining five dogs. Injection volume was 0.2 mL cm?1 of cranial length. A computed tomography (CT) scan was performed on dogs injected with dye and contrast to identify spread of contrast. Dissection to visualize dye spread in the orbit was performed in all dogs. Injection success was defined as spread of contrast into the peribulbar space. The pattern of distribution of contrast-dye was also assessed. Comparisons between operator and bilateral injections were assessed using a Student t test (p < 0.05). All other data are reported as number (n/N) and percentage (%).ResultsPeribulbar spread was noted in 19/20 injections (95%) on dissection. CT imaging (five dogs) illustrated peribulbar contrast spread in 9/10 injections (90%), with mixed peribulbar/retrobulbar spread for the remaining injection. Contrast was present at the rostral alar foramen in 4/10 (40%) injections, orbital fissure in 5/10 (50%), oval foramen in 1/10 (10%), maxillary nerve in 3/10 (30%) and intracranial in 5/10 (50%). Coverage of the maxillary nerve was noted on 3/20 (15%) injections on dissection. No further dye spread was noted.Conclusions and clinical relevanceThis technique demonstrated peribulbar spread of injectate in 100% of injections for the 10 canine cadavers studied. Further studies are required to evaluate this technique clinically.  相似文献   

4.
ObjectiveTo develop an ultrasound-guided dorsal approach to the brachial plexus and to investigate the nerve distribution and staining of a dyed injectate in common kestrel (Falco tinnunculus) cadavers.Study designProspective, cadaver study.AnimalsA group of three common kestrel cadavers (six wings).MethodsAll cadavers were fresh-frozen at –20 °C and thawed for 10 hours at room temperature before the study. The cadavers were placed in sternal recumbency and their wings were abducted. A 8–13 MHz linear-array transducer was placed over the scapulohumeral joint, at the centre of a triangle formed by the scapula and the humerus. The brachial plexus was identified between the scapulohumeralis muscle and the pectoralis major muscle, as hypoechoic structures lying just cranially to the axillary vessels. After ultrasound-guided brachial plexus identification, a 22 gauge, 50 mm insulated needle was advanced in-plane using ultrasound visualization. A volume of 0.5 mL kg–1 of a 3:1 (2% lidocaine:methylene blue) solution was injected. Following cadaver dissection, the pattern of the spread was assessed, and the extent of nerve staining was measured with a calliper and deemed adequate if more than 0.6 cm of the nerve staining was achieved.ResultsThe brachial plexus was clearly identified in all wings with the dorsal approach. After dye injection, all the branches of the brachial plexus defined as nerves 1–5 (N1, N2, N3, N4 and N5) were completely stained in five (83%) and partially stained in one (17%) of the six wings.Conclusions and clinical relevanceThe ultrasound-guided dorsal approach allows a clear visualization of the brachial plexus structure. The injection of 0.5 mL kg–1of a lidocaine/dye solution produced complete nerve staining in most cases. Further in vivo studies are mandatory to confirm the clinical efficacy of this locoregional anaesthesia technique in common kestrels (Falco tinnunculus).  相似文献   

5.
Invasive dental procedures performed in the standing, sedated horse are facilitated by local and regional anaesthesia. The traditional transcutaneous approach to the mental foramen is used to desensitise the incisive region including the mandibular incisors, but is not well tolerated by many sedated patients. In this study, a new, intraoral needle insertion technique for nerve block at the mental foramen was investigated. In 15 equine cadaver heads and two live horses, computed tomography (CT) was used to verify Tuohy needle placement into each mental foramen using an intraoral technique. Varying volumes of contrast medium (3, 6, 10 mL) were injected into the mandibular canal with and without digital occlusion of the mental foramen. The distance of retrograde flow was measured. Additionally, measurements were taken to determine the position of the mental foramen within the interdental space. Correct placement of Tuohy needles and injection of contrast medium into the mandibular canal using an intraoral approach at the mental foramen was achieved in all injections. Retrograde flow of contrast medium was accomplished with all volumes, regardless of occlusion. Although not statistically significant, the 10 mL group appeared to have a greater distance of flow. The needle insertion technique described here appears to be a potential alternative to traditional transcutaneous approaches to mental nerve block for procedures involving the incisive region. In addition, it was found that 79% of the mandibular canals injected with 10 mL of contrast medium had retrograde flow to the position of PM4, suggesting this method may be a useful alternative technique for nerve block for the more rostrally located cheek teeth. The location of the mental foramen was consistently found in the distal third of the interdental space (approximately 60–80% of the distance between the distal aspect of the lateral corner incisor and the mesial aspect of the second premolar).  相似文献   

6.
Magnetic resonance imaging (MRI) examinations from 18 dogs with a histologically confirmed peripheral nerve sheath tumor (PNST) of the brachial plexus were assessed retrospectively. Almost half (8/18) had a diffuse thickening of the brachial plexus nerve(s), six of which extended into the vertebral canal. The other 10/18 dogs had a nodule or mass in the axilla (1.2-338 cm3). Seven of those 10 masses also had diffuse nerve sheath thickening, three of which extended into the vertebral canal. The majority of tumors were hyperintense to muscle on T2-weighted images and isointense on T1-weighted images. Eight of 18 PNSTs had only minimal to mild contrast enhancement and many (13/18) enhanced heterogeneously following gadolinium DTPA administration. Transverse plane images with a large enough field of view (FOV) to include both axillae and the vertebral canal were essential, allowing in-slice comparison to detect lesions by asymmetry of structures. Higher resolution, smaller FOV, multiplanar examination of the cervicothoracic spine was important for appreciating nerve root and foraminal involvement. Short tau inversion recovery, T2-weighted, pre and postcontrast T1-weighted pulse sequences were all useful. Contrast enhancement was critical to detecting subtle diffuse nerve sheath involvement or small isointense nodules, and for accurately identifying the full extent of disease. Some canine brachial plexus tumors can be challenging to detect, requiring a rigorous multiplanar multi-pulse sequence MRI examination.  相似文献   

7.
This study aimed to document the detailed features of the morphological structure and the innervation areas of the brachial plexus in Merlin (Falco columbarius). The skin and muscles of five adult male Merlins were dissected under the stereo microscope. The Merlin had two plexus trunks. The accessory brachial plexus consisted of ventral rami C10 and C11. C11 was divided into two branches: the cranial and caudal. The brachial plexus was composed of a rather complex network involving the ventral rami of C11‐C13, T1 and T2. In addition, a thin branch from the last two cervical sympathetic nerves participated in the plexus formation. C12, C13 and T1 had rather thick trunk. C12, C13 and T1 were also involved in the formation of the brachial plexus emerging after 1 cm from the foramen inter‐vertebrale as three trunk roots.  相似文献   

8.
Basic studies were carried out to apply frozen allogeneic nerve grafts in dogs after wide-ranging defects of the brachial plexus due to surgical resection of tumor. In this study, morphological variations in branching patterns of the brachial plexus were examined in ten beagle dogs, to evaluate whether the brachial plexus might represent a useful source of allogeneic nerve grafts. Spatial relationships between the axillary lymph node, which had the possibility of carcinomatous metastasis, and the musculocutaneous (MC) nerve, which was important for the function of the forelimbs, were also investigated. In all ten cases examined, the brachial plexus received ventral roots from the fifth cervical nerve to the first thoracic nerve. No significant variation in the branching pattern was found in any nerve except the phrenic, MC and dorsal thoracic nerves. Four communicating branches were observed and had some morphological variations which might be negligible for nerve grafting. Considering previous physiological and anatomical reports, the most important nerve to be reunited in graft operations for functional recovery is the radial nerve. The MC nerve and median or ulnar nerve should also be considered as possibilities for reuniting. Distances between the axillary lymph nodes and the MC nerve ranged from 11.2 mm to 21 mm (mean +/- SD: 16.1 +/- 2.3 mm). In conclusion, it was suggested that morphological variations in the brachial plexus were technically acceptable to apply allogeneic nerve grafts at least in beagle dogs.  相似文献   

9.
Objective To describe an ultrasound‐guided technique and the anatomical basis for three clinically useful nerve blocks in dogs. Study design Prospective experimental trial. Animals Four hound‐cross dogs aged 2 ± 0 years (mean ± SD) weighing 30 ± 5 kg and four Beagles aged 2 ± 0 years and weighing 8.5 ± 0.5 kg. Methods Axillary brachial plexus, femoral, and sciatic combined ultrasound/electrolocation‐guided nerve blocks were performed sequentially and bilaterally using a lidocaine solution mixed with methylene blue. Sciatic nerve blocks were not performed in the hounds. After the blocks, the dogs were euthanatized and each relevant site dissected. Results Axillary brachial plexus block Landmark blood vessels and the roots of the brachial plexus were identified by ultrasound in all eight dogs. Anatomical examination confirmed the relationship between the four ventral nerve roots (C6, C7, C8, and T1) and the axillary vessels. Three roots (C7, C8, and T1) were adequately stained bilaterally in all dogs. Femoral nerve block Landmark blood vessels (femoral artery and femoral vein), the femoral and saphenous nerves and the medial portion of the rectus femoris muscle were identified by ultrasound in all dogs. Anatomical examination confirmed the relationship between the femoral vessels, femoral nerve, and the rectus femoris muscle. The femoral nerves were adequately stained bilaterally in all dogs. Sciatic nerve block. Ultrasound landmarks (semimembranosus muscle, the fascia of the biceps femoris muscle and the sciatic nerve) could be identified in all of the dogs. In the four Beagles, anatomical examination confirmed the relationship between the biceps femoris muscle, the semimembranosus muscle, and the sciatic nerve. In the Beagles, all but one of the sciatic nerves were stained adequately. Conclusions and clinical relevance Ultrasound‐guided needle insertion is an accurate method for depositing local anesthetic for axillary brachial plexus, femoral, and sciatic nerve blocks.  相似文献   

10.
ObjectiveTo compare palpation-guided with ultrasound-guided brachial plexus blockade in Hispaniolan Amazon parrots.Study designProspective randomized experimental trial.AnimalsEighteen adult Hispaniolan Amazon parrots (Amazona ventralis) weighing 252–295 g.MethodsAfter induction of anesthesia with isoflurane, parrots received an injection of lidocaine (2 mg kg?1) in a total volume of 0.3 mL at the axillary region. The birds were randomly assigned to equal groups using either palpation or ultrasound as a guide for the brachial plexus block. Nerve evoked muscle potentials (NEMP) were used to monitor effectiveness of brachial plexus block. The palpation-guided group received the local anesthetic at the space between the pectoral muscle, triceps, and supracoracoideus aticimus muscle, at the insertion of the tendons of the caudal coracobrachial muscle, and the caudal scapulohumeral muscle. For the ultrasound-guided group, the brachial plexus and the adjacent vessels were located with B-mode ultrasonography using a 7–15 MHz linear probe. After location, an 8-5 MHz convex transducer was used to guide injections. General anesthesia was discontinued 20 minutes after lidocaine injection and the birds recovered in a padded cage.ResultsBoth techniques decreased the amplitude of NEMP. Statistically significant differences in NEMP amplitudes, were observed within the ultrasound-guided group at 5, 10, 15, and 20 minutes after injection and within the palpation-guided group at 10, 15, and 20 minutes after injection. There was no statistically significant difference between the two groups. No effect on motor function, muscle relaxation or wing droop was observed after brachial plexus block.Conclusions and clinical relevanceThe onset of the brachial plexus block tended to be faster when ultrasonography was used. Brachial plexus injection can be performed in Hispaniolan Amazon parrots and nerve evoked muscle potentials were useful to monitor the effects on nerve conduction in this avian species. Neither technique produced an effective block at the doses of lidocaine used and further study is necessary to develop a useful block for surgical analgesia.  相似文献   

11.
In human medicine, spinal pain and radiculopathy are commonly managed by computed tomography (CT)‐guided facet joint injections and by transforaminal or translaminar epidural injections. In dogs, CT‐guided lumbosacral epidural or lumbar facet joint injections have not been described. The aim of this experimental, ex vivo, feasibility study was to develop techniques and to assess their difficulty and accuracy. Two canine cadavers were used to establish the techniques and eight cadavers to assess difficulty and accuracy. Contrast medium was injected and a CT scan was performed after each injection. Accuracy was assessed according to epidural or joint space contrast opacification. Difficulty was classified as easy, moderately difficult, or difficult, based on the number of CT scans needed to guide insertion of the needle. A total of six translaminar and five transforaminal epidural and 53 joint injections were performed. Translaminar injections had a high success rate (100%), were highly accurate (75%), and easy to perform (100%). Transforaminal injections had an moderately high success rate (75%), were accurate (75%), and moderately difficult to perform (100%). Success rate of facet joint injections was 62% and was higher for larger facet joints, such as L7‐S1. Accuracy of facet joint injections ranged from accurate (37–62%) to highly accurate (25%) depending on the volume injected. In 77% of cases, injections were moderately difficult to perform. Possible complications of epidural and facet joint injections were subarachnoid and vertebral venous plexus puncture and periarticular spread, respectively. Further studies are suggested to evaluate in vivo feasibility and safety of these techniques.  相似文献   

12.
Limited information exists on distribution of local anaesthetic solution following palmar digital nerve blocks. The aim of this study was to demonstrate potential distribution of local anaesthetic solution following perineural injection of the palmar digital nerves using 2 different volumes of contrast medium and 2 different injections sites. Twelve mature horses were used. Perineural injection of the palmar digital nerves were performed at the level of or 2 cm proximal to the proximal aspect of the ipsilateral ungular cartilage, using 1.5 or 2.5 ml radiopaque contrast medium. In total, 96 injections were performed. Four standard radiographic views of the pastern were obtained immediately after injections and 10 and 20 min later. Images were analysed subjectively and objectively. After distal injections, the contrast medium was more localised around the injection site; after proximal injections the contrast patch had greater proximal–distal length. The greatest proximal diffusion was to 31.7% of the length of the proximal phalanx (from the level of the proximal interphalangeal joint) after distal injections and to 70% after proximal injections. The larger volume resulted in significantly greater proximal diffusion than the smaller volume at the distal, but not at the proximal injection site (P<0.01). There was significant proximal diffusion with time after proximal and distal injections (P<0.01). In most limbs, numerous radiopaque lines of various thickness extended proximally from the contrast patches; subjectively, their number and thickness were greater at the distal injection site. In conclusion, palmar digital nerve blocks at the level of the ungular cartilage using ≤2.5 ml local anaesthetic solution may improve proximal interphalangeal joint and pastern region pain. If using a more proximal site, distal fetlock region pain may be improved. Due to diffusion into lymphatic vessels, too small a volume at the distal injection site may not provide sufficient analgesia.  相似文献   

13.
Patterns of cutaneous anesthesia were determined in 4 dogs referred for evaluation of brachial plexus trauma. Using these patterns in conjunction with other clinical and electrophysiologic data, avulsion of spinal nerve roots contributing to the brachial plexus (brachial plexus avulsion) was diagnosed in each case. Two of the 4 dogs had avulsions of the C7-T1 nerve roots and the T2 branch to T1. One dog had C7 and C8 nerve root avulsion, and one had avulsion of the C8 and T1 nerve roots and the T2 communicating branch to T1. Each dog had a distinct pattern of cutaneous anesthesia.  相似文献   

14.
Objective  To evaluate the quality of brachial plexus blockade with 0.75% ropivacaine in domestic chickens.
Study design  Prospective experimental trial.
Animals  Six 30-week-old female chickens, weighing 4.5 ± 0.4 kg.
Methods  Six brachial plexus injections were performed after anesthetic induction with isoflurane. After achieving adequate muscle relaxation, the animals were positioned in dorsal recumbency and injected with ropivacaine (1 mL kg−1). The birds recovered and assessments of motor function and response to pinch were scored every 5 minutes for 180 minutes. The scores were from zero (no response) to three (greatest response). The scores over time were analyzed using a Wilcoxon nonparametric test with statistical significance accepted if p  ≤ 0.05.
Results  There was a significant difference ( p  < 0.05) from 15 to 130 minutes and 15 to 120 minutes for motor and sensory blocks, respectively. The onset of both blocks took 15 minutes and the effective periods of sensory and motor anesthesia were 105 and 115 minutes, respectively. Comparison between blocks at different times did not demonstrate significant differences ( p  > 0.05).
Conclusions and clinical relevance  No complications were observed after the technique. Brachial plexus blockade with 0.75% ropivacaine is a simple and effective technique for procedures on the thoracic limb of domestic chickens.  相似文献   

15.
We describe the morphological organization of the deer brachial plexus in order to supply data to veterinary neuroclinics and anaesthesiology. The deer (Mazama gouazoubira) brachial plexus is composed of four roots: three cervical (C6, C7 and C8) and one thoracic (T1). Within each sex group, no variations are observed between the left and the right brachial plexus, though sex-related differences are seen especially in its origin. The origin of axillary and radial nerves was: C6, C7, C8 and T1 in males and C8-T1 (radial nerve) and C7, C8 and T1 (axillary nerve) in females; musculocutaneous nerve was: C6-C7 (males) and C8-T1 (females); median and ulnar nerves was: C8-T1 (males) and T1 (females); long thoracic nerve was: C7 (males) and T1 (females); lateral thoracic nerve was: C6, C7, C8 and T1 (males) and T1 (females); thoracodorsal nerve was: C6, C7, C8 and T1 (males) and C8-T1 (females); suprascapular nerve was: C6-C7 (males) and C6 (females) and subscapular nerve was: C6-C7 (males) and C7 (females). This study suggests that in male deer the origin of the brachial plexus is more cranial than in females and the origin of the brachial plexus is slightly more complex in males, i.e. there is an additional number of roots (from one to three). This sexual dimorphism may be related to specific biomechanical functions of the thoracic limb and electrophysiological studies may be needed to shed light on this morphological feature.  相似文献   

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17.
A retrospective analysis of masses of the brachial plexus and contributing nerve roots in dogs seen at the University of Minnesota over a 17-year period was conducted. The goal of the study was to characterize their computed tomographic (CT) appearance and determine the minimum mass size confidently detectable. Twenty-four cases with a recorded diagnosis of brachial plexus or caudal cervical nerve root mass were found, wherein both the medical records and CT images were available for evaluation. These masses were characterized based on the presence or absence of contrast enhancement, margin character, size, extent of local invasion, and presence of vertebral canal or spinal cord involvement. Within the limits of this study, and the available histopathology, there appeared to be no clinically exploitable relationship between the tomographic appearance and the histologic interpretation. Twenty masses were noted to contrast enhance, typically with rim enhancement and a hypodense center. Only two dogs had a palpable axillary mass on physical examination. As measured, based on the largest dimension within a single slice, detectable masses ranged from 1.0 to 6.5 cm.  相似文献   

18.
ObjectiveTo determine whether the addition of bupivacaine or contrast medium to methylene blue dye would affect dye distribution following ultrasound (US)-guided transversus abdominis plane (TAP) injections.Study designProspective, randomized, blinded cadaveric study.AnimalsA total of 29 fresh Beagle dog cadavers.MethodsEach hemiabdomen (n = 58) was randomized into one of three groups: group M, 1% methylene blue; group MB, 50:50 mixture of 1% methylene blue and 0.5% bupivacaine; group MC, 25:75 mixture of 1% methylene blue and contrast agent (iohexol). TAP injections (0.5 mL kg–1) were performed bilaterally by a trained individual followed by dissection of the abdominal walls. Craniocaudal and dorsoventral spread along tissue planes was measured. Staining of branches of the thoracic and lumbar spinal nerves was considered successful when dye on the nerve was >10 mm. One-way anova with post hoc Tukey test was used to compare craniocaudal and dorsoventral spread and Kruskal–Wallis test to compare incidence of nerve staining among groups.ResultsTAP injections were successful in 52 out of 58 hemiabdomens. Dorsoventral spread was greater for group M (60 ± 10 mm) compared with MC (49 ± 9 mm; p = 0.01) but not MB (52 ± 9 mm; p = 0.09). No difference was found in craniocaudal spread or number of nerves stained among groups.Conclusion and clinical relevanceThe significant difference found in spread of tissue staining between methylene blue alone and methylene blue mixed with contrast in the TAP blocks should be kept in mind when interpreting dye-based cadaveric regional anesthesia studies.  相似文献   

19.
An interventional ultrasound technique to increase the safety of surgical treatment of the calf forelimb was tested. First, the brachial plexus was evaluated using ultrasonography and then 2% lidocaine was injected under ultrasound guidance. Ultrasonically, the brachial plexus appeared as multiple hypoechoic areas surrounded by a hyperechoic rim or a hyperechoic structure characterised by multiple discontinuous lines. It was located between the omotransverse muscle and axillary artery and vein. The sensitive effect in the forelimb was seen mainly in the area supplied by the musculocutaneous nerve, indicating successful blockage in the nerve plexus. Out of the eight forelimbs, the motor effect was observed in seven forelimbs. These results suggest the clinical feasibility of ultrasound-guided brachial plexus block in bovine medicine, although further studies are needed to examine various approaches, including the sites of needle insertion and the appropriate volume and dosage of anaesthetic.  相似文献   

20.
The anatomy of the brachial plexus in the common hippopotamus (Hippopotamus amphibius), which has not been previously reported, was first examined bilaterally in a newborn hippopotamus. Our observations clarified the following: (1) the brachial plexus comprises the fifth cervical (C5) to first thoracic (T1) nerves. These formed two trunks, C5-C6 and C7-T1; in addition, the axillary artery passed in between C6 and C7, (2) unique branches to the brachialis muscle and those of the lateral cutaneous antebrachii nerves ramified from the median nerve, (3) nerve fibre analysis revealed that these unique nerve branches from the median nerve were closely related and structurally similar to the musculocutaneous (MC) nerve; however, they had changed course from the MC to the median nerve, and (4) this unique branching pattern is likely to be a common morphological feature of the brachial plexus in amphibians, reptiles and certain mammals.  相似文献   

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