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1.
ObjectiveTo describe a lateral ultrasound (US)-guided approach to the radial, ulnar, median and musculocutaneous (RUMM) nerves through a single proximal in-plane insertion in cats and to determine whether one or two injection points are required to successfully stain all the target nerves.Study designProspective study.AnimalsA total of eight client-owned healthy cats and 12 cat cadavers.MethodsIn live cats, the US anatomy of the brachium, the landmarks and the site for needle accesses were determined. Then, 12 thawed feline cadavers were used to assess the spread of dye solution and nerve staining following the US-guided proximal-lateral-humeral RUMM injection using one and two injection points. Each cadaver was injected with 0.15 mL kg–1 of a 0.25% new methylene blue solution in either a single injection aimed for the radial nerve of one limb (G1) or via two sites delivering 0.1 mL kg–1 and 0.05 mL kg–1 aimed for the radial and musculocutaneous nerves of the opposite limb, respectively (G2). Upon dissection, staining of the target nerves around their circumference for length of >1 cm was considered successful.ResultsSonoanatomy was consistent with anatomy upon dissection and target nerves were identified in all cadavers. Staining was 100% successful for the radial, median and ulnar nerves in both groups, and 41.7% and 100% for the musculocutaneous nerve in G1 and G2, respectively.Conclusions and clinical relevanceThis novel lateral US-guided approach for the proximal RUMM nerve block allowed a good identification of the nerves and related structures, and it provided a consistent muscular structure through which the needle could be easily guided. An injection performed in two aliquots (within the caudal and cranial compartments of the neurovascular sheath) appeared to be necessary to successfully stain all the target nerves.  相似文献   

2.
OBJECTIVE: To document simple and reliable local, infiltrating nerve blocks for the saphenous, tibial and common peroneal nerves in the dog. STUDY DESIGN: Laboratory technique development; in vivo blind, controlled, prospective study. ANIMALS: Twenty canine cadavers and 18 clinically normal, client-owned dogs. METHODS: A peripheral nerve blockade technique of the tibial, common peroneal, and saphenous nerves was perfected through anatomic dissection. Injections were planned in the caudal thigh for the tibial and common peroneal nerves, and in the medial thigh for the saphenous nerve. Cadaver limbs were injected with methylene blue dye and subsequently dissected to confirm successful dye placement. Clinically normal dogs undergoing general anesthesia for unrelated, elective procedures were randomly assigned to treatment (bupivacaine; n = 8) or control (saline; n = 8) nerve blocks of the nerves under study. Upon recovery from general anesthesia, skin sensation in selected dermatomes was evaluated for 24 hours. RESULTS: Cadaver tibial, common peroneal, and saphenous perineural infiltrations were successful in nonchondrodystrophoid dogs (100, 100, and 97%, respectively.) Intraneural injection was rare (1%; 1/105; tibial nerve) in cadaver dogs. In the treatment group of normal dogs, duration of loss of cutaneous sensation in some dermatomes (saphenous, superficial and deep peroneal nerve) was significantly different than control dogs; the range of desensitization occurred for 1-20 hours. No clinical morbidity was detected. CONCLUSIONS: This technique for local blockade of the tibial, common peroneal, and saphenous nerves just proximal to the stifle is easy to perform, requires minimal supplies and results in significant desensitization of the associated dermatomes in clinically normal, nonchondrodystrophoid dogs. CLINICAL RELEVANCE: This technique may be an effective tool for post-operative analgesia to the femoro-tibial joint and distal pelvic limb. Other applications, using sustained-release drugs or methods, may include anesthesia/analgesia in high-risk patients or as a treatment for chronic pelvic limb pain or self-mutilation.  相似文献   

3.
ObjectiveTo provide ultrasonographic mapping of the axillary region of dogs to facilitate identification of the major branches of the brachial plexus in relation to the axillary artery.Study designProspective study.AnimalsA total of two dog cadavers and 50 client-owned, healthy dogs weighing >15 kg.MethodsIn Phase 1, anatomical dissections were performed to identify the relation of the major brachial plexus nerves to the axillary artery. In Phase 2, with the dogs in dorsal recumbency with thoracic limbs flexed naturally, the axillary space was scanned using a linear array probe oriented on the parasagittal plane until the axis transverse to nerves was found. Then, the transducer was rotated to a slight lateral angle approximately 30° to midline. The examination aimed to identify the axillary artery and the musculocutaneous, radial, median and ulnar nerves in addition to determining their position and distribution in four predefined sectors.ResultsThe musculocutaneous nerve was observed in all animals cranial to the axillary artery. The radial, ulnar and median nerves were distributed around the axillary artery, with >90% on the caudal aspect of the axillary artery (sectors 1 and 2).Conclusions and clinical relevanceUltrasonography identified the location of the brachial plexus nerves near the studied sectors, providing useful guidance for performing a brachial plexus nerve block.  相似文献   

4.
A technique for ultrasonography of the brachial plexus and major nerves of the canine thoracic limb is described based on examination of five canine cadavers and three healthy dogs. The ventral branches of the spinal nerves that contribute to the brachial plexus are identifiable at their exit from the intervertebral foramina. These nerves may be followed distally, cranial to the first rib, until they form the brachial plexus. The musculocutaneous, ulnar, and median nerves are identified on the medial aspect of mid‐humerus and followed proximally to the axillary region and distally to the elbow. The radial nerve, formed by multiple nerve components, is seen on the mediocaudal aspect of the humerus. Nerves appear as hypoechoic tubular structures with an internal echotexture of discontinuous hyperechoic bands, surrounded by a thin rim of highly echogenic tissue. Improved understanding of the ultrasonographic anatomy of the brachial plexus and its main branches supports clinical use of this modality.  相似文献   

5.
OBJECTIVE: To develop a surgical technique for using the distal aspect of the ulna as a transposition autograft in a distal radial defect and to assess patency of vascular supply and viability of the distal ulna in a heterotopic position. STUDY DESIGN: Cadaveric study and clinical cases. ANIMALS: Twenty-two normal canine thoracic limbs; 3 dogs with distal radial osteosarcoma. METHODS: The arteries and veins of 12 limbs were injected with latex. Barium sulfate suspension was injected into the brachial artery of 10 other limbs after removal of the distal radius only (n = 2), ulna transposition (UT) (n = 6), or no procedure (n = 2). The distal ulna grafts were then harvested and decalcified in formic acid. The grafts were cut into 3-5 mm transverse sections and radiographed with a nonscreen film system to determine filling of intramedullary vessels with barium suspension. UT was performed in 3 dogs with distal radial osteosarcoma. Bone scintigraphy was performed 2-7 days after surgery to assess viability of the transposed ulna graft. RESULTS: Angiography confirmed patency of the caudal interosseous artery in all but 2 limbs in which the UT technique was performed; however, barium-filled vessels were identified in the medullary cavity of all ulnar grafts. Scintigraphy confirmed graft viability in the 3 dogs, all of which had good to excellent limb function. CONCLUSIONS: The distal aspect of the canine ulna can be used as a vascularized transposition autograft to replace distal radial defects, and viability can be maintained. CLINICAL RELEVANCE: The UT technique appears to be an acceptable limb-sparing technique for dogs with tumors of the distal aspect of the radius.  相似文献   

6.
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7.
Background: Hypothyroidism has been implicated in the development of multiple peripheral mono‐ and polyneuropathies in dogs. The objectives of this study were to evaluate the clinical and electrophysiologic effects of experimentally induced hypothyroidism on the peripheral nervous system of dogs. Hypothesis: Chronic hypothyroidism will induce peripheral nerve sensorimotor dysfunction. Animals: Eighteen purpose‐bred, female dogs. Methods: Prospective, longitudinal study: Hypothyroidism was induced by radioactive iodine administration in 9 dogs, and the remaining 9 served as untreated controls. Neurological examinations were performed monthly. Electrophysiologic testing consisting of electromyography (EMG); motor nerve conduction studies of the sciatic‐tibial, radial, ulnar, and recurrent laryngeal nerves; sciatic‐tibial and ulnar F‐wave studies; sensory nerve conduction studies of the tibial, ulnar, and radial nerves; and evaluation of blink reflex and facial responses were performed before and 6, 12, and 18 months after induction of hypothyroidism and compared with controls. Results: Clinical evidence of peripheral nervous dysfunction did not occur in any dog. At 6 month and subsequent evaluations, all hypothyroid dogs had EMG and histologic evidence of hypothyroid myopathy. Hypothyroid dogs had significant (P≤ .04) decreases in ulnar and sciatic‐tibial compound muscle action potentials over time, which were attributed to the concurrent myopathy. No significant differences between control and hypothyroid dogs were detected in electrophysiologic tests of motor (P≥ .1) or sensory nerve conduction velocity (P≥ .24) or nerve roots (P≥ .16) throughout the study period, with values remaining within reference ranges in all dogs. Conclusion: Chronic hypothyroidism induced by thyroid irradiation does not result in clinical or electrophysiologic evidence of peripheral neuropathy, but does cause subclinical myopathy.  相似文献   

8.
OBJECTIVE: To compare the biomechanical properties of radial graft (RG) versus ulnar transposition graft (UTG) limb-sparing techniques in the dog. STUDY DESIGN: Cadaveric study. ANIMALS: Six pairs of normal canine thoracic limbs. METHODS: In each pair of limbs, 1 limb was subjected to the RG technique and the other to the UTG technique. Limbs were tested in axial loading until failure. Modes of failure and biomechanical properties were compared between the 2 groups. Percent coverage of the metacarpal bone by the plate was retrospectively compared between the limbs that failed by fracture of the metacarpal bones and those that did not. RESULTS: RG limbs had significantly greater stiffness, yield load, maximum load, maximum energy, and post-yield energy. All UTG limbs failed by cranial bending of the plate. Half of the RG limbs failed by caudal bending of the plate and half by fracture of the third metacarpal bone at the distal end of the plate. Limbs with <80% plate coverage of the metacarpal bone were significantly more likely to fail by metacarpal fracture. CONCLUSIONS: The RG technique was biomechanically superior to the UTG technique under the conditions studied. At least 80% plate coverage of the metacarpal bone should be achieved. CLINICAL RELEVANCE: Exercise restriction and coaptation bandages should be considered for patients undergoing the UTG technique to minimize potential biomechanical complications.  相似文献   

9.
Knowing the structure and variations of the plexus brachialis is important in neck and shoulder surgery. The knowledge of the brachial plexus reduces the injury rate of the nerves in surgical interventions to the axillary region. The major nerve trunks of the thoracic limb were the suprascapular, subscapular, axillary, radial, musculocutaneous, median and ulnar nerves. In Van cats, the brachial plexus was formed by the ventral branches of the spinal nerves, C6-C7-C8 and T1. The 7th cervical nerve was quite thick compared to the others. The subscapular nerve was the thinnest (on the right side, the average length was 6.55 ± 0.60 mm and on the left side was 6.50 ± 0.60 mm), and the radial nerve was the thickest (the average length on the right side was 28.48 ± 0.44 mm and on the left side was 29.11 ± 0.55 mm). The suprascapular nerve was formed by the ventral branch of the 6th cervical nerve. The subscapular nerves were formed by a branch originating from the 6th cervical nerve and the two medial and caudal branches originating from the 7th cervical nerve. No communicating branch between the ulnar nerve and the median nerve was observed in the palmar region. The axillary nerve was formed by the ventral branches of the 7th nerve, the musculocutaneous nerve was formed by ventral branches of the 6th and 7th cervical nerves, and the ulnar nerve was formed by ventral branches of the 8th cervical and the 1st thoracic nerves. The radial nerve was the thickest branch in the brachial plexus. In Van cats, the origin and distribution of nerves were similar to those reported in the literature for other species of cats, with the exception of the suprascapular, subscapular and axillary nerves.  相似文献   

10.
A schwannoma of the sixth cervical spinal nerve in a 5-year-old Shetland Sheepdog was surgically excised, sparing the thoracic limb and resulting in long-term survival. The dog had been referred because of slowly progressive left thoracic limb lameness. The lesion was localized to the left suprascapular and musculocutaneous nerves or the C6 and C7 spinal nerves on the basis of neurologic examination, electrodiagnostic examination, and myelography. Surgical exploration revealed a mass, which was excised and identified histologically as a schwannoma. Three and a half years later, the dog was normal except for mild gait abnormality, focal muscle atrophy, and a focal area of decreased cutaneous sensation of the left thoracic limb.  相似文献   

11.
Objective— To develop instrumentation and a technique for transverse ulnar bone transport osteogenesis in dogs.
Study Design— Cadaveric study and in vivo validation (1 dog).
Sample Population— Paired cadaveric antebrachii (n=10 dogs) and 1 live dog.
Methods— Circular fixator constructs were applied and fitted with reeling or linear motors designed to transport an ulnar segment transversely into a defect created by excising the distal 50% of the ipsilateral radius. A longitudinal osteotomy of the adjacent ulna was created and the segment was transported across the radial defect. Pre- and post-distraction CT scans were used to compare the efficacy of each construct. The procedure was performed unilaterally in a live dog using the reeling motor (RM) construct.
Results— Both constructs effectively transported the ulnar segment into the defect. Subjectively, the RMs were easier to apply and operate. No significant differences were observed in the objective measures of efficacy between the 2 construct types. The live dog produced viable regenerate bone after transverse ulnar bone transport.
Conclusions— Transverse ulnar bone transport should be considered a potential method for limb salvage in dogs with osteosarcoma (OSA) of the distal radius. The RMs were effective and clinically applicable.
Clinical Relevance— Transverse ulnar bone transport osteogenesis affords the benefits of longitudinal radial bone transport osteogenesis, allowing resolution of large longitudinal radial defects in a substantially less time as a result of shortening the transport distance. This would be beneficial when treating conditions such as OSA where minimizing convalescence and maximizing quality of life is a priority.  相似文献   

12.
The contribution individual ventral spinal nerve roots made to the canine median nerve, ulnar nerve, musculocutaneous nerve, and their muscle nerve branches was determined electrophysiologically. Each spinal nerve root was sequentially stimulated. Utilizing quantitative signal averaging techniques, the evoked potential was measured at each tested peripheral nerve. Evoked potential to the median nerve originated from the seventh cervical spinal root (C7) through the second thoracic spinal root (T2) with most input from C8 and T1. The ulnar nerve received evoked potential from C7-T2. Although T1 provided the major input to both the median and ulnar nerves, the relative contribution of T1 was greater in the ulnar nerve. The musculocutaneous nerve received input from ventral spinal roots C6-T1 with C6 and C7 providing most of the evoked potential. The ventral spinal roots which supplied the bulk of the evoked potential to a particular muscle nerve were consistent between individual dogs. Variation of evoked potential input was greatest from spinal roots which supplied less than 10% of the total potential.  相似文献   

13.
OBJECTIVE: To describe an intraoperative ultrasound imaging technique during dorsal laminectomy in 2 dogs with caudal cervical vertebral instability and malformation (CCVIM, "Wobbler syndrome"). STUDY DESIGN: Clinical case report. SAMPLE POPULATION: Two dogs with CCVIM. RESULTS: On neurologic examination there was tetraparesis with upper motor neuron signs in the thoracic limbs and lower motor neuron signs in the pelvic limbs in dog 1, and hyperreflexia of the rear limbs, normoreflexia of the right front limb, and hyporeflexia of the left front limb of dog 2. Both dogs had signs of marked cervical pain and radiographic signs of cervical spinal cord compression. Intraoperative ultrasonography of the spinal cord revealed protruding intervertebral disc at C5-6 (dog 1) and C6-7 (dog 2), and the parallel borders of the spinal cord and central canal after decompression. Continuous dorsal laminectomy (CDL) resulted in improvement over 16 months (dog 1) and 20 months (dog 2). CONCLUSIONS: Intraoperative ultrasonographic imaging of the cervical spinal cord after CDL was helpful in determining adequate decompression (postlaminectomy) of the spinal cord in relation to the ventral and lateral compressive component(s) and to image the protruding intervertebral disc. CLINICAL RELEVANCE: Intraoperative ultrasonography can be used to provide valuable information on the spinal cord and surrounding soft tissues for the neurosurgeon.  相似文献   

14.
OBJECTIVE: To describe the surgical technique and clinical results of treatment for forelimb angular limb deformities, secondary to premature distal radial or ulnar physeal closure, by using T-plate fixation of a distal radial closing wedge osteotomy in 18 dogs. STUDY DESIGN: Retrospective clinical study. SAMPLE POPULATION: 18 client-owned dogs. METHODS: The medical records of 18 dogs that underwent a distal radial closing wedge osteotomy with T-plate fixation for correction of a forelimb angular limb deformity were reviewed. Small pins (Kirschner wires) were used to obtain the appropriate alignment of the antebrachiocarpal and elbow joints and proper limb orientation. In-hospital follow-up evaluation was obtained at the time fracture healing was observed radiographically. Further long-term follow-up was obtained by owner interview. RESULTS: Osteotomy sites were radiographically healed within 4 to 12 weeks (mean, 8 weeks) after surgery in the 14 dogs that returned for in-hospital follow-up. Limb function was graded as good or excellent in all dogs. Long-term follow-up by owner interview rated limb function and cosmetic appearance as good to excellent in all dogs. Plate removal was necessary in one dog 7 months after surgery because of osteopenia in the radius. CONCLUSION: This surgical technique was considered successful in the treatment of angular limb deformities in all dogs. A good to excellent prognosis is to be expected with this technique, with minimal complications. CLINICAL RELEVANCE: The use of a T-plate for the correction of angular limb deformities has not been previously described in the literature. This technique permits accurate correction of the angular limb deformity and minimizes postoperative complications.  相似文献   

15.

Objectives

To describe the ventral spinal nerve rami contribution to the formation of the brachial plexus (BP), and to compare ease of performing and nerve staining between three blind techniques for BP blockade in dogs.

Study design

Prospective, randomized, blind study.

Animals

A total of 18 dog cadavers weighing 28.2 ± 9.7 kg (mean ± standard deviation).

Methods

Dogs were randomly assigned to two of three BP treatments: traditional approach (TA), perpendicular approach (PA), and axillary approach (AA). Dye (0.2 mL kg?1) was injected in the left BP using a spinal needle; another BP treatment was used in the right BP. Landmarks (L) included: L1, midpoint between point of the shoulder and sixth cervical (C6) transverse process; L2, scapulohumeral joint; and L3, first rib. For TA, the needle was introduced craniocaudally through L1, medial to the limb and cranial to L3. For PA, the needle was directed perpendicular and caudal to L2, aligned with L1, until cranial to L3. For AA, the needle was directed ventrodorsally, parallel and cranial to L3 until at L1. All BPs were scored for dyeing quality [0 (poor) to 5 (excellent)]. The left BP was dissected for nerve origins. Durbin test was used to compare scores (p < 0.05).

Results

In all dogs, the musculocutaneous nerve originated from C7 and C8; the radial nerve from C8, the first thoracic vertebra (T1) (16/18 dogs) and C7 (2/18); and the median and ulnar nerves from C8, T1 (17/18) and C7 (1/18). Respective raw scores and adjusted scores for the incomplete block design were not significantly different (p = 0.72; ranks TA 16.5, PA 19.0, AA 18.5).

Conclusions and clinical relevance

The musculocutaneous, median, ulnar and radial nerves originate from C7, C8 and T1. Regardless of the technique, knowledge of anatomy and precise landmarks are relevant for correct dye dispersion.  相似文献   

16.
OBJECTIVE: To describe a thermographic imaging protocol, identify normal thermographic patterns (ie, color map reflecting the skin temperature distribution) for various regions of interest (ROIs) of dog limbs, and evaluate effects of clipping the coat on thermographic patterns and limb temperature in healthy dogs. ANIMALS: 10 healthy dogs. PROCEDURES: Each dog was thermographically evaluated in the same room (ambient temperature, 21 degrees C) via ROIs that included cranial and caudal views of the body, full lateral body views, full views of the limbs, and views of various limb regions. After initial imaging, the coat was clipped on the forelimbs and hind limbs only. Each dog was then evaluated 15 and 60 minutes and 24 hours after clipping by use of the same protocol. RESULTS: For each ROI within a category (intact coat and each time point after clipping), mean temperatures were similar among the 10 dogs. Pairwise comparisons for 15 and 60 minutes and 24 hours established patterns of temperature stabilization among the 3 time points. Temperatures did not differ significantly between the left and right limbs. There was a mean success rate of 75% for use of image pattern analysis for recognition of similar thermographic patterns in the forelimbs and hind limbs. CONCLUSIONS AND CLINICAL RELEVANCE: Thermography can be a viable, noninvasive imaging modality that provides consistent images with reproducible thermal patterns in ROIs examined in healthy dogs. Although the coat had a predictable influence to decrease the mean temperature, thermal patterns remained fairly consistent after the coat was clipped.  相似文献   

17.
The effects of epidural and intravenous (IV) methadone (0.5mg/kg) on the minimum alveolar concentration of isoflurane (ISO(MAC)) were compared in dogs. Six dogs (16.5 ± 2.5 kg bodyweight) received three treatments in random order during isoflurane anaesthesia, with a 7 day washout interval between each study. Methadone was injected via a lumbosacral epidural catheter introduced 10 cm cranially into the epidural canal and the electrical stimulation for ISO(MAC) determination was applied either to the thoracic (EP(T) treatment) or to the pelvic limb (EP(P) treatment) during separate study days. In the IV treatment, ISO(MAC) was determined via electrical stimulation of the pelvic limb. Variables were recorded before (baseline), 2.5 and 5h after drug injection. The ISO(MAC) decreased significantly (P<0.05) from baseline at 2.5 and 5h after methadone in all treatments. At 2.5h, the magnitude of ISO(MAC) reduction did not differ between treatments (mean decreases from baseline: 30-33%). The ISO(MAC) reduction lasted longer following epidural methadone in the thoracic limb (decreases from baseline: 30% at 5h in the EP(T) treatment vs. 19% and 16% in the EP(P) and IV treatments, respectively). Although the isoflurane sparing effect provided by epidural methadone was not significantly greater than IV methadone during the initial stage (2.5h), it was more prolonged than the IV route in specific dermatomes (5h in the thoracic limb) with the epidural technique employed. Methadone may therefore provide a greater isoflurane sparing effect when administered epidurally, compared to IV, when noxious stimulation occurs in specific dermatomes.  相似文献   

18.
ObjectiveTo describe a new approach to block the femoral nerve and to evaluate the distribution of a dye injected into the psoas compartment using a new femoral nerve block approach; to assess its clinical application, when combined with a sciatic nerve block, for surgical anaesthesia/analgesia of the pelvic limb in dogs.Study designProspective anatomical, research and clinical study.AnimalsTwo dog cadavers; two dogs that had to be euthanized for reasons unrelated to this study, and 15 dogs undergoing pelvic limb orthopaedic surgery.MethodsPhase 1: anatomical dissections were performed to determine a simple method to approach the femoral nerve within the psoas compartment. Phase 2: 0.1 mL kg?1 of a lidocaine-new methylene blue solution was injected bilaterally after successful electrolocation of the femoral nerve in two anaesthetized dogs. Colorant spread was evaluated through femoral nerve dissections after euthanasia. Phase 3: in 15 dogs undergoing pelvic limb orthopaedic surgery under light general anaesthesia with isoflurane, intra-operative analgesic effect (cardiovascular responses) and early post-operative pain score, of the novel femoral nerve block combined with a sciatic nerve block as the sole analgesic protocol, were evaluated.ResultsPhase 1: a needle inserted from the lateral aspect of the lumbar muscles, cranially to the iliac crest and with a 30–45° caudo-medial direction, reaches the femoral nerve in the caudal portion of the psoas compartment. Phase 2: Four femoral nerves were stained >2 cm. Phase 3: this novel lateral pre-iliac approach, combined with the sciatic nerve block, blunted the intra-operative cardiovascular response to surgical stimulation in 13 out of 15 anaesthetized dogs. In addition, rescue analgesia was not required in the early post-operative 2-hour period.Conclusion and clinical relevanceThe lateral pre-iliac femoral nerve block technique may provide adequate intra- and early post-operative pain relief in dogs undergoing pelvic limb surgery.  相似文献   

19.
Transversus abdominis plane (TAP) is a fascial plane containing the thoracolumbar nerve branches that innervate the abdominal wall. Limited information is available on the anatomical organization of these nerve branches in the dog, which is of great importance for the success of the TAP block anaesthetic technique. The aim of this study was to describe the origin and conformation of thoracolumbar nerves running through the TAP in 20 hemi‐abdominal walls of 10 adult mongrel dog cadavers with an average body weight of 12.6 kg (range: 9.6‐15.6). The abdominal walls were dissected from superficial to deep direction, the skin and both obliquus externus abdominis and obliquus internus abdominis muscles were dissected and reflected dorsally to expose the transversus abdominis muscle and the thoracolumbar nerve branches located in this plane. The anatomical features of ventral nerve branches were described. The thoracic nerve branches: T7–T12 and costoabdominalis; and the lumbar nerve branches: iliohypogastricus cranialis, iliohypogastricus caudalis, ilioinguinalis and cutaneus femoris lateralis were identified in all the cadavers. Anatomical variations related to the presence or absence within the TAP of the T7, T8 and T9 nerve branches were found. These variations should be taken into account when planning the TAP block technique in dogs.  相似文献   

20.
Objective To develop a technique for placing continuous peripheral nerve block (CPNB) catheters adjacent to palmar nerves in horses and to evaluate the effect of low‐volume local anesthetic (LA) infusion on nociception in the distal equine thoracic limb. Study design In vitro and in vivo laboratory investigation. Study material and animals Forty‐two thoracic limbs from 22 equine cadavers and five horses. Methods Thoracic limb specimens were dissected to find landmarks for catheter insertion adjacent to medial and lateral palmar nerves. Based on the anatomy of the proximal metacarpus, a technique for placing palmar CPNB catheters was developed and the potential for catheter dislodgement studied in vitro by fluoroscopic visualization during passive carpal flexion and dye injection following simulated limb motion. The feasibility of CPNB catheter instrumentation in standing, sedated horses was tested in five animals, with ultrasound control. Electrical and mechanical stimulation thresholds and response latencies for hoof withdrawal responses (HWR) were determined following saline or LA infusion. Results Medial and lateral CPNB catheters were inserted percutaneously 2 and 4–5 cm, respectively, distal to the accessory carpal bone and advanced for ～7 and 10 cm, respectively, to place the tip just proximal to the communicating branch of the nerves. Catheters were placed correctly in 88% and 85% of cadaver limbs. In the standing horses, LA infusion not only increased HWR thresholds and latencies to noxious mechanical or electrical stimulation but also caused vasodilation and limb swelling over time. Conclusion The technique, developed in vitro, for placing and maintaining palmar CPNB catheters in the equine thoracic limb was successfully applied in vivo. Catheters were well tolerated but LA infusion may cause limb swelling, suggesting a need for further exploration of drug and infusion regimens. Clinical relevance Continuous perineural LA infusion along palmar nerves may develop into an effective analgesic technique in horses suffering from lower limb pain.  相似文献   

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