A non-inferiority study comparing the ultrasound-guided parasacral with a novel greater ischiatic notch plane approach in canine cadavers |
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| Institution: | 1. Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA;2. Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina;1. Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium;1. Anaesthesiology and Intensive Care Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece;2. Surgery & Obstetrics Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece;1. Dick White Referrals, Station Farm, Six Mile Bottom, Cambridgeshire, UK;2. Hospital Veterinari Glòries, Barcelona, Spain;3. Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, FL, USA;1. Willows Veterinary Centre and Referral Service, Solihull, UK;2. Paragon Veterinary Referrals, Wakefield, UK;3. Virtual Veterinary Specialists, Middlesex, UK;4. Ela trabalha em Plakentia Veterinary Clinic, Ag. Paraskevi, Greece;5. Waltham Petcare Science Institute, Leicestershire, UK;1. Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA;2. Veterinary Information Network, Davis, CA, USA;1. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp St., Columbus, OH 43210, USA;2. Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607 USA;3. Brain Imaging and Analysis Center, Radiology Department, Duke University, 40 Duke Medicine Circle, Durham, NC 27710, USA;4. Department of Comparative, Diagnostic & Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16th Ave, Gainesville, FL 32608, USA;5. Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA |
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| Abstract: | ObjectiveTo describe the gross and ultrasound anatomy of the parasacral region and an ultrasound-guided greater ischiatic notch (GIN) plane approach aimed at staining the lumbosacral trunk (LST) in canine cadavers. To evaluate if the ultrasound-guided GIN plane approach is non-inferior to the previously described ultrasound-guided parasacral approach at staining the LST.Study designProspective, randomized, non-inferiority experimental anatomic study.AnimalsA total of 17 (23.9 ± 5.2 kg) mesocephalic canine cadavers.MethodsAnatomic and echographic landmarks, and the feasibility of performing a GIN plane technique were evaluated using two canine cadavers. The remaining 15 cadavers had each hemipelvis randomly assigned to be administered either parasacral or GIN plane injection of 0.15 mL kg–1 dye solution. The parasacral region was dissected after injections to assess the staining of LST, cranial gluteal nerve, pararectal fossa and pelvic cavity. The stained LST were removed and processed for histological evaluation of intraneural injections. A one-sided z-test for non-inferiority (non-inferiority margin –14%) was used to statistically evaluate the success of the GIN plane versus the parasacral approach. Data were considered statistically significant when p < 0.05.ResultsThe GIN plane and parasacral approach stained the LST in 100% and 93.3% of the injections, respectively. The success rate difference between treatments was 6.7% 95% confidence interval, –0.6 to 19.0%; p < 0.001 for non-inferiority]. The GIN plane and parasacral injections stained the LST for 32.7 ± 16.8 mm and 43.1 ± 24.3 mm, respectively (p = 0.18). No evidence of intraneural injection was found.Conclusions and clinical relevanceThe ultrasound-guided GIN plane technique resulted in nerve staining that was non-inferior to the parasacral technique and may be considered an alternative to the parasacral approach to block the LST in dogs. |
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| Keywords: | analgesia dogs local anesthesia parasacral ischial plane block regional anesthesia |
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