Ultrasound-guided subscalene approach for the brachial plexus in dogs: a descriptive cadaveric study

IF 1.9 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia Pub Date : 2025-04-24 DOI:10.1016/j.vaa.2025.04.005

Santiago E. Fuensalida , Lisa Tarragona , Alfredo Díaz , Nicolas H. Giansanti , Angela Briganti , Diego A. Portela , Pablo E. Otero

{"title":"Ultrasound-guided subscalene approach for the brachial plexus in dogs: a descriptive cadaveric study","authors":"Santiago E. Fuensalida , Lisa Tarragona , Alfredo Díaz , Nicolas H. Giansanti , Angela Briganti , Diego A. Portela , Pablo E. Otero","doi":"10.1016/j.vaa.2025.04.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To describe the ultrasound anatomy of the subscalene groove, evaluate the feasibility of an in-plane subscalene approach to the brachial plexus (BP) and compare one- and two-point injection techniques for BP staining in canine cadavers.</div></div><div><h3>Study design</h3><div>Prospective, randomized, descriptive anatomical study.</div></div><div><h3>Animals</h3><div>Nineteen thawed male and female adult canine cadavers [mass 3–40 kg, body condition scores 4–6/9 (range)].</div></div><div><h3>Methods</h3><div>Ultrasonography and anatomical dissections were performed in two cadavers to study the relationship between cervical muscles and the ventral branches of the last three cervical spinal nerves (C6, C7, C8) and the first thoracic spinal nerve (T1). Seventeen thawed cadavers were then used to assess nerve staining following ultrasound-guided subscalene injections. Group 1 dogs (G1, <em>n</em> = 17) were injected with 0.4 mL kg<sup>–1</sup> of dye cranial to C8 in the subscalene groove using a single injection point. Group 2 dogs (G2, <em>n</em> = 17) were injected with dye in the same intermuscular plane, split into two injections: 0.3 mL kg<sup>–1</sup> cranial to C8 and 0.1 mL kg<sup>–1</sup> cranial to C7 on the contralateral side. Staining was considered successful if C6, C7, C8 and T1 were stained circumferentially (>1 cm) and unsuccessful if any branch was unstained. Outcomes were analyzed using Fisher’s exact test, with significance set at <em>p</em> < 0.05.</div></div><div><h3>Results</h3><div>Sonoanatomy matched anatomical dissections, with target nerves identified in all cadavers. Staining success rates were 41% in G1 and 88% in G2 (<em>p</em> = 0.0104). Median (range) stained ventral branches were 3 (2–4) in G1 and 4 (3–4) in G2.</div></div><div><h3>Conclusions and clinical relevance</h3><div>The ultrasound-guided subscalene approach facilitated reliable identification of the BP at the subscalene groove. Successful staining of all target nerves required two injection aliquots. Future clinical studies are warranted to assess the applicability and efficacy of this technique in live animals.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 4","pages":"Pages 470-479"},"PeriodicalIF":1.9000,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary anaesthesia and analgesia","FirstCategoryId":"97","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1467298725000972","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To describe the ultrasound anatomy of the subscalene groove, evaluate the feasibility of an in-plane subscalene approach to the brachial plexus (BP) and compare one- and two-point injection techniques for BP staining in canine cadavers.

Study design

Prospective, randomized, descriptive anatomical study.

Animals

Nineteen thawed male and female adult canine cadavers [mass 3–40 kg, body condition scores 4–6/9 (range)].

Methods

Ultrasonography and anatomical dissections were performed in two cadavers to study the relationship between cervical muscles and the ventral branches of the last three cervical spinal nerves (C6, C7, C8) and the first thoracic spinal nerve (T1). Seventeen thawed cadavers were then used to assess nerve staining following ultrasound-guided subscalene injections. Group 1 dogs (G1, n = 17) were injected with 0.4 mL kg^–1 of dye cranial to C8 in the subscalene groove using a single injection point. Group 2 dogs (G2, n = 17) were injected with dye in the same intermuscular plane, split into two injections: 0.3 mL kg^–1 cranial to C8 and 0.1 mL kg^–1 cranial to C7 on the contralateral side. Staining was considered successful if C6, C7, C8 and T1 were stained circumferentially (>1 cm) and unsuccessful if any branch was unstained. Outcomes were analyzed using Fisher’s exact test, with significance set at p < 0.05.

Results

Sonoanatomy matched anatomical dissections, with target nerves identified in all cadavers. Staining success rates were 41% in G1 and 88% in G2 (p = 0.0104). Median (range) stained ventral branches were 3 (2–4) in G1 and 4 (3–4) in G2.

Conclusions and clinical relevance

The ultrasound-guided subscalene approach facilitated reliable identification of the BP at the subscalene groove. Successful staining of all target nerves required two injection aliquots. Future clinical studies are warranted to assess the applicability and efficacy of this technique in live animals.

查看原文本刊更多论文

超声引导下斜角肌下入路治疗犬臂丛：描述性尸体研究。

目的：描述斜角肌下沟的超声解剖，评估斜角肌下入路进入臂丛（BP）的可行性，并比较一点注射和两点注射技术在犬尸体上进行BP染色的效果。研究设计：前瞻性、随机、描述性解剖研究。动物：19具解冻的雄性和雌性成年犬尸体[质量3-40公斤，身体状况评分4-6/9（范围）]。方法：对2具尸体进行超声检查和解剖解剖，研究颈肌与后3条颈脊神经（C6、C7、C8）和第一胸脊神经（T1）腹侧支的关系。然后用17具解冻的尸体来评估超声引导下斜角肌下注射后的神经染色。组1 （G1, n = 17）在斜角肌下沟单点注射0.4 mL kg-1的颅至C8染料。2组（G2, n = 17）在同一肌间平面注射染料，分两次注射，对侧注射0.3 mL kg-1颅至C8和0.1 mL kg-1颅至C7。如果C6、C7、C8和T1呈周向染色（bbb1cm），则认为染色成功，如果任何分支未染色，则认为染色不成功。结果分析采用Fisher精确检验，显著性设置为p < 0.05。结果：超声解剖与解剖解剖相匹配，所有尸体都识别出目标神经。G1组染色成功率为41%，G2组为88% （p = 0.0104）。G1组腹支染色中位（范围）为3 (2-4)，G2组为4（3-4）。结论及临床意义：超声引导下斜角肌下入路可可靠地识别斜角肌下沟处的BP。成功染色所有目标神经需要两次注射等量。未来的临床研究需要评估该技术在活体动物中的适用性和有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Veterinary anaesthesia and analgesia 农林科学-兽医学

CiteScore

3.10

自引率

17.60%

发文量

审稿时长

97 days

期刊介绍： Veterinary Anaesthesia and Analgesia is the official journal of the Association of Veterinary Anaesthetists, the American College of Veterinary Anesthesia and Analgesia and the European College of Veterinary Anaesthesia and Analgesia. Its purpose is the publication of original, peer reviewed articles covering all branches of anaesthesia and the relief of pain in animals. Articles concerned with the following subjects related to anaesthesia and analgesia are also welcome: the basic sciences; pathophysiology of disease as it relates to anaesthetic management equipment intensive care chemical restraint of animals including laboratory animals, wildlife and exotic animals welfare issues associated with pain and distress education in veterinary anaesthesia and analgesia. Review articles, special articles, and historical notes will also be published, along with editorials, case reports in the form of letters to the editor, and book reviews. There is also an active correspondence section.