Perla Velazquez-Delgado, Eduardo Gutierrez-Blanco, Antonio Ortega-Pacheco, Jose Leonardo Guillermo-Cordero, Brighton T Dzikiti, Alexander Valverde
{"title":"羊椎旁胸腰椎近端阻滞的解剖标志:尸体和体内研究。","authors":"Perla Velazquez-Delgado, Eduardo Gutierrez-Blanco, Antonio Ortega-Pacheco, Jose Leonardo Guillermo-Cordero, Brighton T Dzikiti, Alexander Valverde","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>The objective of this study was to describe the anatomy of the spinal nerves, specifically the last thoracic nerve (T13) and the first to third lumbar nerves (L1 to L3), in order to safely carry out an accurate proximal paravertebral block (PPVB) in sheep. This study consisted of 2 phases. In Phase 1, 7 sheep cadavers were dissected to identify the path and relevant anatomical landmarks of spinal nerves T13 and L1 to L3. In Phase 2, 2 healthy sheep received bilateral injections of 0.35 mL/kg body weight (BW) for each hemithoracolumbar area (0.088 mL/kg BW per nerve) of a dye-lidocaine solution (50:50) using a PPVB approach and then assessed for 15 min for signs of systemic and local effects of lidocaine. After euthanasia, the infiltrated area was dissected to assess the spread of the dye. Successful nerve staining (> 2 cm in length), macroscopic evidence of intraneural/intravascular injection, and spread to the epidural space and the abdominal cavity were recorded. In Phase 1, each branch of all nerves was easily identified and located using the caudal aspect of the spinous apophysis and the lateral edge of the transverse process of the respective vertebrae. An overlap was observed between the costoabdominal (T13), the iliohypogastric (L1), and ilioinguinal (L2) nerves. In Phase 2, all nerves were stained at least 2 cm from the injection site. There was no diffusion of the dye into the epidural space or abdominal cavity. In conclusion, using the anatomical landmarks described specifically for sheep, the PPVB provided accurate perineural distribution of the injected dye-lidocaine solution, which could result in clinical analgesia of the flank.</p>","PeriodicalId":9550,"journal":{"name":"Canadian journal of veterinary research = Revue canadienne de recherche veterinaire","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536352/pdf/cjvr_04_294.pdf","citationCount":"0","resultStr":"{\"title\":\"Anatomical landmarks for a proximal paravertebral thoracolumbar block in sheep: Cadaver and <i>in-vivo</i> study.\",\"authors\":\"Perla Velazquez-Delgado, Eduardo Gutierrez-Blanco, Antonio Ortega-Pacheco, Jose Leonardo Guillermo-Cordero, Brighton T Dzikiti, Alexander Valverde\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The objective of this study was to describe the anatomy of the spinal nerves, specifically the last thoracic nerve (T13) and the first to third lumbar nerves (L1 to L3), in order to safely carry out an accurate proximal paravertebral block (PPVB) in sheep. This study consisted of 2 phases. In Phase 1, 7 sheep cadavers were dissected to identify the path and relevant anatomical landmarks of spinal nerves T13 and L1 to L3. In Phase 2, 2 healthy sheep received bilateral injections of 0.35 mL/kg body weight (BW) for each hemithoracolumbar area (0.088 mL/kg BW per nerve) of a dye-lidocaine solution (50:50) using a PPVB approach and then assessed for 15 min for signs of systemic and local effects of lidocaine. After euthanasia, the infiltrated area was dissected to assess the spread of the dye. Successful nerve staining (> 2 cm in length), macroscopic evidence of intraneural/intravascular injection, and spread to the epidural space and the abdominal cavity were recorded. In Phase 1, each branch of all nerves was easily identified and located using the caudal aspect of the spinous apophysis and the lateral edge of the transverse process of the respective vertebrae. An overlap was observed between the costoabdominal (T13), the iliohypogastric (L1), and ilioinguinal (L2) nerves. In Phase 2, all nerves were stained at least 2 cm from the injection site. There was no diffusion of the dye into the epidural space or abdominal cavity. In conclusion, using the anatomical landmarks described specifically for sheep, the PPVB provided accurate perineural distribution of the injected dye-lidocaine solution, which could result in clinical analgesia of the flank.</p>\",\"PeriodicalId\":9550,\"journal\":{\"name\":\"Canadian journal of veterinary research = Revue canadienne de recherche veterinaire\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2022-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536352/pdf/cjvr_04_294.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian journal of veterinary research = Revue canadienne de recherche veterinaire\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"\",\"RegionNum\":4,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Veterinary\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian journal of veterinary research = Revue canadienne de recherche veterinaire","FirstCategoryId":"97","ListUrlMain":"","RegionNum":4,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Veterinary","Score":null,"Total":0}
Anatomical landmarks for a proximal paravertebral thoracolumbar block in sheep: Cadaver and in-vivo study.
The objective of this study was to describe the anatomy of the spinal nerves, specifically the last thoracic nerve (T13) and the first to third lumbar nerves (L1 to L3), in order to safely carry out an accurate proximal paravertebral block (PPVB) in sheep. This study consisted of 2 phases. In Phase 1, 7 sheep cadavers were dissected to identify the path and relevant anatomical landmarks of spinal nerves T13 and L1 to L3. In Phase 2, 2 healthy sheep received bilateral injections of 0.35 mL/kg body weight (BW) for each hemithoracolumbar area (0.088 mL/kg BW per nerve) of a dye-lidocaine solution (50:50) using a PPVB approach and then assessed for 15 min for signs of systemic and local effects of lidocaine. After euthanasia, the infiltrated area was dissected to assess the spread of the dye. Successful nerve staining (> 2 cm in length), macroscopic evidence of intraneural/intravascular injection, and spread to the epidural space and the abdominal cavity were recorded. In Phase 1, each branch of all nerves was easily identified and located using the caudal aspect of the spinous apophysis and the lateral edge of the transverse process of the respective vertebrae. An overlap was observed between the costoabdominal (T13), the iliohypogastric (L1), and ilioinguinal (L2) nerves. In Phase 2, all nerves were stained at least 2 cm from the injection site. There was no diffusion of the dye into the epidural space or abdominal cavity. In conclusion, using the anatomical landmarks described specifically for sheep, the PPVB provided accurate perineural distribution of the injected dye-lidocaine solution, which could result in clinical analgesia of the flank.
期刊介绍:
The Canadian Journal of Veterinary Research, published by the Canadian Veterinary Medical Association, is Canada''s only veterinary research publication. This quarterly peer-reviewed online-only journal has earned a wide international readership through the publishing of high quality scientific papers in the field of veterinary medicine. The Journal publishes the results of original research in veterinary and comparative medicine.