Objective

To compare the dye distribution following either two lateral abdominal or one lateral abdominal and one subcostal ultrasound-guided transversus abdominis plane (TAP) injections of a clinically relevant volume of dye solution in dogs.

Study design

Randomized cadaveric study.

Animals

A total of eight canine cadavers.

Methods

On one side of each cadaver, two TAP injections were performed on the lateral aspect of the abdomen (approach LL), caudal to the last rib and cranial to the iliac crest. On the contralateral hemiabdomen, one subcostal (caudal to the costal arch) and one lateral abdominal injection (between last rib and iliac crest), were performed (approach SL). Side allocation was randomly determined. A spinal needle was introduced in-plane to the transducer for each injection of methylene blue (0.25 mL kg⁻¹). All cadavers were dissected to assess dye distribution and number of stained target nerves.

Results

All injections were performed in the TAP. The proportion of target nerve staining was 53.5% versus 80.4% with approaches LL and SL, respectively (p = 0.005). Approach LL stained the first lumbar (L1) spinal nerve in 100% of injections and ninth thoracic (T9), T10, T11, T12, T13 and L2 were stained in 0%, 0%, 37.5%, 62.5%, 87.5% and 87.5% of injections, respectively. Approach SL stained T11, L1 and L2 in 100% of injections and T9, T10, T12 and T13 were stained in 37.5%, 87.5%, 75% and 62.5% of injections, respectively. Approach SL resulted in greater staining of nerves cranial to T12 compared with approach LL. The two approaches were equivalent in staining nerves caudal to T12.

Conclusions and clinical relevance

Approach SL provided a broader distribution of the injected solution than approach LL, which may result in a larger blocked area in live animals undergoing celiotomy.

中文翻译：

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犬尸体腹横肌平面阻滞两种方法的比较

客观的

比较在狗的两个侧腹部或一个侧腹部和一个肋下超声引导下腹横肌平面 (TAP) 注射临床相关体积的染料溶液后的染料分布。

学习规划

随机尸体研究。

动物

一共有八具犬类尸体。

方法

在每具尸体的一侧，在腹部外侧（LL 方法）、最后一根肋骨的尾部和髂嵴的颅骨上进行两次 TAP 注射。在对侧半腹侧，进行了一次肋下注射（肋弓尾部）和一次侧腹注射（最后一根肋骨和髂嵴之间）（SL 入路）。侧分配是随机确定的。每次注射亚甲蓝 (0.25 mL kg ^-1 ) 时，将脊椎针在平面内引入换能器。解剖所有尸体以评估染料分布和染色目标神经的数量。

结果

所有注射均在 TAP 中进行。目标神经染色的比例分别为 53.5%和80.4%，分别使用方法 LL 和 SL ( p  = 0.005)。方法 LL 在 100% 的注射中染色第一腰椎 (L1) 脊神经，第九胸椎 (T9)、T10、T11、T12、T13 和 L2 染色为 0%、0%、37.5%、62.5%、87.5% 和分别为 87.5% 的注射液。方法 SL 在 100% 的注射中对 T11、L1 和 L2 染色，在 37.5%、87.5%、75% 和 62.5% 的注射中分别染色 T9、T10、T12 和 T13。与方法 LL 相比，方法 SL 导致对 T12 颅神经的更大染色。这两种方法在染色 T12 尾神经方面是等效的。

结论和临床相关性

方法 SL 提供了比方法 LL 更广泛的注射溶液分布, 这可能导致在接受剖腹术的活体动物中更大的阻塞区域。