Objective

To examine the anatomy of the lumbar epaxial region and to describe two different ultrasound-guided approaches for the lumbar erector spinae plane (ESP) block in dogs.

Study design

An anatomical and experimental cadaver study.

Animals

A group of 19 canine cadavers.

Methods

The anatomy was described following dissection of two cadavers. Bilateral ultrasound-guided ESP injections with 0.4 mL kg^–1 of contrast dye were performed in 17 adult Beagle cadavers using either transversal (TVS) or parasagittal (PST) approaches. Computed tomography was performed to measure the total length of the contrast dye column and the epidural, intravascular, hypaxial and intra-abdominal migration. Dissections were performed to assess the spread of the contrast dye and to determine the degree of staining of the dorsal branches of the spinal nerves (DBSN). Mann–Whitney U and chi-square tests were used to compare data between groups.

Results

Using both techniques, the contrast dye was observed within the ESP compartment. There was no difference in the total length of the contrast dye column between TVS and PST approaches (p = 0.056). Using the TVS approach, multisegmental staining of the DBSN was visible with 100% (17/17) of injections, while complete staining of the DBSN was achieved at 94% of the injection sites. Using the PST approach, these values were 29% (5/17) and 23% (4/17), respectively. The TVS approach stained more DBSN than the PST approach (p = 0.001), with a median (range) of 2 (2–3) versus 0 (0–3) DBSN, respectively. Using the TVS approach, epidural and intravascular migration were present in 2/17 (p = 0.485) and 3/17 (p = 0.227) injections, respectively.

Conclusions and clinical relevance

Both ultrasound-guided approaches resulted in a spread of the contrast dye within the ESP compartment. Although there were no differences in the total length of the contrast dye column, the TVS approach was superior to the PST approach in staining DBSN.

中文翻译：

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腰椎竖脊肌平面阻滞：犬尸体中两种超声引导方法的解剖学和染料分布评估

客观的

检查腰椎外轴区域的解剖结构并描述两种不同的超声引导方法，用于治疗犬的腰椎竖脊肌平面 (ESP) 阻滞。

学习规划

解剖和实验尸体研究。

动物

一组 19 具犬类尸体。

方法

在解剖两具尸体后描述了解剖结构。使用横向 (TVS) 或旁矢状 (PST) 方法在 17 具成年比格犬尸体中进行了双侧超声引导的 ESP 注射和 0.4 mL kg ^{– 1}对比染料。进行计算机断层扫描以测量对比染料柱的总长度和硬膜外、血管内、近轴和腹内迁移。进行解剖以评估对比染料的扩散并确定脊神经背侧分支 (DBSN) 的染色程度。Mann-Whitney U和卡方检验用于比较组间数据。

结果

使用这两种技术，在 ESP 隔室内观察到对比染料。TVS 和 PST 方法之间对比染料柱的总长度没有差异 ( p  = 0.056)。使用 TVS 方法，DBSN 的多节段染色在 100% (17/17) 的注射中可见，而 DBSN 的完全染色在 94% 的注射部位实现。使用 PST 方法，这些值分别为 29% (5/17) 和 23% (4/17)。TVS 方法比 PST 方法染色更多的 DBSN（p  = 0.001），中位数（范围）分别为 2 (2-3)和0 (0-3) DBSN。使用 TVS 方法，硬膜外和血管内迁移出现在 2/17 ( p  = 0.485) 和 3/17 ( p = 0.227) 注射，分别。

结论和临床相关性

两种超声引导方法都会导致 ESP 隔室内的对比染料扩散。尽管对比染料柱的总长度没有差异，但 TVS 方法在染色 DBSN 方面优于 PST 方法。