Objective

To describe the sonoanatomy of the abdominal wall in live cats and to compare the distribution pattern of two versus three ultrasound-guided transversus abdominis plane (TAP) injections using clinically applicable volumes of lidocaine–dye solution in cat cadavers.

Study design

Prospective anatomical study.

Animals

A total of eight client-owned healthy cats and eight cat cadavers.

Methods

Ultrasound anatomy of the abdominal wall, landmarks and sites for needle access were determined in live cats. Ultrasound-guided TAP injections were performed in eight thawed cat cadavers. Volumes of 0.25 or 0.16 mL kg⁻¹ per point of a lidocaine–dye solution were injected using either two [subcostal and preiliac (SP)] or three [subcostal, retrocostal and preiliac (SRP)] injection points, respectively. Each cadaver was then dissected to determine the injectate distribution and the number of thoracolumbar nerves stained with each approach. The target nerves were defined as the ventromedial branches of the thoracic nerves 10 (T10), T11, T12, T13 and lumbar nerves 1 (L1) and L2.

Results

Sonoanatomy was consistent with anatomy upon dissection and the TAP was identified in all cadavers. A total of 16 subcostal, 16 preiliac and nine retrocostal TAP injections were performed. The overall staining success rate of the target nerves was 66.7% and 92.6% for the SP and SPR approaches, respectively (p = 0.02). The ventromedial branches of T10, T11, T12, T13, L1 and L2 were stained in 57.1%, 100.0%, 85.7%, 28.6%, 42.9% and 85.7%, and in 66.7%, 100.0%, 100.0%, 100.0%, 88.9% and 100.0% of the cases with the SP and SRP approaches, respectively.

Conclusions and clinical relevance

The SRP approach allowed a broader distribution around the target nerves, whereas a staining gap was observed at T13 and L1 with the SP approach. Further studies are necessary to investigate the analgesic effect of these approaches in a clinical setting.

中文翻译：

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猫尸体腹横肌平面阻滞：使用两点和三点方法对注射液扩散的解剖描述和比较

客观的

描述活猫腹壁的声学解剖结构，并在猫尸体中使用临床适用体积的利多卡因染料溶液，比较两个和三个超声引导下腹横肌平面 (TAP) 注射的分布模式。

学习规划

前瞻性解剖学研究。

动物

共有八只客户拥有的健康猫和八具猫尸体。

方法

在活猫中确定了腹壁、标志和穿刺部位的超声解剖结构。在八具解冻的猫尸体中进行了超声引导下的 TAP 注射。分别使用两个 [肋下和髂前 (SP)] 或三个 [肋下、肋后和前髂 (SRP)] 注射点注射每点0.25 或 0.16 mL kg ^-1的利多卡因染料溶液。然后解剖每具尸体以确定注射液的分布和每种方法染色的胸腰神经的数量。目标神经被定义为胸神经 10 (T10)、T11、T12、T13 和腰神经 1 (L1) 和 L2 的腹内侧支。

结果

解剖时的声解剖学与解剖学一致，并且在所有尸体中都发现了 TAP。总共进行了 16 次肋下、16 次髂前和 9 次肋后 TAP 注射。SP 和 SPR 方法的目标神经的总体染色成功率分别为 66.7% 和 92.6% ( p  = 0.02)。T10、T11、T12、T13、L1 和 L2 的腹内侧分支被染色的比例分别为 57.1%、100.0%、85.7%、28.6%、42.9% 和 85.7%，以及 66.7%、100.0%、100.0%。 SP 和 SRP 方法的案例分别为 88.9% 和 100.0%。

结论和临床相关性

SRP 方法允许更广泛的分布在目标神经周围，而使用 SP 方法在 T13 和 L1 处观察到染色间隙。需要进一步的研究来调查这些方法在临床环境中的镇痛效果。