Objective

To develop an ultrasound-guided dorsal approach to the brachial plexus and to investigate the nerve distribution and staining of a dyed injectate in common kestrel (Falco tinnunculus) cadavers.

Study design

Prospective, cadaver study.

Animals

A group of three common kestrel cadavers (six wings).

Methods

All cadavers were fresh-frozen at –20 °C and thawed for 10 hours at room temperature before the study. The cadavers were placed in sternal recumbency and their wings were abducted. A 8–13 MHz linear-array transducer was placed over the scapulohumeral joint, at the centre of a triangle formed by the scapula and the humerus. The brachial plexus was identified between the scapulohumeralis muscle and the pectoralis major muscle, as hypoechoic structures lying just cranially to the axillary vessels. After ultrasound-guided brachial plexus identification, a 22 gauge, 50 mm insulated needle was advanced in-plane using ultrasound visualization. A volume of 0.5 mL kg^–1 of a 3:1 (2% lidocaine:methylene blue) solution was injected. Following cadaver dissection, the pattern of the spread was assessed, and the extent of nerve staining was measured with a calliper and deemed adequate if more than 0.6 cm of the nerve staining was achieved.

Results

The brachial plexus was clearly identified in all wings with the dorsal approach. After dye injection, all the branches of the brachial plexus defined as nerves 1–5 (N1, N2, N3, N4 and N5) were completely stained in five (83%) and partially stained in one (17%) of the six wings.

Conclusions and clinical relevance

The ultrasound-guided dorsal approach allows a clear visualization of the brachial plexus structure. The injection of 0.5 mL kg^–1of a lidocaine/dye solution produced complete nerve staining in most cases. Further in vivo studies are mandatory to confirm the clinical efficacy of this locoregional anaesthesia technique in common kestrels (Falco tinnunculus).

中文翻译：

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超声引导背侧入路治疗红隼（Falco tinnunculus）臂丛神经阻滞：一项尸体研究

客观的

开发一种超声引导的臂丛神经背侧入路，并研究染色注射液在普通红隼 ( Falco tinnunculus ) 尸体中的神经分布和染色。

学习规划

前瞻性，尸体研究。

动物

一组三具常见的红隼尸体（六只翅膀）。

方法

在研究之前，所有尸体都在 –20 °C 下新鲜冷冻并在室温下解冻 10 小时。尸体被放置在胸骨上，他们的翅膀被绑架。一个 8-13 MHz 线阵换能器被放置在肩胛骨关节上方，在由肩胛骨和肱骨形成的三角形的中心。在肩胛肱肌和胸大肌之间发现臂丛神经，因为低回声结构位于腋血管的头侧。在超声引导下臂丛神经识别后，使用超声可视化在平面内推进 22 号、50 毫米绝缘针。0.5 mL kg ^{–1 的}体积注射 3:1（2% 利多卡因：亚甲蓝）溶液。尸体解剖后，评估扩散模式，并用卡尺测量神经染色的程度，如果神经染色超过 0.6 厘米，则认为是足够的。

结果

背侧入路时，在所有翅膀中都清楚地识别出臂丛神经。注射染料后，臂丛神经的所有分支定义为神经 1-5（N1、N2、N3、N4 和 N5），其中五个（83%）完全染色，六个翅膀中的一个（17%）部分染色.

结论和临床相关性

超声引导的背侧入路可以清楚地观察臂丛神经结构。在大多数情况下，注射 0.5 mL kg ^–1的利多卡因/染料溶液会产生完全的神经染色。必须进行进一步的体内研究，以确认这种局部麻醉技术在常见红隼（Falco tinnunculus）中的临床疗效。