1
|
Byrne J, Wendt-Hornickle E, Tearney C, Franzen-Klein D, Ahlmann-Garcia A, Ienello L. Ultrasound-guided ventral approach to the brachial plexus block in barred owls (Strix varia): a cadaveric study. Vet Anaesth Analg 2024:S1467-2987(24)00147-8. [PMID: 39266398 DOI: 10.1016/j.vaa.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/05/2024] [Accepted: 08/06/2024] [Indexed: 09/14/2024]
Abstract
OBJECTIVE To develop an ultrasound (US)-guided ventral approach to the brachial plexus (BP) and evaluate nerve anatomy and staining in barred owl cadavers. STUDY DESIGN Prospective, cadaveric study. ANIMALS Eleven adult male and female barred owl cadavers with a body mass of 0.43-0.98 kg. METHODS Eleven frozen cadavers were thawed for 48 hours, weighed and assigned a body condition score. Ten cadavers were placed in dorsal recumbency with wings abducted. US-guided visualization of the BP was achieved by placing a 13-6 MHz linear probe over the ventral aspect of the scapulohumeral joint, parallel to the sternum. A 22 gauge, 50 mm insulated needle was advanced in-plane in a caudal-to-cranial direction. In each owl, injection targeting one BP was performed with 0.4 mL kg-1 of a 1:1 0.5% ropivacaine and 1% methylene blue solution. Dissection was performed 15 minutes postinjection. Nerve staining was deemed successful if ≥ 1 cm of circumferential staining was achieved. The eleventh owl cadaver was injected with a 1:1 solution of 1% methylene blue and 74% ioversol contrast into both wings, and computed tomography (CT) was performed just before and 15 minutes after injection. RESULTS The BP was clearly identified ultrasonographically in cadavers weighing > 0.5 kg. An injectate volume of 0.4 mL kg-1 provided complete staining of the BP branches in all cadavers. CT scan revealed no contrast within the coelomic cavity. CONCLUSIONS AND CLINICAL RELEVANCE The US-guided BP injection using a ventral approach was easily performed in barred owl cadavers weighing > 0.5 kg. The injection of 0.4 mL kg-1 of a ropivacaine-dye solution resulted in complete staining of the BP branches in all wings, suggesting that this technique could provide analgesia for structures distal to the scapulohumeral joint. Clinical studies are necessary to confirm the safety and efficacy of this technique in barred owls and other bird species.
Collapse
Affiliation(s)
- Jessica Byrne
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, MN, USA.
| | - Erin Wendt-Hornickle
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, MN, USA
| | - Caitlin Tearney
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, MN, USA
| | - Dana Franzen-Klein
- The Raptor Center, College of Veterinary Medicine, University of Minnesota, MN, USA
| | | | - Lauren Ienello
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, MN, USA
| |
Collapse
|
2
|
Mead SA, Allen MJ, Elsayed SAH, Gittel CS. Evaluating the Efficacy of a Peripheral Nerve Simulator-Guided Brachial Plexus Block in Rabbits Undergoing Orthopaedic Surgery Compared to Systemic Analgesia. Vet Sci 2024; 11:213. [PMID: 38787185 PMCID: PMC11125770 DOI: 10.3390/vetsci11050213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/24/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024] Open
Abstract
Locoregional anaesthetic techniques are invaluable for providing multimodal analgesia for painful surgical procedures. This prospective, randomised study describes a nerve stimulator-guided brachial plexus blockade (BPB) in rabbits undergoing orthopaedic surgery in comparison to systemic lidocaine. Premedication was provided with intramuscular (IM) medetomidine, fentanyl, and midazolam. Anaesthesia was induced (propofol IV) and maintained with isoflurane. Nine rabbits received a lidocaine BPB (2%; 0.3 mL kg-1), and eight received a lidocaine constant rate infusion (CRI) (2 mg kg-1 IV, followed by 100 µg kg-1 min-1). Rescue analgesia was provided with fentanyl IV. Carprofen was administered at the end of the surgery. Postoperative pain was determined using the Rabbit Grimace Scale (RGS) and a composite pain scale. Buprenorphine was administered according to the pain score for two hours after extubation. Rabbits were filmed during the first two hours to measure distance travelled and behaviours. Food intake and faeces output were compared. Every rabbit in CRI required intraoperative rescue analgesia compared to none in BPB. However, rabbits in both groups had similar pain scores, and there was no difference in the administration of postoperative analgesia. There were no significant differences in food intake or faeces production over 18 h, and no significant differences in distance travelled or behaviours examined during the first two hours. BPB seems superior for intraoperative analgesia. Postoperatively, both groups were comparable.
Collapse
Affiliation(s)
- Sophie A. Mead
- Queen’s Veterinary School Hospital, University of Cambridge, Cambridge CB3 0ES, UK;
- Southfields Veterinary Specialists, Basildon SS14 3AP, UK
| | - Matthew J. Allen
- Surgical Discovery Centre, University of Cambridge, Cambridge CB3 0ES, UK
| | - Sara Ahmed Hassouna Elsayed
- Faculty of Veterinary Medicine, Alexandria University, Alexandria 5424041, Egypt
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
| | - Claudia S. Gittel
- Queen’s Veterinary School Hospital, University of Cambridge, Cambridge CB3 0ES, UK;
- Rossdales Equine Hospital, Cotton End Rd, Newmarket CB8 7NN, UK
| |
Collapse
|
3
|
Trujanovic R, Rohrbach H. Ultrasound-Guided Block of the Sciatic and the Femoral Nerves in Rabbits-A Descriptive Anatomical Study. Animals (Basel) 2023; 13:2393. [PMID: 37508169 PMCID: PMC10376789 DOI: 10.3390/ani13142393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/20/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
The rabbit is a popular animal model for human biomechanical research involving surgery on the hind limb. Mortality is higher in rabbits when undergoing general anesthesia compared to dogs and cats. Moreover, due to their nature as prey animals, rabbits have a tendency to hide signs of pain, making it challenging to detect discomfort at an early stage. Incorporating regional anesthesia into an anesthetic protocol can greatly reduce the requirements for systemic anesthetic and analgesic drugs, thereby minimizing associated side effects. In other species, a block of the sciatic (ScN) and the femoral nerves (FN) is usually applied in patients undergoing hind limb surgery. In phase 1 of this study, the ScN and the FN have been localized and an appropriate approach has been evaluated under sonographic guidance. In phase 2, a mixture of new methylene blue and lidocaine have been administered to the ScN and the FN in 10 cadavers (20 hind limbs). Staining of the nerves was evaluated by dissection. Ultrasonographically, the ScN appeared as a binocular structure surrounded by a hyperechoic rim. The FN appeared as a hypoechoic structure in the dorsal part of the iliopsoas muscle (IPM), becoming hyperechoic/honey-comb-like in the ventral part. Both nerves could be successfully stained in all animals over a median length of 2.3 cm which was considered effective. This technique allows feasible and accurate access to block the ScN and the FN and may lead to successful analgesia in rabbits undergoing hind limb surgery.
Collapse
Affiliation(s)
- Robert Trujanovic
- Anesthesia and Perioperative Intensive Care Unit, Department of Small Animals and Horses, University of Veterinary Medicine, 2210 Vienna, Austria
- Anaesthesiology and Pain Therapy Section, Department for Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland
| | - Helene Rohrbach
- Anaesthesiology and Pain Therapy Section, Department for Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland
| |
Collapse
|
4
|
Abstract
Rabbits occupy facets of veterinary medicine spanning from companion mammals, wildlife medicine, zoologic species, and research models. Therefore, analgesia is required for a variety of conditions in rabbits and is a critical component of patient care. Considerations when selecting an analgesic protocol in rabbits include timing of administration, route of administration, degree or anticipated pain, ability to access or use controlled drugs, systemic health, and any potential side effects. This review focuses on pharmacologic and locoregional management of pain in rabbits and emphasizes the need for further studies on pain management in this species.
Collapse
Affiliation(s)
- Sarah Ozawa
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 Williams Moore Dr, Raleigh, NC 27606, USA.
| | - Alessia Cenani
- Department of Surgical and Radiographical Sciences, School of Veterinary Medicine University of California Davis, One Shields Avenue, Davis, CA 95616, USA
| | - David Sanchez-Migallon Guzman Lv
- Department of Medicine and Epidemiology, School of Veterinary Medicine University of California Davis, One Shields Avenue, Davis, CA 95616, USA
| |
Collapse
|
5
|
Felisberto R, Flaherty D, Tayari H. Ultrasound‐ and nerve stimulation‐guided sciatic and saphenous nerve blocks in a pet rabbit (
Oryctolagus cuniculus
) undergoing calcaneal fracture repair. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ricardo Felisberto
- Anaesthesia Department Southern Counties Veterinary Specialists Ringwood UK
| | - Derek Flaherty
- Anaesthesia Department Southern Counties Veterinary Specialists Ringwood UK
| | - Hamaseh Tayari
- Anaesthesia Department Southern Counties Veterinary Specialists Ringwood UK
| |
Collapse
|
6
|
Jané D, Gusmão B, Oliveira B, Custódio L, Reis Filho N, Trein T, Floriano B. Comparison of two volumes for sciatic perineural injection using 1% methylene blue in rabbit cadavers. ARQ BRAS MED VET ZOO 2021. [DOI: 10.1590/1678-4162-12302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT The purpose of this study was to assess the efficacy of a blind technique for sciatic and femoral nerve block in rabbit cadavers by evaluating the spread of 1% methylene blue at two different volumes. Nine recently euthanized rabbits weighing 2.5(0.3kg were used. The sciatic (SN) and femoral (FN) nerves of each limb were randomly assigned for injection with 1% methylene blue at 0.2mL/kg (G0.2) or 0.3mL/kg (G0.3). Nerves were dissected and measured for depth and extension of staining (cm). Mean comparisons were performed using paired t test. The relation between volume and nerve staining ( 2cm was assessed using chi-square test. The mean depth of SN was 1.9±0.2 and 1.6±0.3cm and staining 1.9±1.4 and 2.0±1.2cm, respectively in G0.2 and G0.3. No relation was found between depth and dye spread and there was no association between nerve staining ( 2.0cm and volume of solution. The FN failed to be stained in all subjects. In conclusion, SN injection can be successfully performed without guidance in rabbits. The lower volume (0.2mL/kg) is recommended to avoid systemic toxicity.
Collapse
Affiliation(s)
- D.R. Jané
- Centro Universitário das Faculdades Integradas de Ourinhos, Brasil
| | - B.S. Gusmão
- Centro Universitário das Faculdades Integradas de Ourinhos, Brasil
| | - B.B. Oliveira
- Centro Universitário das Faculdades Integradas de Ourinhos, Brasil
| | - L.P. Custódio
- Centro Universitário das Faculdades Integradas de Ourinhos, Brasil
| | - N.P. Reis Filho
- Centro Universitário das Faculdades Integradas de Ourinhos, Brasil
| | | | - B.P. Floriano
- Centro Universitário das Faculdades Integradas de Ourinhos, Brasil
| |
Collapse
|
7
|
Abstract
With the increasing frequency of rabbits as veterinary patients, the expectation for high-quality, intensive veterinary care, and resultantly an understanding of anesthesia has been increasing. Sedation and general anesthesia are commonly required for many routine and emergency procedures in rabbits, and this results in the need for a strong awareness of anesthetic principles, knowledge of limitations of anesthesia, and maintenance of high standards of anesthesia.
Collapse
|
8
|
Barastegui D, Gallardo-Calero I, Rodriguez-Carunchio L, Barrera-Ochoa S, Knorr J, Rivas-Nicolls D, Soldado F. Effect of vascularized periosteum on revitalization of massive bone isografts: An experimental study in a rabbit model. Microsurgery 2021; 41:157-164. [PMID: 32949430 DOI: 10.1002/micr.30647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/28/2020] [Accepted: 08/28/2020] [Indexed: 11/09/2022]
Abstract
INTRODUCTION In the last years, limb salvage has become the gold standard treatment over amputation. Today, 90% of extremity osteogenic sarcomas can be treated with limb salvage surgery. However, these reconstructions are not exempt from complications. Massive allografts have been associated to high risk of nonunion (12-57%), fracture (7-30%) and infection (5-21%). Association of vascularized periosteum flap to a massive bone allograft (MBA) has shown to halve the average time of allograft union in clinical series, even compared to vascularized fibular flap. Creeping substitution process has been reported in massive allograft when periosteum flap was associated. However, we have little data about whether it results into allograft revitalization. We hypothesize that the association of a periosteum flap to a bone isograft promotes isograft revitalization, defined as the colonization of the devitalized bone by new-form vessels and viable osteocytes, turning it vital. MATERIALS AND METHODS Forty-four New Zealand white male rabbits underwent a 10 mm segmental radial bone defect. In 24 rabbits the bone excision included the periosteum (controls); in 20 rabbits (periosteum group) bone excision was performed carefully detaching periosteum in order to preserve it. Cryopreserved bone isograft from another rabbit was trimmed and placed to the defect gap and was fixed with a retrograde intramedullar 0.6 mm Kirschner wire. Rabbits were randomized and distributed in 3 subgroups depending on the follow-up (control group: 5 rabbits in 5-week follow up group, 8 rabbits in 10-week follow-up group, 7 rabbits in 20-week follow-up group; periosteum group: 5 rabbits in 5-week follow up group, 7 rabbits in 10-week follow-up group, 7 rabbits in 20-week follow-up group). Fluoroscopic images of rabbit forelimb were taken after sacrifice to address union. Each specimen was blindly evaluated in optical microscope (magnification, ×4) after hematoxylin and eosin staining to qualitative record: presence of new vessels and osteocytes in bone graft lacunae (yes/no) to address revitalization, presence of callus (yes/no) and woven bone and cartilage tissue area (mm2 ) to address remodeling (osteoclast resorption of old bone and substitution by osteoblastic new bone formation). RESULTS No isograft revitalization occurred in any group, but it was observed bone graft resorption and substitution by new-formed bone in periosteum group. This phenomenon was accelerated in 5-week periosteum group (control group: 49.5 ± 9.6 mm2 vs. periosteum group: 34.9 ± 10.4 mm2 ; p = .07). Remodeled lamellar bone was observed in both 20-week groups (control group: 6.1 ± 6.3 mm2 vs. periosteum group: 5.8 ± 3.0 mm2 , p = .67). Periosteum group showed complete integration and graft substitution, whereas devitalized osteons were still observed in 20-week controls. All periosteum group samples showed radiographic union through a bone callus, whereas controls showed nonunion in eight specimens (Union rate: control group 60% vs. periosteum group 100%, p = .003). CONCLUSIONS Association of vascularized periosteum to a massive bone isograft has shown to accelerate bone graft substitution into a newly formed bone, thus, no bone graft revitalization occurs.
Collapse
Affiliation(s)
- David Barastegui
- Orthopedic and Trauma Surgery, Instituto Cugat, Fundación García Cugat, Hospital Quiron, Barcelona, Spain
| | - Irene Gallardo-Calero
- Hand Surgery Unit, Orthopaedic Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Leonardo Rodriguez-Carunchio
- Department of Pathology, Faculty of Medicine, Hospital Clinic, Barcelona, Spain
- University of Vic. Central University of Catalonia (UVic-UCC), Barcelona, Spain
| | - Sergi Barrera-Ochoa
- icatMA Hand and Microsugery Unit, ICATME, Hospital Universitari Quiron-Dexeus, Barcelona, Spain
| | - Jorge Knorr
- Pediatric Hand Surgery and Microsurgery Unit, Barcelona University, Childrens Hospital HM Nens, Barcelona, Spain
- Unidad UCA Mikel Sanchez, Vithas San José, Vitoria, Spain
| | - Danilo Rivas-Nicolls
- Department of Plastic, Aesthetic and Reconstructive Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Francisco Soldado
- Pediatric Hand Surgery and Microsurgery Unit, Barcelona University, Childrens Hospital HM Nens, Barcelona, Spain
- Unidad UCA Mikel Sanchez, Vithas San José, Vitoria, Spain
| |
Collapse
|
9
|
Injection techniques for auricular nerve blocks in the rabbit cadaver. Vet Anaesth Analg 2019; 47:274-279. [PMID: 32029354 DOI: 10.1016/j.vaa.2019.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/28/2019] [Accepted: 11/26/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To describe the landmarks for localization and to determine the methodology and volume of methylene blue dye to adequately stain the auricular nerves in rabbit cadavers. STUDY DESIGN Prospective, randomized, cadaveric study. ANIMALS A total of 26 rabbit cadavers (Dutch-Belted and New Zealand White breeds). METHODS Part I: anatomical dissections were performed to identify the sensory auricular nerves and to establish the ideal injection approach and volume of dye required for nerve staining. Part II: a single injection technique using 0.1 mL kg-1 dye was evaluated for staining the greater auricular nerve and two techniques (perpendicular and angled needle approaches) using 0.075 mL kg-1 dye were evaluated for the auriculotemporal nerve. Dye spread was evaluated through cadaveric dissections and nerve staining graded using a 0-2 point scale. Injections were considered successful if the nerve was stained circumferentially. Cadavers were assessed for staining of the mandibular nerve owing to the close proximity to the auriculotemporal nerve. Fisher's exact test and mixed effects logistic regression model were used for statistical analysis. RESULTS The greater auricular nerve was stained in 24/27 (88.9%) injections. The auriculotemporal nerve was stained in 7/12 injections (58.3%) with the perpendicular needle approach; staining success increased to 80% (12/15 injections) with the angled needle approach; however, this difference was not statistically significant (p = 0.228). Mandibular nerve staining occurred on seven auriculotemporal injections with no statistically significant difference in the incidence of nerve staining between techniques. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that the auricular nerves in rabbit cadavers can be successfully located and stained using anatomic landmarks and the described injection techniques.
Collapse
|
10
|
Abstract
Even when performed by skilled operators, locating the nerves can be challenging in small exotic pets; in such cases, the use of an electrical nerve stimulator may be useful to confirm the correct identification of the target nerve. Exotic animal anesthesia and analgesia have dramatically progressed over the past decade and continue to do so as more research and technologies develop. Technological advancements such as airway devices, endoscopic intubation techniques, positive intermittent pressure ventilators, and invasive and noninvasive blood pressure monitors have played a significant role in improving patient safety and the anesthetic outcomes of exotic animals.
Collapse
|
11
|
Abstract
Locoregional techniques are used in exotic pets to improve perioperative analgesia as well as decrease the requirement of systemic analgesics during and after invasive surgeries. This article focuses on the techniques that have been described for exotic mammals, birds, and reptiles, focusing on those that rely on ultrasonographic or nerve stimulator guidance.
Collapse
Affiliation(s)
- Dario d'Ovidio
- Private Practitioner, Via Cristoforo Colombo 118, Arzano, NA 80022, Italy.
| | - Chiara Adami
- Clinical Sciences and Services, Royal Veterinary College, University of London, Hawkshead Campus, Hatfield AL97TA, United Kingdom
| |
Collapse
|
12
|
Mencalha R, Sousa CADS, Costa O, Abidu-Figueiredo M. Ultrasound and gross anatomy of the brachial plexus and major nerves of the forelimb. An anesthetic approach using the domestic rabbit (Oyctolagus cuniculus) as an experimental model1. Acta Cir Bras 2016; 31:218-26. [DOI: 10.1590/s0102-865020160040000001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/11/2016] [Indexed: 11/21/2022] Open
|