Anatomical and experimental studies of brachial plexus, sciatic, and femoral nerve-location using peripheral nerve stimulation in the dog
Anatomical and experimental studies of brachial plexus, sciatic, and femoral nerve-location using peripheral nerve stimulation in the dog
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DOI：
10.1111/j.1467-2995.2007.00356.x
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发表时间：
2008-01-01
影响因子：
1.7
通讯作者：
Adogwa, Andrew O.
中科院分区：
文献类型：
--
作者：
Mahler, Stephan P.;Adogwa, Andrew O.
目的研究犬臂丛、坐骨神经和股神经的解剖，为使用周围神经刺激器进行神经阻滞提供实验依据。研究设计前瞻性实验研究。动物身体4具，健康成年犬4只，体重23+/-2.5 kg。第二阶段：使用电刺激器和屏蔽针，在4只麻醉犬的侧卧状态下(美托咪定，5 mU kg(-1)/氯胺酮5 mg kg(-1))，评估这些技术的实用性和电刺激的价值。结果臂丛神经的针以大约20-30°的角度插入肩峰内侧肩峰内侧，与动物所在平面垂直，方向平行于动物的长轴，腹尾方向。对于坐骨神经，穿刺针正好位于骶结节韧带的头侧，穿过臀浅肌，与水平面成约60度角，沿颅腹方向，直到坐骨水平。对于股神经，针垂直于皮肤，正好位于股动脉的头侧，并略微指向尾部。使用外周神经刺激器定位所有神经，并在0.2~0.4 mA的电流下诱发肌肉收缩。结论周围神经电刺激可准确定位犬的臂丛神经分支、坐骨神经和股神经，与盲针相比，周围神经刺激提高了神经阻滞的可靠性。
Objective To investigate the anatomy of the brachial plexus, sciatic, and femoral nerves for the use of a peripheral nerve-stimulator to perform nerve blocks in dogs.Study design Prospective experimental trial.Animals Four canine cadavers and four healthy adult dogs weighing 23 +/- 2.5 kg.Methods Phase I: in four canine cadavers, an anatomical study was conducted to evaluate accurate needle-insertion techniques. Phase II: the utility of these techniques, and the value of electrostimulation, were evaluated in four anesthetized dogs in lateral recumbency (medetomidine, 5 mu g kg(-1)/ketamine 5 mg kg(-1)) using an electrical stimulator and shielded needles.Results For the brachial plexus, the needle was inserted cranial to the acromion, medial to the subscapularis muscle, at an angle of approximately 20-30 degrees in relation to a plane vertical to the surface on which the animal was lying, oriented parallel to the long axis of the animal, in a ventro-caudal direction. For the sciatic nerve, the needle was inserted just cranial to the sacrotuberous ligament, through the gluteus superficialis muscle, at an angle of approximately 60 degrees in relation to the horizontal plane, in a ventro-cranial direction, and up to the level of the ischium. For the femoral nerve, the needle was inserted perpendicular to the skin, just cranial to the femoral artery, and directed a little caudally. Using a peripheral nerve-stimulator, all nerves were located, and muscle contractions were elicited at a current of 0.2-0.4 mA. No complications were observed during the procedures.Conclusion Electrostimulation of peripheral nerves is useful in locating the branches of the brachial plexus as well as the sciatic and femoral nerves in dogs.Clinical relevance Peripheral nerve stimulation increases the reliability of a nerve block when compared with blind needle-insertion.