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Assessment of an ultrasound-guided technique for catheterization of the caudal thoracic paravertebral space in dog cadavers

BACKGROUND: The caudal thoracic paravertebral (CTPV) block is a regional anesthesia technique currently used in human medicine to provide analgesia in abdominal surgical procedures. AIM: The objectives of this study are to describe an ultrasound-guided technique to place catheters in CTPV space in c...

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Detalles Bibliográficos
Autores principales: Serra, Roger Medina, Jimenez, Carolina Palacios, Monticelli, Paolo, Plested, Mark, Viscasillas, Jaime
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Faculty of Veterinary Medicine 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794404/
https://www.ncbi.nlm.nih.gov/pubmed/31998616
http://dx.doi.org/10.4314/ovj.v9i3.7
Descripción
Sumario:BACKGROUND: The caudal thoracic paravertebral (CTPV) block is a regional anesthesia technique currently used in human medicine to provide analgesia in abdominal surgical procedures. AIM: The objectives of this study are to describe an ultrasound-guided technique to place catheters in CTPV space in canine cadavers and evaluate the distribution of a 50:50 contrast-dye solution administered through them. METHODS: Eight thawed adult beagle cadavers (9.2 ± 2.0 kg body total weight) were used. Thirteen catheters were placed. In the first phase, a volume of 0.3 ml kg(−1) of the contrast-dye was administered in all cases. After the injections, computed tomography (CT) scans were carried out to assess the distribution of the contrast-dye. In the second phase, an extra 0.2 ml kg(−1) of the contrast-dye was administered through eight catheters, followed by a second CT scan. Two cadavers were dissected to assess the distribution of the contrast-dye. The injection site varied between T8-9 and T12-13. RESULTS: The evaluation of the CT scans showed contrast-dye within the paravertebral space in 92% (12/13) of the injections. The distribution pattern observed after the injections performed within the TPV space was linear and intercostal in all cases. The median (range) linear spread of the contrast was 7 (5–10) spinal nerves and involved 3 (2–8) intercostal spaces. The contrast-dye reached lumbar regions in 42% of the injections (5/12). A larger spread of the contrast-dye was not observed after the administration of a second dose of the injectate. No signs of epidural, intrapleural/intrapulmonary, intravascular, or intraabdominal spread were observed. The dissection of the two cadavers confirmed the spread of the contrast-dye along the sympathetic trunk and intercostal spaces. CONCLUSION: The administration of 0.3 ml kg(−1) of the contrast-dye in the CTPV space resulted in a distribution compatible with the block of nerves responsible for the innervation of the majority of the abdominal viscera and cranial abdominal wall.