Abstract
To determine the minimum volume of methylene blue (MB) to completely color the brachial plexus (BP) nerves, simulating an effective anesthetic block in cats. Fifteen adult male cat cadavers were injected through subscapular approach with volumes of 2, 3, 4, 5 and 6 ml in both forelimbs, for a total of 30 brachial plexus blocks (BPB). After infusions, the specimens were carefully dissected preserving each nervous branch. The measurement of the effective area was indicated by the impregnation of MB. Nerves were divided into four segments from the origin at the spinal level until the insertion into the thoracic limb muscles. The blocks were considered effective only when all the nerves were strongly or totally colored. Volumes of 2, 3 and 4 ml were considered insufficient suggesting a failed block, however, volumes of 5 and 6 ml were associated with a successful block. The injection of methylene blue, in a volume of 6 ml, completely colored the brachial plexus. At volumes of 5 and 6 ml the brachial plexus blocks were considered a successful regional block, however, volumes of 2, 3 and 4 ml were considered a failed regional block.
Highlights
Multimodal anesthesia is the administration of different drugs and/or techniques to exploit their synergistic effects
The brachial plexus (BP) is a set of nerve fibers that innervate the forelimb and shoulder, comprising motor and sensory nerves that are present in specific areas, whose origin is the spinal cord between segments C5 and T22
The goal of this study was to determine the minimal volume of methylene blue to completely color the brachial plexus nerves after the application of different volumes by the subscapular approach, simulating the local anesthetic required to anesthetize all the structures involved in forelimb and shoulder surgery in cats
Summary
Multimodal anesthesia is the administration of different drugs and/or techniques to exploit their synergistic effects. Regional blocks are an important tool used by the anesthesiologists, since these techniques provide complete intraoperative analgesia and suppression the sympatheticadrenal axis In this context, the brachial plexus block (BPB) is the most accepted anesthetic protocol for the forelimbs and shoulder major surgeries, because the desensitization of the peripheral nerves provides analgesia for the musculoskeletal structures. The brachial plexus (BP) is a set of nerve fibers that innervate the forelimb and shoulder, comprising motor and sensory nerves that are present in specific areas, whose origin is the spinal cord between segments C5 and T22 In most species it usually consists of the suprascapular, subscapular, musculocutaneous, axillary, radial, median and ulnar nerves. The radial nerve is the largest nerve composing the BP and is responsible for the motor innervation of the extensor muscles in the region of the arm, while the ulnar nerve is responsible for innervating the muscles of the flexor carpi ulnar and digital flexor
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