Abstract
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.
Highlights
The caudal thoracic paravertebral (CTPV) block is a regional anesthesia technique currently used in human medicine to provide perioperative analgesia in abdominal surgical procedures such as laparoscopic cholecystectomy, ventral hernia repair, open renal surgery, and open major gynecological midline surgery among others (Richardson et al, 1995; Naja et al, 2002; El-Boghdadly et al, 2016)
In spite of the small number of dogs used in this study, our results showed that the described technique could be a suitable method to place TPV catheters in the caudal area of the thorax
The placement of catheters in the TPV space has been described as challenging by some authors in the human literature (Luyet et al, 2009), its use has considerably increased in recent years
Summary
The caudal thoracic paravertebral (CTPV) block is a regional anesthesia technique currently used in human medicine to provide perioperative analgesia in abdominal surgical procedures such as laparoscopic cholecystectomy, ventral hernia repair, open renal surgery, and open major gynecological midline surgery among others (Richardson et al, 1995; Naja et al, 2002; El-Boghdadly et al, 2016). The aims of this study are to describe an ultrasoundguided technique to place caudal TPV catheters in canine cadavers and evaluate the distribution of a contrast-dye solution administered through the catheter. The study hypotheses were first that catheter placement in the CTPV space can be feasible using a US-guided technique and, second, that the distribution of the contrast-dye at this site will reach the caudal thoracic nerves responsible for analgesia of the cranial abdomen. 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. 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.
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