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The use of a nerve stimulation test to confirm sacrococcygeal epidural needle placement in cats

      Abstract

      Objective

      To determine if a nerve stimulation test (NST) could act as a monitoring technique to confirm sacrococcygeal epidural needle placement in cats.

      Study design

      Prospective experimental trial in a clinical setting.

      Animals

      Twenty-four adult cats, scheduled for a therapeutic procedure where epidural anesthesia was indicated.

      Methods

      Under general anesthesia, an insulated needle was inserted through the S3-Cd1 intervertebral space guided by the application of a fixed electrical current (0.7 mA) until a motor response was obtained. The NST was considered positive when the epidural nerve stimulation produced a motor response of the muscles of the tail, whereas it was considered negative when no motor response was evoked. In the NST positive cases, 0.3 mL kg−1 of 0.5% bupivacaine was administrated before needle withdrawal. Ten minutes after injection, epidural blockade was confirmed by the loss of perineal (anal), and pelvic limbs reflexes (patellar and withdrawal).

      Results

      The use of a fixed electrical stimulation current of 0.7 mA resulted in correct prediction of sacrococcygeal epidural injection, corroborated by post bupivacaine loss of perineal and pelvic limb reflexes, in 95.8% of the cases.

      Conclusion and clinical relevance

      This study demonstrates the feasibility of using, in a clinical setting, an electrical stimulation test as an objective and in real-time method to confirm sacrococcygeal epidural needle placement in cats.

      Keywords

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      References

        • Fletcher TF
        • Malkmus SA
        Spinal anatomy of experimental animals.
        in: Yaksh TL Spinal Drug Delivery. Elsevier, New York, USA1999: 71-96
        • Ghoshal NG
        Spinal nerves.
        in: Getty R Sisson and Grossman’s The Anatomy of the Domestic Animals. 5th edn. WB Saunders Co, Philadelphia, USA1982: 1862-1887
        • Maierl J
        • Liebich HG
        Investigations on the postnatal development of the macroscopic proportions and the topographic anatomy of the feline spinal cord.
        Anat Histol Embryol. 1998; 27: 375-379
        • O’Hearn AK
        • Wright BD
        Coccygeal epidural with local anesthetic for catheterization and pain management in the treatment of feline urethral obstruction.
        J Vet Emerg Crit Care. 2011; 21: 50-52
        • Otero PE
        • Campoy L
        Epidural and spinal anesthesia.
        in: Campoy L Read M Small Animals Regional Anesthesia and Analgesia. Wiley-Blackwell, New York, USA2013: 227-260
        • Otero PE
        • Portela DA
        • Brinkyer JA
        • et al.
        Use of electrical stimulation to monitor lumbosacral epidural and intrathecal needle placement in rabbits.
        Am J Vet Res. 2012; 73: 1137-1141
        • Otero PE
        • Zaccagnini AS
        • Fuensalida SE
        • et al.
        Use of electrical nerve stimulation to monitor lumbosacral epidural needle placement in cats.
        Vet Anaesth Analg. 2014; 41: 325-329
        • Otero PE
        • Verdier N
        • Ceballos M
        • et al.
        The use of electrical stimulation to guide epidural and intrathecal needle advancement at the L5-L6 intervertebral space in dogs.
        Vet Anaesth Analg. 2014; https://doi.org/10.1111/vaa.12137
        • St. Clair LE
        Carnivore myology.
        in: Getty R Sisson and Grossman’s The Anatomy of the Domestic Animals. 5th edn. WB Saunders Co, Philadelphia, USA1982: 1507-1537
        • Tsui BC
        • Wagner AM
        • Cunningham K
        • et al.
        Can continuous low current electrical stimulation distinguish insulated needle position in the epidural and intrathecal spaces in pediatric patients?.
        Paediatr Anaesth. 2005; 15: 959-963