Anatomical characterization of the brachial plexus in dog cadavers and comparison of three blind techniques for blockade

Published:December 12, 2017DOI:



      To describe the ventral spinal nerve rami contribution to the formation of the brachial plexus (BP), and to compare ease of performing and nerve staining between three blind techniques for BP blockade in dogs.

      Study design

      Prospective, randomized, blind study.


      A total of 18 dog cadavers weighing 28.2 ± 9.7 kg (mean ± standard deviation).


      Dogs were randomly assigned to two of three BP treatments: traditional approach (TA), perpendicular approach (PA), and axillary approach (AA). Dye (0.2 mL kg−1) was injected in the left BP using a spinal needle; another BP treatment was used in the right BP. Landmarks (L) included: L1, midpoint between point of the shoulder and sixth cervical (C6) transverse process; L2, scapulohumeral joint; and L3, first rib. For TA, the needle was introduced craniocaudally through L1, medial to the limb and cranial to L3. For PA, the needle was directed perpendicular and caudal to L2, aligned with L1, until cranial to L3. For AA, the needle was directed ventrodorsally, parallel and cranial to L3 until at L1. All BPs were scored for dyeing quality [0 (poor) to 5 (excellent)]. The left BP was dissected for nerve origins. Durbin test was used to compare scores (p < 0.05).


      In all dogs, the musculocutaneous nerve originated from C7 and C8; the radial nerve from C8, the first thoracic vertebra (T1) (16/18 dogs) and C7 (2/18); and the median and ulnar nerves from C8, T1 (17/18) and C7 (1/18). Respective raw scores and adjusted scores for the incomplete block design were not significantly different (p = 0.72; ranks TA 16.5, PA 19.0, AA 18.5).

      Conclusions and clinical relevance

      The musculocutaneous, median, ulnar and radial nerves originate from C7, C8 and T1. Regardless of the technique, knowledge of anatomy and precise landmarks are relevant for correct dye dispersion.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Veterinary Anaesthesia and Analgesia
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Allam M.W.
        • Lee D.G.
        • Nulsen F.E.
        • Fortune E.A.
        The anatomy of the brachial plexus of the dog.
        Anat Rec. 1952; 114: 173-179
        • Campoy L.
        • Read M.
        The thoracic limb.
        in: Campoy L. Read M. Small Animal Regional Anesthesia and Analgesia. 1st edn. Wiley-Blackwell, USA2013: 141-165
        • Campoy L.
        • Read M.
        • Peralta S.
        Canine and feline local anesthetic and analgesic techniques.
        in: Grimm K.A. Lamont L.A. Tranquilli W.J. Lumb & Jones' Veterinary Anesthesia and Analgesia. 5th edn. Wiley-Blackwell, USA2015: 827-857
        • Campoy L.
        • Martin-Flores M.
        • Looney A.L.
        • et al.
        Distribution of a lidocaine-methylene blue solution staining in brachial plexus, lumbar plexus and sciatic nerve blocks in the dog.
        Vet Anaesth Analg. 2008; 35: 348-354
        • Campoy L.
        • Bezuidenhout A.J.
        • Gleed R.D.
        • et al.
        Ultrasound-guided approach for axillary brachial plexus, femoral nerve, and sciatic nerve blocks in dogs.
        Vet Anaesth Analg. 2010; 37: 144-153
        • Dyce K.M.
        • Sack W.O.
        • Wensing C.J.G.
        The nervous system.
        in: Dyce K.M. Sack W.O. Wensing C.J.G. Textbook of Veterinary Anatomy. 4th edn. Elsevier, USA2010: 321-323
        • Evans H.E.
        • de Lahunta A.
        Guide to Dissection of the Dog.
        7th edn. Elsevier, USA2010: 6-31
        • Futema F.
        • Fantoni D.T.
        • Auler Jr., J.O.
        • et al.
        A new brachial plexus block technique in dogs.
        Vet Anaesth Analg. 2002; 29: 133-139
        • Kendall M.G.
        • Gibbons J.D.
        Rank correlation methods.
        5th edn. Oxford University Press, USA1990: 129-135
        • Lemke K.A.
        • Dawson S.D.
        Local and regional anesthesia.
        Vet Clin North Am Small Anim Pract. 2000; 30: 839-857
        • Mahler S.P.
        • Reece J.L.M.
        Electrical nerve stimulation to facilitate placement of an indwelling catheter for repeated brachial plexus block in a traumatized dog.
        Vet Anaesth Analg. 2007; 34: 365-370
        • Mahler S.P.
        • Adogwa A.O.
        Anatomical and experimental studies of brachial plexus, sciatic, and femoral nerve-location using peripheral nerve stimulation in the dog.
        Vet Anaesth Analg. 2008; 35: 80-89
        • Miller R.A.
        Comparative studies upon the morphology and distribution of the brachial plexus.
        Am J Anat. 1934; 54: 143-175
        • Moens N.M.M.
        • Caulkett N.A.
        The use of a catheter to provide brachial plexus block in dogs.
        Can Vet J. 2000; 41: 685-689
        • Mosing M.
        • Reich H.
        • Moens Y.
        Clinical evaluation of the anaesthetic sparing effect of brachial plexus block in cats.
        Vet Anaesth Analg. 2010; 37: 154-161
        • Nutt P.
        Brachial plexus analgesia in the dog.
        Vet Rec. 1962; 74: 874-877
        • Ricco C.
        • Shih A.
        • Killos M.
        • et al.
        Different volumes of injectate using electrostimulator and blinded techniques for brachial plexus block in dogs.
        Vet Rec. 2013; 173: 608
        • Rioja E.
        • Sinclair M.
        • Chalmers H.
        • et al.
        Comparison of three techniques for paravertebral brachial plexus blockade in dogs.
        Vet Anaesth Analg. 2012; 39: 190-200
        • Wenger S.
        Brachial plexus block using electrolocation for pancarpal arthrodesis in a dog.
        Vet Anaesth Analg. 2004; 31: 272-275
        • Wenger S.
        • Moens Y.
        • Jäggin N.
        • Schatzmann U.
        Evaluation of the analgesic effect of lidocaine and bupivacaine used to provide a brachial plexus block for forelimb surgery in 10 dogs.
        Vet Rec. 2005; 156: 639-642
        • Trumpatori B.J.
        • Carter J.E.
        • Hash J.
        • et al.
        Evaluation of a midhumeral block of the radial, ulnar, musculocutaneous and median (RUMM block) nerves for analgesia of the distal aspect of the thoracic limb in dogs.
        Vet Surg. 2010; 39: 785-796
        • Yuan L.
        • Tang W.
        • Fu G.Q.
        • et al.
        Combining interscalene brachial plexus block with intravenous-inhalation combined anesthesia for upper extremity fractures surgery: a randomized controlled trial.
        Int J Surg. 2014; 12: 1484-1488