Abstract
Objectives
To describe the ultrasound-guided rectus sheath block technique and the anatomical
spread of two volumes of methylene blue injection in dog cadavers.
Study design
Blinded, prospective, experimental cadaveric study.
Animals
A total of eight dog cadavers weighing 8.9 ± 1.6 kg.
Methods
Ultrasound-guided rectus sheath injections were performed bilaterally 1 cm cranial
to the umbilicus using 0.25 mL kg–1 (low volume; LV) and 0.50 mL kg–1 (high volume; HV) of 0.5% methylene blue dye. A total of 16 hemiabdomens were injected.
The ultrasound image quality of the muscular and fascial plane landmarks and needle
visualization were scored using a standardized scale. Cadavers were dissected to determine
the distribution of the dye and to assess staining of ventral branches of the spinal
nerves.
Results
Fewer ventral spinal nerve branches were stained in the LV group than in the HV group,
at 2.00 ± 0 and 2.90 ± 0.83, respectively (p < 0.01). Ventral branches of thoracic (T) and lumbar (L) spinal nerves (T10, T11,
T12, T13 and L1) were stained 25%, 100%, 75%, 25% and 0% of the time in LV group and
12.5%, 87.5%, 100.0%, 75.0% and 13.0% in HV group. A lesser extent of cranial–caudal
dye distribution was observed in the LV group than in the HV group (7.1 ± 1.8 cm and
9.2 ± 1.8 cm, respectively; p = 0.03). There was no significant difference in medial–lateral spread of dye, number
of test doses or ultrasound image quality scores between groups.
Conclusions and clinical relevance
The results of this study suggest that, on an anatomical basis, this easily performed
block has the potential to provide effective abdominal wall analgesia for the ventral
midline. This study supports the potential of the rectus sheath block for abdominal
procedures, and further investigations on its clinical efficacy are warranted.
Keywords
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Article info
Publication history
Published online: September 28, 2019
Accepted:
September 5,
2019
Received:
June 1,
2019
Identification
Copyright
© 2019 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
