Abstract
Objective
To examine the anatomy of the lumbar epaxial region and to describe two different
ultrasound-guided approaches for the lumbar erector spinae plane (ESP) block in dogs.
Study design
An anatomical and experimental cadaver study.
Animals
A group of 19 canine cadavers.
Methods
The anatomy was described following dissection of two cadavers. Bilateral ultrasound-guided
ESP injections with 0.4 mL kg–1 of contrast dye were performed in 17 adult Beagle cadavers using either transversal
(TVS) or parasagittal (PST) approaches. Computed tomography was performed to measure
the total length of the contrast dye column and the epidural, intravascular, hypaxial
and intra-abdominal migration. Dissections were performed to assess the spread of
the contrast dye and to determine the degree of staining of the dorsal branches of
the spinal nerves (DBSN). Mann–Whitney U and chi-square tests were used to compare data between groups.
Results
Using both techniques, the contrast dye was observed within the ESP compartment. There
was no difference in the total length of the contrast dye column between TVS and PST
approaches (p = 0.056). Using the TVS approach, multisegmental staining of the DBSN was visible
with 100% (17/17) of injections, while complete staining of the DBSN was achieved
at 94% of the injection sites. Using the PST approach, these values were 29% (5/17)
and 23% (4/17), respectively. The TVS approach stained more DBSN than the PST approach
(p = 0.001), with a median (range) of 2 (2–3) versus 0 (0–3) DBSN, respectively. Using the TVS approach, epidural and intravascular migration
were present in 2/17 (p = 0.485) and 3/17 (p = 0.227) injections, respectively.
Conclusions and clinical relevance
Both ultrasound-guided approaches resulted in a spread of the contrast dye within
the ESP compartment. Although there were no differences in the total length of the
contrast dye column, the TVS approach was superior to the PST approach in staining
DBSN.
Keywords
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Article info
Publication history
Published online: November 11, 2020
Accepted:
July 13,
2020
Received:
November 28,
2019
Identification
Copyright
© 2020 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
