Femoral nerve block: a novel psoas compartment lateral pre-iliac approach in dogs.
Summary of "Femoral nerve block: a novel psoas compartment lateral pre-iliac approach in dogs."
Objectiveâ€‚ To describe a new approach to block the femoral nerve and to evaluate the distribution of a dye injected into the psoas compartment using a new femoral nerve block approach; to assess its clinical application, when combined with a sciatic nerve block, for surgical anaesthesia/analgesia of the pelvic limb in dogs. Study designâ€‚ Prospective anatomical, research and clinical study. Animalsâ€‚ Two dog cadavers; two dogs that had to be euthanized for reasons unrelated to this study, and 15 dogs undergoing pelvic limb orthopaedic surgery. Methodsâ€‚ Phase 1: anatomical dissections were performed to determine a simple method to approach the femoral nerve within the psoas compartment. Phase 2: 0.1â€ƒmLâ€ƒkg(-1) of a lidocaine-new methylene blue solution was injected bilaterally after successful electrolocation of the femoral nerve in two anaesthetized dogs. Colorant spread was evaluated through femoral nerve dissections after euthanasia. Phase 3: in 15 dogs undergoing pelvic limb orthopaedic surgery under light general anaesthesia with isoflurane, intra-operative analgesic effect (cardiovascular responses) and early post-operative pain score, of the novel femoral nerve block combined with a sciatic nerve block as the sole analgesic protocol, were evaluated. Resultsâ€‚ Phase 1: a needle inserted from the lateral aspect of the lumbar muscles, cranially to the iliac crest and with a 30-45Â° caudo-medial direction, reaches the femoral nerve in the caudal portion of the psoas compartment. Phase 2: Four femoral nerves were stained >2â€ƒcm. Phase 3: this novel lateral pre-iliac approach, combined with the sciatic nerve block, blunted the intra-operative cardiovascular response to surgical stimulation in 13 out of 15 anaesthetized dogs. In addition, rescue analgesia was not required in the early post-operative 2-hour period. Conclusion and clinical relevanceâ€‚ The lateral pre-iliac femoral nerve block technique may provide adequate intra- and early post-operative pain relief in dogs undergoing pelvic limb surgery.
Department of Veterinary Clinics, Veterinary Teaching Hospital 'Mario Modenato', University of Pisa, Pisa, Italy Anesthesiology Department, Faculty of Veterinary Science, University of Buenos Aires, Buenos Aires, Argentina Dick White Referrals, Six Mile B
This article was published in the following journal.
Name: Veterinary anaesthesia and analgesia
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22765834
- DOI: http://dx.doi.org/10.1111/j.1467-2995.2012.00765.x
Medical and Biotech [MESH] Definitions
A powerful flexor of the thigh at the hip joint (psoas major) and a weak flexor of the trunk and lumbar spinal column (psoas minor). Psoas is derived from the Greek "psoa", the plural meaning "muscles of the loin". It is a common site of infection manifesting as abscess (PSOAS ABSCESS). The psoas muscles and their fibers are also used frequently in experiments in muscle physiology.
Autonomic Nerve Block
Interruption of sympathetic pathways, by local injection of an anesthetic agent, at any of four levels: peripheral nerve block, sympathetic ganglion block, extradural block, and subarachnoid block.
Disease involving the femoral nerve. The femoral nerve may be injured by ISCHEMIA (e.g., in association with DIABETIC NEUROPATHIES), nerve compression, trauma, COLLAGEN DISEASES, and other disease processes. Clinical features include MUSCLE WEAKNESS or PARALYSIS of hip flexion and knee extension, ATROPHY of the QUADRICEPS MUSCLE, reduced or absent patellar reflex, and impaired sensation over the anterior and medial thigh.
The vein accompanying the femoral artery in the same sheath; it is a continuation of the popliteal vein and becomes the external iliac vein.
Inferior and external epigastric arteries arise from external iliac; superficial from femoral; superior from internal thoracic. They supply the abdominal muscles, diaphragm, iliac region, and groin. The inferior epigastric artery is used in coronary artery bypass grafting and myocardial revascularization.
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