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Home / Equine Research Bank / Animals (Basel) / Assessment of an Ultrasound-Guided Rectus Sheath Block in Fo...
Animals : an open access journal from MDPI2023; 13(23); 3600; doi: 10.3390/ani13233600

Assessment of an Ultrasound-Guided Rectus Sheath Block in Foals: A Cadaveric Study.

Abstract: In neonatal equines, pathologies involving umbilical structures are an important cause of morbidity, and surgical removal of urachal remnants is a common procedure in clinical practice. Surgery involving the ventral abdominal wall can cause substantial pain, leading to complications and prolonged recovery. The objectives of this study were to describe a two-point bilateral ultrasound-guided rectus sheath block at the level of the umbilicus and to evaluate the extent of dye distribution in foal cadavers. Ten foal cadavers were included in the study, in which a bilateral two-point ultrasound-guided rectus sheath block was performed-one injection 5 cm cranially and a second one 5 cm caudally to the umbilicus. The injectate consisted of a mixture of iodinated contrast medium and blue dye at a volume of 0.25 mL kg per injection point (total 1 mL kg). After the injection, computer tomography and subsequent dissection of the ventral abdominal wall were performed. The extension of the contrast medium, the number of stained nerves, and contamination of the abdominal cavity were evaluated. The cranio-caudal extension of the contrast ranged from 0.8 to 1.4 cm per milliliter of injectate. The most commonly stained ventral branches of spinal nerves were thoracic (Th) nerves 16, 17, and 18 (95%, 85%, and 80% of the nerves, respectively). Abdominal contamination was found in four animals. The results suggest that the block could provide periumbilical analgesia. Further studies with different volumes of injectate and living animals are warranted.
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Publication Date: 2023-11-21 PubMed ID: 38066951PubMed Central: PMC10705729DOI: 10.3390/ani13233600Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research examines an ultrasound-guided rectus sheath block method for reducing pain in foals after ventral abdominal wall surgeries. Using dye injections in foal cadavers, the study assesses the effectiveness and potential contamination of this procedure.

Research Objective

The research aimed to describe an ultrasound-guided rectus sheath block method and to assess its effectiveness in distributing the analgesia in foals’ abdominal area. This was mainly focused on reducing the pain post-surgery in foals.

Research Method

  • In this cadaveric study, ten foal cadavers were used for the purpose of this research.
  • A two-point bilateral ultrasound-guided rectus sheath block, one injection 5 cm towards the head and a second one 5cm towards the tail from the umbilicus, was performed on each foal cadaver.
  • A mix of iodinated contrast medium and blue dye at a quantity of 0.25 mL kg for each injection point was used as the injectate.
  • CT scans and subsequent dissection of the ventral abdominal wall were executed post-injection. This helped in observing the extent of the injectate dispersion and any potential abdominal contamination.

Observations and Findings

  • The extension of the injectate contrast varied from 0.8 – 1.4 cm per milliliter of the solution.
  • The most consistently dyed ventral branches of spinal nerves were the thoracic nerves 16, 17, and 18, indicating that these nerves were the most likely areas targeted by the analgesia.
  • Abdominal contamination, potentially indicating the occurrence of leakage or over-spread of the injectate, was found in four out of the ten animals.

Conclusion

Based on the findings, the research suggests that the ultrasound-guided rectus sheath block could provide effective pain relief in the proximity of the umbilicus in foals undergoing surgery. Future investigations using different injection volumes and live animals for the analysis are recommended for a comprehensive evaluation of this method’s potential applications and limitations.

Cite This Article

APA
Gutiérrez Bautista ÁJ, Söbbeler FJ, Koch R, Viscasillas J, Kästner S. (2023). Assessment of an Ultrasound-Guided Rectus Sheath Block in Foals: A Cadaveric Study. Animals (Basel), 13(23), 3600. https://doi.org/10.3390/ani13233600

Publication

Animals : an open access journal from MDPI
ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 13
Issue: 23
PII: 3600

Researcher Affiliations

Gutiérrez Bautista, Álvaro Jesús
  • Small Animal Clinic, University of Veterinary Medicine Hanover, Foundation, Bünteweg 9, 30559 Hannover, Germany.
Söbbeler, Franz Josef
  • Small Animal Clinic, University of Veterinary Medicine Hanover, Foundation, Bünteweg 9, 30559 Hannover, Germany.
Koch, Rüdiger
  • Institute of Anatomy, University of Veterinary Medicine Hanover, Foundation, Bischofsholer Damm 15, 30173 Hanover, Germany.
Viscasillas, Jaime
  • Hospital Veterinario Anicura Valencia Sur, Av. de Picassent, 28, 46460 Valencia, Spain.
Kästner, Sabine
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559 Hannover, Germany.

Conflict of Interest Statement

The authors declare no conflict of interest.

References

This article includes 31 references
  1. Graubner C, Gerber V, Doherr M, Spadavecchia C. Clinical Application and Reliability of a Post Abdominal Surgery Pain Assessment Scale (PASPAS) in Horses. Vet. J. 2011;188:178–183.
    doi: 10.1016/j.tvjl.2010.04.029pubmed: 20627635google scholar: lookup
  2. Muir W.W. Pain: Mechanisms and Management in Horses. Vet. Clin. N. Am. Equine Pract. 2010;26:467–480.
    doi: 10.1016/j.cveq.2010.07.008pubmed: 21056294google scholar: lookup
  3. Robertson S.A., Sanchez L.C.. Treatment of Visceral Pain in Horses. Vet. Clin. N. Am. Equine Pract. 2010;26:603–617.
    doi: 10.1016/j.cveq.2010.08.002pubmed: 21056302google scholar: lookup
  4. Koenig J, Cote N. Equine Gastrointestinal Motility—Ileus and Pharmacological Modification. Can. Vet. J. 2006;47:551–559.
    pmc: PMC1461410pubmed: 16808227
  5. Lisowski Z.M., Pirie R.S., Blikslager A.T., Lefebvre D., Hume D.A., Hudson N.P.H.. An Update on Equine Post-Operative Ileus: Definitions, Pathophysiology and Management. Equine Vet. J. 2018;50:292–303.
    doi: 10.1111/evj.12801pubmed: 29281117google scholar: lookup
  6. Küls N., Trujanovic R., Otero P.E., Larenza-Menzies M.P.. Ultrasound-Guided Transversus Abdominis Plane Block in Shetland Ponies: A Description of a Three-Point Injection Technique and Evaluation of Potential Analgesic Effects. J. Equine Vet. Sci. 2020;90:102994.
    doi: 10.1016/j.jevs.2020.102994pubmed: 32534772google scholar: lookup
  7. St James M., Ferreira T.H., Schroeder C.A., Hershberger-Braker K.L., Schroeder K.M.. Ultrasound-Guided Rectus Sheath Block: An Anatomic Study in Dog Cadavers. Vet. Anaesth. Analg. 2020;47:95–102.
    doi: 10.1016/j.vaa.2019.09.001pubmed: 31786077google scholar: lookup
  8. Ferguson S., Thomas V., Lewis I. The Rectus Sheath Block in Paediatric Anaesthesia: New Indications for an Old Technique?. Pediatr. Anesth. 1996;6:463–466.
    doi: 10.1046/j.1460-9592.1996.d01-24.xpubmed: 8936544google scholar: lookup
  9. Schleich C.L.. Schmerzlose Operationen. 5th ed. Springer; Berlin/Heidelberg, Germany: 1906.
  10. Reig Codina L., Werre S.R., Brown J.A.. Short-Term Outcome and Risk Factors for Post-Operative Complications Following Umbilical Resection in 82 Foals (2004–2016). Equine Vet. J. 2019;51:323–328.
    doi: 10.1111/evj.13021pubmed: 30216491google scholar: lookup
  11. Fischer B., Clark-Price S. Anesthesia of the Equine Neonate in Health and Disease. Vet. Clin. N. Am. Equine Pract. 2015;31:567–585.
    doi: 10.1016/j.cveq.2015.09.002pubmed: 26612748google scholar: lookup
  12. Jakobsson J., Wickerts L., Forsberg S., Ledin G. Transversus Abdominal Plane (TAP) Block for Postoperative Pain Management: A Review. F1000Res. 2015;4:1359.
    doi: 10.12688/f1000research.7015.1pmc: PMC4754005pubmed: 26918134google scholar: lookup
  13. Ellenberger W., Baum H. In: Handbuch der Vergleichenden Anatomie der Haustiere. Zietzschmann O., Ackerknecht E., Grau H., editors. Springer; Berlin/Heidelberg, Germany: 1974.
  14. Budras K.D., Sack W.O., Rock S., Berg R. Anatomy of the Horse. 6th ed. Schluetersche; London, UK: 2012.
  15. Freitag F.A.V., Amora D.D.S., Muehlbauer E., Dornbusch P.T., Machado M., Montiani-Ferreira F., Prisco Farias E.L., Valverde A., Duque Moreno J.C.. Ultrasound-Guided Modified Subcostal Transversus Abdominis Plane Block and Influence of Recumbency Position on Dye Spread in Equine Cadavers. Vet. Anaesth. Analg. 2021;48:596–602.
    doi: 10.1016/j.vaa.2021.03.006pubmed: 33903072google scholar: lookup
  16. Calice I., Kau S., Knecht C., Trujanovic R., Auer U. Ultrasound-Guided Rectus Sheath Injection in Pig Cadavers—A Pilot Study. Vet. Anaesth. Analg. 2021;48:S985–S986.
    doi: 10.1016/j.vaa.2021.09.016google scholar: lookup
  17. Ferreira T.H., Schroeder C.A., James M.S., Hershberger-Braker K.L.. Description of an Ultrasound-Guided Rectus Sheath Block Injection Technique and the Spread of Dye in Calf Cadavers. Vet. Anaesth. Analg. 2021;49:203–209.
    doi: 10.1016/j.vaa.2021.12.006pubmed: 35067478google scholar: lookup
  18. Ienello L., Kennedy M., Wendt-Hornickle E., Baldo C., Moshnikova V., Guedes A. Ultrasound-Guided Rectus Sheath Block Injections in Miniature Swine Cadavers: Technique Description and Distribution of Two Injectate Volumes. Vet. Anaesth. Analg. 2022;49:210–218.
    doi: 10.1016/j.vaa.2022.01.001pubmed: 35105527google scholar: lookup
  19. Ishikawa Y., Sakai D.M., Im J.S., Zhang S., Reed R.A., Quandt J.E., Baldo C.F., Walters B., Barletta M.. Antinociceptive Effects of Bupivacaine Injected within the Internal Abdominis Rectus Sheath in Standing Healthy Horses. Vet. Anaesth. Analg. 2023;50:294–301.
    doi: 10.1016/j.vaa.2023.02.013pubmed: 37024406google scholar: lookup
  20. Pöpping D.M., Elia N., Van Aken H.K., Marret E., Schug S.A., Kranke P., Wenk M., Tramèr M.R.. Impact of Epidural Analgesia on Mortality and Morbidity After Surgery: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Ann. Surg. 2014;259:1056.
    doi: 10.1097/SLA.0000000000000237pubmed: 24096762google scholar: lookup
  21. Lardone E., Sarotti D., Giacobino D., Ferraris E., Franci P. Thoracic Epidural Anaesthesia vs Intrathecal Morphine in Dogs Undergoing Major Thoracic and Abdominal Surgery: Clinical Study. BMC Vet. Res. 2022;18:200.
    doi: 10.1186/s12917-022-03296-3pmc: PMC9137148pubmed: 35624498google scholar: lookup
  22. Doherty T., Valverde A. Manual of Equine Anesthesia & Analgesia. Blackwell Publishing; Oxford, UK: 2006. Epidural Analgesia and Anesthesiea; pp. 275–281.
  23. Baldo C.F., Almeida D., Wendt-Hornickle E., Guedes A. Transversus Abdominis Plane Block in Ponies: A Preliminary Anatomical Study. Vet. Anaesth. Analg. 2018;45:392–396.
    doi: 10.1016/j.vaa.2018.01.009pubmed: 29559203google scholar: lookup
  24. Salaria O.N., Kannan M., Kerner B., Goldman H. A Rare Complication of a TAP Block Performed after Caesarean Delivery. Case Rep. Anesth. 2017;2017:1072576.
    doi: 10.1155/2017/1072576pmc: PMC5682055pubmed: 29214081google scholar: lookup
  25. Otero P.E., Romano M., Zaccagnini A.S., Fuensalida S.E., Verdier N., Sanchez F., Portela D.A.. Transversus Abdominis Plane Block in Cat Cadavers: Anatomical Description and Comparison of Injectate Spread Using Two- and Three-Point Approaches. Vet. Anaesth. Analg. 2021;48:432–441.
    doi: 10.1016/j.vaa.2021.02.002pubmed: 33745824google scholar: lookup
  26. Enzerink E., van Weeren P.R., van der Velden M.A. Closure of the Abdominal Wall at the Umbilicus and the Development of Umbilical Hernias in a Group of Foals from Birth to 11 Months of Age. Vet. Rec. 2000;147:37–39.
    doi: 10.1136/vr.147.2.37pubmed: 10955891google scholar: lookup
  27. Woolf C.J., Chong M.-S.. Preemptive Analgesia—Treating Postoperative Pain by Preventing the Establishment of Central Sensitization. Anesth. Analg. 1993;77:362–379.
    doi: 10.1213/00000539-199377020-00026pubmed: 8346839google scholar: lookup
  28. Capdevila X., Barthelet Y., Biboulet P., Ryckwaert Y., Rubenovitch J., d’Athis F.. Effects of Perioperative Analgesic Technique on the Surgical Outcome and Duration of Rehabilitation after Major Knee Surgery. Anesthesiology 1999;91:8–15.
    doi: 10.1097/00000542-199907000-00006pubmed: 10422923google scholar: lookup
  29. Stamenkovic D.M., Bezmarevic M., Bojic S., Unic-Stojanovic D., Stojkovic D., Slavkovic D.Z., Bancevic V., Maric N., Karanikolas M.. Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review. J. Clin. Med. 2021;10:4659.
    doi: 10.3390/jcm10204659pmc: PMC8537195pubmed: 34682777google scholar: lookup
  30. Sites B.D., Brull R. Ultrasound Guidance in Peripheral Regional Anesthesia: Philosophy, Evidence-Based Medicine, and Techniques. Curr. Opin. Anesthesiol. 2006;19:630.
    doi: 10.1097/ACO.0b013e3280101423pubmed: 17093367google scholar: lookup
  31. Serra R.M., Jimenez C.P., Monticelli P., Plested M., Viscasillas J. Assessment of an Ultrasound-Guided Technique for Catheterization of the Caudal Thoracic Paravertebral Space in Dog Cadavers. Open Vet. J. 2019;9:230–237.
    doi: 10.4314/ovj.v9i3.7pmc: PMC6794404pubmed: 31998616google scholar: lookup

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