Cadaveric comparison of the accuracy of ultrasound-guided versus ‘blind’ perineural injection of the tibial nerve in horses.
Abstract: During diagnostic evaluation of hindlimb lameness in horses the tibial nerve block is traditionally performed based on anatomical reference points, but it can be difficult to achieve effective local anaesthesia using this blind technique. Ultrasound (US)-guided injection could increase the accuracy of injection. The aim of this study was to compare the accuracy of both techniques. Twenty-one paired sets of cadaver hindlimbs were injected with 1 mL methylene blue using the blind or US-guided technique. There was no significant difference in stain width and length and in coloured nerve length between techniques. However, the successful rate of nerve staining was 85.7% and 47.6% for the US-guided and blind technique, respectively (P = 0.02; odds ratio 6.6; 95% confidence interval, 1.5-29.4). This study suggests that the US-guided technique is more accurate than the blind technique. However, in the treated sample, a single US-guided injection did not consistently result in nerve staining.
Copyright © 2021 Elsevier Ltd. All rights reserved.
Publication Date: 2021-01-06 PubMed ID: 33593495DOI: 10.1016/j.tvjl.2020.105603Google Scholar: Lookup
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- Comparative Study
- Journal Article
Summary
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This research article examines the accuracy of ultrasound-guided and traditional ‘blind’ techniques for injecting the tibial nerve in horses. The study concludes that ultrasound-guided injections are generally more accurate, but a single ultrasound-guided injection did not always effectively stain the nerve.
Background and Aim
- The application of nerve blocks in the diagnostic evaluation of hindlimb lameness in horses is a common standard procedure.
- Traditionally, a ‘blind’ technique using anatomical reference points has been used for these perineural injections. However, due to variances in patients’ bodies, achieving effective local anaesthesia using this method can be challenging.
- The accuracy of perineural injections could possibly be improved using ultrasound (US)-guided injections, hence this research study compares the accuracy of this technique with traditional blind injections.
- Twenty-one pairs of cadaveric horse hindlimbs were included in the study and injected with 1ml methylene blue dye; one in each pair was subjected to a blind technique, while the other used ultrasound-guided injection.
- The success of each technique was evaluated based on the rate of successful nerve staining, indicated by the methylene blue dye, where the width and length of the dye stain as well as the length of the nerve coloured were measured.
- There was no significant difference detected in the width and length of the stain dyes, as well as the coloured nerve length between the two techniques.
- Better success rates were noted with the US-guided technique, with an 85.7% success rate, as compared to a 47.6% success rate with the blind technique. The difference found was statistically significant.
- Despite concluding that the US-guided technique of perineural injection in horses is more accurate than the blind technique, the researchers acknowledge a limitation in the study, emphasising that in their samples, a single US-guided injection did not consistently result in successful nerve staining.
- Thus, although US-guided injections may generally be more accurate, multiple injections might be required to increase effectiveness.
Methodology
Results
Conclusion
Cite This Article
APA
van der Laan M, Raes E, Oosterlinck M.
(2021).
Cadaveric comparison of the accuracy of ultrasound-guided versus ‘blind’ perineural injection of the tibial nerve in horses.
Vet J, 269, 105603.
https://doi.org/10.1016/j.tvjl.2020.105603 Publication
Researcher Affiliations
- Department of Veterinary Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium. Electronic address: maylin@live.nl.
- Department of Veterinary Medical Imaging and Small Animal Orthopedics, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium.
MeSH Terms
- Anesthesia, Local / methods
- Anesthesia, Local / veterinary
- Animals
- Cadaver
- Hindlimb
- Horse Diseases / diagnosis
- Horses
- Injections / veterinary
- Lameness, Animal / diagnosis
- Methylene Blue
- Nerve Block / methods
- Nerve Block / veterinary
- Tibial Nerve / drug effects
- Ultrasonography, Interventional / methods
- Ultrasonography, Interventional / veterinary
Citations
This article has been cited 2 times.- Amari M, Rabbogliatti V, Ravasio G, Auletta L, Brioschi FA, Riccaboni P, Dell'Aere S, Roccabianca P. Development of an ultrasound-guided radiofrequency ablation technique in the equine cadaveric distal limb: histological findings and potential for treating chronic lameness. Front Vet Sci 2024;11:1437989.
- De Schryver M, Oosterlinck M. An Explorative Anatomical Study on Inter-Individual Variation of the Tibial Nerve and Landmarks for Perineural Anesthesia in Horses. Animals (Basel) 2024 Jul 24;14(15).
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