Description of a novel ultrasound guided peribulbar block in horses: a cadaveric study.
Abstract: Standing surgery in horses combining intravenous sedatives, analgesics and local anaesthesia is becoming more popular. Ultrasound guided (USG) peribulbar nerve block (PB) has been described in dogs and humans for facial and ocular surgery, reducing the risk of complications versus retrobulbar nerve block (RB). Objective: To describe a technique for USG PB in horse cadavers. Methods: Landmarks and PB technique were described in two equine cadaver heads (Phase 1), with computed tomography (CT) imaging confirming contrast location and spread. In Phase 2, ten equine cadaver heads were randomised to two operators naïve to the USG PB, with moderate experience with ultrasonography and conventional "blind" RB. Both techniques were demonstrated once. Subsequently, operators performed five USG PB and five RB each, unassisted. Contrast location and spread were evaluated by CT. Injection site success was defined for USG PB as extraconal contrast, and for RB intraconal contrast. Results: Success was 10/10 for USG PB and 0/10 for RB (p < 0.001). Of the RB injections, eight resulted in extraconal contrast and two in the masseter muscle (p = 0.47). Conclusions: The USG PB had a high injection site success rate compared with the RB technique; however, we cannot comment on clinical effect. The USG technique was easily learnt, and no potential complications were seen. The USG PB nerve block could have a wide application for use in horses for ocular surgeries (enucleations, eyelid, corneal, cataract surgeries, and ocular analgesia) due to reduced risk of iatrogenic damage. Further clinical studies are needed.
© 2021 The Korean Society of Veterinary Science.
Publication Date: 2021-03-29 PubMed ID: 33774938PubMed Central: PMC8007447DOI: 10.4142/jvs.2021.22.e22Google Scholar: Lookup
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Summary
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This research article investigates the success of a new ultrasound guided peribulbar nerve block (USG PB) technique for horses, as compared to a more traditional retrobulbar (RB) method. The study found that the USG PB was a more successful and safer approach that could be widely used in equine ocular surgeries.
Methods of the Study
- The researchers utilized twelve equine cadaver heads for this initial study into the new USG PB technique.
- Anatomical landmarks and the methodology for the PB were introduced and utilized in two of the cadaver heads and were confirmed by computed tomography (CT) imaging.
- For the remaining ten cadaver heads, they were divided equally between two operators. These operators were new to the USG PB method, however, they had moderate experience with ultrasonography and the RB method.
- Both operators performed five USG PB and five RB each, working without any assistance.
- The location and dispersion of the contrast, administered for both methods, were further evaluated via CT imaging.
Results of the Study
- Through the study the research team discovered that the success rate for the USG PB was 100%, whereas the RB technique didn’t achieve any success.
- Eight out of ten RB injections resulted in extraconal contrast and two ended up in the masseter muscle.
- It was found that the USG PB method was more efficient with a high success rate in terms of injection site.
Conclusions
- In conclusion, the USG PB method was more successful and safer than the more traditional RB technique.
- While the study could not comment on the clinical effect, researchers found that the USG PB technique was easily learnt and there were no apparent potential complications.
- It was also suggested that the USG PB could have wide application in equine ocular surgeries such as enucleations, eyelid, corneal, cataract surgeries, and ocular analgesia, as it presented a reduced risk of iatrogenic (caused by the medical examination or treatment) damage.
- However, the need for additional clinical studies was stated by the team.
Cite This Article
APA
Leigh H, Gozalo-Marcilla M, Esteve V, Gutiérrez Bautista ÁJ, Martin Gimenez T, Viscasillas J.
(2021).
Description of a novel ultrasound guided peribulbar block in horses: a cadaveric study.
J Vet Sci, 22(2), e22.
https://doi.org/10.4142/jvs.2021.22.e22 Publication
Researcher Affiliations
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Easter Bush Campus, The University of Edinburgh, Bush Farm, Roslin. EH25 9RG, Scotland, UK. Hannah.leigh@ed.ac.uk.
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Easter Bush Campus, The University of Edinburgh, Bush Farm, Roslin. EH25 9RG, Scotland, UK.
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia 46115, Spain.
- Clinic for Small Animals, University of Veterinary Medicine, Hannover 305559, Germany.
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia 46115, Spain.
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia 46115, Spain.
MeSH Terms
- Animals
- Cadaver
- Contrast Media / analysis
- Head
- Horses
- Nerve Block / methods
- Nerve Block / veterinary
- Observer Variation
- Tomography, X-Ray Computed / veterinary
Conflict of Interest Statement
The authors declare no conflicts of interest.
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Citations
This article has been cited 2 times.- Marzok M, Almubarak A, Elkhidr RY, Elkawi MA, El-Sherif MW. Ultrasound-guided peribulbar block in dromedary camels: a descriptive cadaveric study. BMC Vet Res 2025 Jul 2;21(1):431.
- Hermans H, Lloyd-Edwards RA, Ferrão-van Sommeren AJH, Tersmette AA, Schouten JCM, Serra Bragança FM, van Loon JPAM. Comparing Blind and Ultrasound-Guided Retrobulbar Nerve Blocks in Equine Cadavers: The Training Effect. Animals (Basel) 2022 Jan 9;12(2).
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