Small Animal Surgery Resident Western College of Veterinary Medicine /
University of Saskatchewan,
Canada
Comparison of Two Blind Approaches to the Paravertebral Brachial Plexus Regional Block in Canine Cadavers. Podsiedlik M1, Hofmeister EH2, Duke-Novakovski T1. 1University of Saskatchewan, Western College of Veterinary Medicine, Saskatoon, SK, Canada; 2Auburn University, College of Veterinary Medicine, Auburn, AL.
The landmarks for dorsoventral (DV) approach to the paravertebral brachial plexus block (PVB) can be difficult to palpate. The objective was to describe a blind craniocaudal (CC) approach to the PVB and compare its accuracy, time, and difficulty of performance with a blind DV approach. The operator was initially trained to perform both approaches on five cadavers. Next, CC or DV approach was performed on both thoracic limbs of 20 cadavers (20 for each approach). Methylene blue dye was diluted in saline and equally divided into four aliquots to stain the sixth to eighth cervical and first thoracic spinal nerve ventral branches. Successfully stained (stain > 1 cm) spinal nerves were counted. The time to perform each approach was recorded and ease of performance was scored using a numerical scale (1 ‘easy’ to 4 ‘difficult’). The phrenic nerve was checked for stain. Results are presented as median (minimum–maximum range). The number of stained nerves with the CC approach, 3 (2–4), was higher than the DV approach, 2 (0–4), (P = 0.002). The time to perform the CC approach, 125 (70–194) seconds, was not different from the DV approach, 142 (101–232) seconds, (P = 0.084). The CC approach, 2 (1–4), was easier to perform than the DV approach, 3 (2–4), (P = 0.024). No phrenic nerve staining was observed. Main limitations include cadaveric nature of the study, and small sample size. The CC approach is an alternative to the DV approach for performing the PVB in dogs.