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Comparison of four peribulbar anaesthetic techniques: A preliminary study in equine cadavers

Rabbogliatti, V., De Zani, D., Zani, D.D., Di Cesare, F., Brioschi, F.A., Gioeni, D., Crivellari, B. and Ravasio, G. (2021) Comparison of four peribulbar anaesthetic techniques: A preliminary study in equine cadavers. Veterinary Anaesthesia and Analgesia, 48 (3). pp. 442-450.

Link to Published Version: https://doi.org/10.1016/j.vaa.2020.10.009
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Abstract

Objective

To compare the peribulbar injectate distribution and probability of regional anaesthesia of four peribulbar anaesthetic techniques in equine cadavers.
Study design

Prospective experimental cadaver study.

Animals

A total of 12 isolated equine cadaver heads and 24 eyes.

Methods

The 24 orbits underwent one of four injection techniques (six orbits each) with a mixture (1:4) of contrast medium and saline (CM): 20 mL ventrolateral peribulbar injection (V-20), 20 mL dorsolateral peribulbar injection (D-20), combined ventrolateral and dorsolateral peribulbar injections 10 mL each (VD-20) or 20 mL each (VD-40). To evaluate and score CM distribution at the base of, within the extraocular muscle cone (EOMC), and around the optic nerve (before and after pressure application to the periorbital area), computed tomography was performed. To assess the probability of achieving locoregional anaesthesia, two criteria were applied and both scored as ‘likely’, ‘possible’ or ‘unlikely’. To compare CM distribution scores between injection techniques, Kruskal-Wallis analysis of variance was used. Mann-Whitney U test was used for post hoc comparisons between groups when needed. A p value < 0.05 was considered significant.

Results

The CM distribution within the EOMC and around the optic nerve circumference was detected as ‘possible’ only after pressure application in seven out of 24 orbits (V-20, 3; D-20, 1; VD-40, 3). It was never considered ‘likely’ either before or after pressure application. The CM distribution at the EOMC base was considered ‘likely’ to provide regional anaesthesia in 50% (V-20), 0% (D-20), 33% (VD-20), 100% (VD-40) and in 66% (V-20), 16% (D-20), 50% (VD-20), 100% (VD-40) before and after applying pressure, respectively.

Conclusions and clinical relevance

Complete regional anaesthesia seems more likely using the VD-40 technique, although the authors advise caution due to the risk of potential complications. Future studies are necessary to evaluate the efficacy of the technique in vivo.

Item Type: Journal Article
Murdoch Affiliation(s): Veterinary Medicine
Publisher: Elsevier Ltd.
Copyright: © 2020 Elsevier Ltd on behalf of Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia.
URI: http://researchrepository.murdoch.edu.au/id/eprint/61125
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