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Catheterization of perineural space as method removal of painful syndrome after operative interferences on pectoral limb for dogs
The paper deals with the results of investigation efficiency nerve stimulator Stimuplex NHS12 are resulted at the blockade of brachial plexus with subsequent postoperative analgesia for dogs. Among the methods of the local anaesthetizing, which can provide protecting from pain at operations on pectoral limb a blockade of the brachial plexus is accessible to implementation and most effective. Another anaesthetic technics where are regional blocks of ulnar, radial, musculocutaneus nerves and circular infiltration block. These techniques are less effective and allow numb only a relatively small area of tissue that can be useful for local manipulation, but in the case of orthopedic surgery their use is not enough. Over the past 10–20 years, anesthesiology, including veterinary enriched with many new developments. A large number of approaches to the implementation of local anesthesia in animals came into practice is largely due to medical anesthesia. One should also mention the following new trends in contemporary use as pre- and postoperative treatment, which can effectively eliminate the pain , the use of ultrasound imaging, nerve stimulations while performing regional anesthesia. At the same time greatly increased the capacity of most local anesthetics.
Material for researches was 9 dogs which the modified blockade of the brachial plexus was applied during an operation and in a postoperative period. Six dogs had operative interference concerning osteosynthesis, and three – amputation of extremity. This was the experimental group. Other five dogs had blockade brachial plexus with use of the special isolated needles of «Stimuplex» without postoperative analgesia. This was control group. In the researches we applied the technique of blockade of the brachial plexus, which is described in works of A. Tronsi, N.Diss.
Nerve stimulator is a piece of equipment that is used to generate an electric field in the tissues immediately surrounding a target nerve. It causes the irritation of peripheral nerves, and facilitates implementation of blockades of nerves and interlacings. The danger of mechanical damage of nerve here is practically eliminated. When a stimulant needle goes close enough near to the nerve, set an electric impulse causes muscular reductions through nerve fibres and paresthesia caused by a current through sensible eisodic fibres. Application of stimulation of nerves is given by possibility of receipt of objective muscular answer, a direct contact absents between a needle and nerve, that prophylactic mechanical damages of nerve.
After sedation all animals for determination of optimum location of needle near-by a nerve at implementation of blockade nerve stimulator Stimuplex NHS12 applied the animals of both groups. In a control group applied the standard technique of blockade.
The technique of blockade of brachial plexus for the animals of the investigated group was modified on an own method. Modified to the technician of blockade of the brachial plexus included for itself the followings stages:
-an explorer blockade of the brachial plexus with nerve stimulation;
- catheterization of perineural space.
The feature of technique for the animals of the investigated group consisted in that for the search of nerves used electric stimulation, and intravenous catheter which was connected with nerve stimulator, since found the optimum site of catheter position(motive answer for an irritation by force 0,22–0,4 mа with frequency 1 hertz answers optimum distance to the nerves, which makes 2–3 mm), a needle from a catheter was taken out, a catheter was fixed to the body of animal, and conducted the injection of 2% lidocaine, in a dose from 7 to 15 ml. Application of explorer blockade enabled to attain anaesthetizing within the limits of 75–115 minutes, and to execute operative interference. Upon termination of operative interference, as postoperative analgesia introduction of 0,2 % was conducted through a canula in a dose, to the proper dose of lidocaine one times on six hours during 2–3 days.
State of animal during an operation and after it investigated on the state pain and other types of sensitiveness.
Application of nerve stimulator at the block of the brachial plexus for dogs enables to dispose a needle and plastic canula on optimum distance near-by nerves, that facilitates implementation of technique of blockade, and warns the origin of its errors.
The inculcated modification of technique of blockade with the use of intravenous catheter and postoperative analgesia considerably reduces the cost of expense materials on treatment in default of inconveniences in the leadthrough of technique of block.
Leadthrough of the postoperative anaesthetizing with the use of 0,2 % bupivacaine one times on six hours during 2–3 days instrumental in the smooth flow of postoperative period.
Key words: blockade of brachial plexus, nerve stimulation, Stimuplex NHS12, postoperative analgesia, modification technique of blockade, intravenous catheter, dogs.
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