New Approach for Ultrasound-Guided Regional Analgesia of Brachial Plexus in Egyptian Donkeys
New Approach for Ultrasound-Guided Regional Analgesia of Brachial Plexus in Egyptian Donkeys
Adel Sobhy1, Ahmed El-khamary1, Ahmed M. Rashwan2,3, Ashraf Shamaa4, Mostafa Kassem5, Mohamed M. A. Abumandour6*, Ahmed El-Mansi7, 8 and Ahmed G. Nomir2
ABSTRACT
It’s important to have a novel ultrasound (US)-guided approach to brachial plexus block since it allows for a better understanding of the surface anatomy and relationships, as well as injury and consequences. This study used three methodologies of approach (anatomical, cadaveric, and live experimental tests) to describe the brachial plexus topography in the donkey, evaluate the US color doppler brachial plexus blockage, and test the analgesic efficacy. We topographically anatomized the brachial plexus in three cadavers. Color Doppler US-guided methylene blue dye was injected into both sides of the brachial plexus: p1 (plexus root 4±0.5 cm above the greater tuberosity) and p2 (division site of all plexus nerves) of six cadavers. Finally, the live experimental study involved brachial plexus injections at both sides of p1 and p2 (standing position). Our results from the cadaveric US showed that the brachial plexus root was sufficiently stained at site p1 as opposed to site p2. In the live experimental study, the brachial plexus appeared as a hyperechoic cluster at the p1 site, while the large and small rounded regions at the p2 site were hypoechoic. The distance at site P1 was 4.8±0.2 cm using 15 ml of Lidocaine local anesthetic solution for blockage. However, the distance at site p2 was 6.8±0.2 cm, and 25 ml of local anesthetic was sufficient for complete nerve blockage. We concluded that by using the color-doppler US-guided for the brachial plexus injection, site p1 was more efficient and avoided vascular penetration than site p2.
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