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Anatomical Measurements for the Blocking Sites of Paravertebral Regional Anaesthesia in Black Bengal Doe

S. Sikder
Department of Medicine and Surgery, Chittagong Veterinary and Animal Sciences University, Chittagong-4202, Bangladesh.

S. S. U. Ahmed
Department of Medicine and Surgery, Chittagong Veterinary and Animal Sciences University, Chittagong-4202, Bangladesh.

A. S. M. G. Kibria
Department of Anatomy and Histology, Chittagong Veterinary and Animal Sciences University, Chittagong-4202, Bangladesh.

M. S. Pallab
Department of Medicine and Surgery, Chittagong Veterinary and Animal Sciences University, Chittagong-4202, Bangladesh.

M. B. Uddin
Department of Medicine and Surgery, Sylhet Agricultural University, Bangladesh.

J. Basu
Department of Anatomy and Histology, Chittagong Veterinary and Animal Sciences University, Chittagong-4202, Bangladesh.

M. M .Uddin
Department of Anatomy and Histology, Chittagong Veterinary and Animal Sciences University, Chittagong-4202, Bangladesh.

Abstract/ Executive Summary:

The study was conducted in 25 black Bengal does to determine the exact site of infiltration of local anaesthetics for the last thoracic (T13), first lumbar (L1) and second lumbar (L2) para vertebral spinal nerve block at the Dept. of Anatomy and Histology, Chittagong Veterinary and Animal Sciences University, Chittagong. The animals were anaesthetized with pentobarbital sodium @ 20 mg / kg body weight IM and bled to death by giving incision on the right common carotid artery and preserved by 10 % formalin and dissected carefully to visualize the spinal nerves for the determination of the exact site of infiltration of local anaesthetic at the perineural area for paravertebral nerve block. For the vertical or proximal approach, the T13 spinal nerve was located at 0.8 ± 0.17 cm caudally from head of the last rib, 0.7 ± 0.22 cm cranio-medially from cranio-lateral angle of L1 transverse process and 3.4 ± 0.20 cm laterally from dorsal midline; L1 spinal nerve was placed at 1.2 ± 0.40 cm medially from cranio-lateral angle of L2 transverse process and 3.5 ± 0.17 cm laterally from the dorsal midline; and L2 spinal nerve was situated at 1.6 ± 0.26 cm medially from cranio-lateral angle of L3 transverse process and 3.7 ± 0.14 cm laterally from the dorsal midline. In horizontal or distal approach, T13 spinal nerve was located at 0.5 ± 0.10 cm and 1.8 ± 0.63 cm cranially from the cranio-lateral and caudo-lateral angles of L1 transverse process respectively and 4.6 ± 0.30 cm laterally from dorsal midline at lateral border of L1 transverse process; L1 spinal nerve was placed at 0.4 ± 0.10 cm and 1.4 ± 0.28 cm caudally and cranially from the cranio-lateral and caudo-lateral angle of L2 transverse process respectively and 5.1 ± 0.20 cm laterally from dorsal midline at lateral border of L2 transverse process and L2 spinal nerve was situated at 2.5 ± 0.42 cm and 0.5 ± 0.10 cm caudally and cranially from the cranio-lateral and caudo-lateral angle of L3 transverse process respectively and 5.5 ± 0.28 cm laterally from dorsal midline at lateral border of L3 transverse process. These measurements will be helpful to determine of the exact site for the deposition of the local anaesthetic agent at the perineural area of the specific paravertebral spinal nerve during paravertebral regional anaesthesia in doe.

Keywords: Black Bengal, Flank, Paravertebral anaesthesia

Location: Department of Anatomy and Histology, Faculty of Veterinary Medicine, Chittagong Veterinary and Animal Sciences University, Khulshi, Chittagong

Start Date: 00-01-2009

End Date: 00-06-2009

Program Area: Animal Health and Management

Commodity: Goat

Objectives:

To determine the exact sites for infiltration of local anaesthetic agent for the blocking of T13, L1 and L2 spinal nerves from the specific landmarks during paravertebral regional anaesthesia in black Bengal doe.

Methodology:

The research work was carried out on 25 black Bengal does (Capra hircus) at the Department of Anatomy and Histology, Faculty of Veterinary Medicine, Chittagong Veterinary and Animal Sciences University, Khulshi, Chittagong during the period from January to June 2009. All the does were adult (2-3 years), body weight 15 to 20 kg, apparently healthy and devoid of any external abnormalities. The animals were maintained in a well ventilated room and kept under good hygienic condition, allowed to graze in the open field for six hours everyday and also supplied concentrate mixture and water ad libitum. The does were anaesthetized with pentobarbital sodium @ 20 mg / kg body weight IM and bled to death by giving incision on the right common carotid artery, after that the whole vascular system was flashed with 0.85 % physiological saline solution and injected with 10% formalin for well preservation following the same route. Careful dissection was made with the help of scalpel, scissors and forceps without rupture of the dorsal and ventral branches of the last thoracic (T13), first (L1) and second (L2) lumbar spinal nerves. Both the branches were made distinct by gentle separation of surrounding structures using tissue forceps. The exact location of the last thoracic, first and second lumbar spinal nerves were measured from the specific landmarks in metric rule during the course of dissection and the result were presented as mean ± SD. Photographs were taken during the course of dissection. The measurement of the exact location from the landmarks of the T13, L1 and L2 spinal nerves for the proximal or vertical and distal or horizontal approaches of the paravertebral regional anaesthesia in black Bengal doe was described. Last thoracic spinal nerve: (a) Head of last rib to the nerve: Head of the last rib to the nerve caudally, parallel to the dorsal midline. b: First lumbar (L1) transverse process to the nerve: Cranio-lateral angle of L1 transverse process to the nerve cranio-medially. c: Dorsal midline to the nerve: Dorsal midline to the nerve laterally at cranial border of L1 transverse process. d: Second lumbar transverse process to the nerve: Cranio-lateral angle of L2 transverse process to the nerve medially. e: Dorsal midline to the nerve: Dorsal midline to the nerve laterally at the cranial border of L2 transverse process. Second lumbar spinal nerve f: Third lumbar (L3) transverse process to the nerve: Cran io-lateral angle of L3 transverse process to the nerve medially. g: Dorsal midline to the nerve: Dorsal midline to the nerve laterally at cranial border of the L3 transverse process. Last thoracic spinal nerve h: Cranio-lateral angle of L1 transverse process to the nerve: Cranio-lateral angle of L1 transverse process to the nerve cranially. i: Caudo-lateral angle of L1 transverse process to the nerve: Caudo-lateral angle of L1 transverse process to the nerve cranially. j: Dorsal midline to the nerve: Dorsal midline to the nerve laterally at lateral border of L1 transverse process.

Source of Information: Bangl. J. Vet. Med. (2010), 8(1): 81 – 86.

Article Link (Online Journal): http://dx.doi.org/10.3329/bjvm.v8i1.8354

Funding Source:

Budget:

Total Budget (Tk.) :

Achievement/Findings:

In conclusion, this study revealed that for any surgical operation in the flank region performed easily by the perfect blocking of the T13, L1 and L2 spinal nerves. The measured parameters for T13, L1 and L2 spinal nerve from the specific landmarks should be considered during proximal or vertical and distal or horizontal approach of paravertebral regional anaesthesia for perfect deposition of local anaesthetic at the perineural area of the specific nerves and complete desensitization of all structures of the flank region in black Bengal doe.

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