Development of an ultrasound-guided technique for retrobulbar nerve block in dromedary camels: a cadaveric study

Badawy, Ahmed; Eshra, Eman A.

doi:10.1016/j.vaa.2017.09.039

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…Ocular penetration is a very rare complication, reported in only 0.075% of blindly performed retrobulbar nerve blocks in humans 20 . In veterinary studies, ocular penetration also occurred infrequently, but, as in our study, was not seen with US‐guided injections in dogs, 21 horses, 14,16 dromedary camels, 22 or donkeys, 23 even with unexperienced operators. One cadaveric study in horses showed no intraocular injections with the blind technique for the peribulbar nerve block, 15 yet also none of the blindly performed blocks were injected in their intended location.…”

Section: Discussionsupporting

confidence: 57%

Safety and accuracy of blind vs. ultrasound‐guided dorsal retrobulbar nerve blocks in horses—A cadaveric study

Thieme

Mesquita

Lieberth

et al. 2022

Veterinary Ophthalmology

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Objective: There is limited knowledge regarding the safety and accuracy of ultrasound-guided retrobulbar nerve blocks in horses. The aim of this study was to compare these parameters between blind and ultrasound-guided injection techniques for the dorsal retrobulbar nerve block in horses. Methods: Equine cadaver heads were used to inject the retrobulbar space with contrast medium (CM). Injections were performed either blindly based on anatomic landmarks (blind group, n = 44) or under ultrasonographic guidance (US-group, n = 44), equally divided between an experienced and unexperienced operator. Needle position and distribution of CM were assessed with computed tomography imaging and evaluated by a board-certified veterinary diagnostic imager blinded to the technique. Safety and accuracy of both techniques were compared.Results: Ocular penetration was observed in two cases (n = 2/44) in the blind group but not in the US group (n = 0/44). No intrathecal, intraneural, or intravascular injections were seen in either group. Safety was significantly improved in the US group (p = .026). There was no statistically significant difference between the groups regarding the accuracy of the injection. Excellent accuracy was achieved more often with the ultrasound-guided technique (n = 11/22) than with the blind technique (n = 7/22) when performed by the unexperienced operator, but this difference was not statistically significant. Conclusion:To prevent globe-threatening complications and improve the safety of the injection, we recommend using the ultrasound-guided injection technique for the dorsal retrobulbar nerve block.

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Section: Discussionsupporting

confidence: 57%

Safety and accuracy of blind vs. ultrasound‐guided dorsal retrobulbar nerve blocks in horses—A cadaveric study

Thieme

Mesquita

Lieberth

et al. 2022

Veterinary Ophthalmology

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“…Ultrasoundguided retrobulbar blocks have recently been described in several species, but have not been evaluated by prospective clinical studies. [10][11][12][13][14][15] The aims of this study were to compare the effectiveness of the blind ITP approach, commonly used by ophthalmologists, and an ultrasound-guided ST technique in dogs undergoing unilateral enucleation by evaluating (a) perioperative opioid consumption and (b) postoperative pain scores.…”

Section: Introductionmentioning

confidence: 99%

“…Performing the ST block with the aid of ultrasound guidance would likely increase specificity and safety of the block. Ultrasound‐guided retrobulbar blocks have recently been described in several species, but have not been evaluated by prospective clinical studies 10–15 …”

Section: Introductionmentioning

confidence: 99%

Comparison of a blind and an ultrasound‐guided technique for Retrobulbar anesthesia in dogs undergoing unilateral subconjunctival enucleation

Briley

Washington

Westermeyer

et al. 2023

Veterinary Ophthalmology

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ObjectiveThis study compared the quality of retrobulbar anesthesia using a blind inferior‐temporal palpebral approach (ITP) with an ultrasound‐guided supratemporal (ST) technique in dogs undergoing unilateral enucleation.Animal studiedTwenty‐one client‐owned dogs were undergoing enucleation.ProceduresDogs were randomly assigned to receive ITP (n = 10) or ST (n = 11) with 0.5% ropivacaine at 0.1 mL/cm of neurocranial length. The anesthetist was blinded to the technique. Intraoperative data included cardiopulmonary variables, inhalant anesthetics requirement, and requirement for rescue analgesia (intravenous fentanyl 2.5 mcg/kg). Postoperative data included pain scores, sedation scores, and need for intravenous hydromorphone (0.05 mg/kg). Treatments were compared using Wilcoxon's rank sum test or Fisher's exact test as appropriate. Comparison of variables over time were tested using a mixed effect linear model on rank. Significance was set at p = 0.05.ResultsIntraoperative cardiopulmonary variables and inhalant requirements were not different between groups. Dogs receiving ITP required median (interquartile range, IQR) 1.25 (0, 2.5) mcg/kg intraoperative fentanyl while those receiving ST required none (p < 0.01). Intraoperative fentanyl was required in 5/10 and 0/11 of dogs in the ITP and ST groups, respectively (p = 0.01). Postoperative analgesia requirements were not significantly different between groups; 2/10 and 1/10 dogs in the ITP and ST groups, respectively. Sedation score negatively affected pain score (p < 0.01).ConclusionsThe ultrasound‐guided ST technique was more effective at decreasing intraoperative opioid requirements than the blind ITP approach in dogs undergoing unilateral enucleation.

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“…Various methods are used for localization of target nerves: ultrasound, computed tomography (CT) and radiography (16,17). Electrical stimulation is also used widely for localization of the target nerve (18,19).…”

mentioning

confidence: 99%

Factors affecting localization and dispersion of alcohol in peripheral nerve block

Liu¹,

Zhang²,

Lu³

et al. 2018

J Rehabil Med

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Development of an ultrasound-guided technique for retrobulbar nerve block in dromedary camels: a cadaveric study

Cited by 5 publications

References 21 publications

Safety and accuracy of blind vs. ultrasound‐guided dorsal retrobulbar nerve blocks in horses—A cadaveric study

Safety and accuracy of blind vs. ultrasound‐guided dorsal retrobulbar nerve blocks in horses—A cadaveric study

Comparison of a blind and an ultrasound‐guided technique for Retrobulbar anesthesia in dogs undergoing unilateral subconjunctival enucleation

Factors affecting localization and dispersion of alcohol in peripheral nerve block

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