Use of electrical nerve stimulation to monitor lumbosacral epidural needle placement in cats

The use of a nerve stimulation test to confirm sacrococcygeal epidural needle placement in cats

“…In this study, the sacrococcygeal epidural MET value was 0.32 ± 0.06 mA, similar to the previously reported values for the lumbosacral epidural space (Otero et al. a). Although the MET values were not recorded when the needle tip was placed in subcutaneous tissue over the sacrococcygeal area, in all of the animals classified as true positive, the application of a 0.7 mA electrical current elicited a motor response only after puncturing the interarcuate ligament.…”

“…The NST has been previously used to confirm epidural or intrathecal needle placement in humans (Tsui et al 2005), rabbits (Otero et al 2012), and dogs (Otero et al 2014b). In cats, the existing significant difference between the threshold current for motor response when the needle tip is positioned above (1.76 AE 0.34 mA) and below (0.34 AE 0.07 mA) the interarcuate ligament at lumbosacral epidural space (Otero et al 2014a) defined a NST cut off value of 0.7 mA. In this study, the sacrococcygeal epidural MET value was 0.32 AE 0.06 mA, similar to the previously reported values for the lumbosacral epidural space (Otero et al 2014a).…”

“…In cats, the existing significant difference between the threshold current for motor response when the needle tip is positioned above (1.76 AE 0.34 mA) and below (0.34 AE 0.07 mA) the interarcuate ligament at lumbosacral epidural space (Otero et al 2014a) defined a NST cut off value of 0.7 mA. In this study, the sacrococcygeal epidural MET value was 0.32 AE 0.06 mA, similar to the previously reported values for the lumbosacral epidural space (Otero et al 2014a). Although the MET values were not recorded when the needle tip was placed in subcutaneous tissue over the sacrococcygeal area, in all of the animals classified as true positive, the application Figure 1 Sacrococcygeal needle placement using the nerve stimulation test in a cat.…”

Sonographic evaluation of epidural and intrathecal injections in cats

“…However, performing epidural injection using this blind and subjective technique in the presence of a large dural sac (Fletcher & Malkmus ) increases the risk for accidental dural puncture and intrathecal injection of anesthetics (Maierl & Liebich ; Otero et al. ), which may result in profound hypotension, cardiovascular collapse and death (Casoni et al. ).…”

“…In cats, the epidural space is traditionally accessed at the lumbosacral level, and needle placement is commonly confirmed with the perception of a 'pop' or a distinct loss of resistance as soon as the needle pierces the interarcuate ligament (Jones 2001;Skarda & Tranquilli 2007;Valverde 2008). However, performing epidural injection using this blind and subjective technique in the presence of a large dural sac (Fletcher & Malkmus 1999) increases the risk for accidental dural puncture and intrathecal injection of anesthetics (Maierl & Liebich 1998;Otero et al 2014), which may result in profound hypotension, cardiovascular collapse and death (Casoni et al 2014).…”