Proximal Perineural Femoral Nerve Injection in Pigs Using an Ultrasound-Guided Lateral Subiliac Approach—A Cadaveric Study

Abstract

Desensitizing the femoral nerve (FN) improves pain control in several species undergoing pelvic limb surgeries. Despite its advantages, this method has not yet been described in pigs, although they make an accepted surgical animal model. Based on anatomical dissections, first performed in two pig cadavers, an ultrasound-guided access for localization and perineural infiltration of the FN trunk at the iliopsoas compartment level was specified. The FN was found running between the psoas major and medial portion of iliac muscle. Ultrasonographically, the FN appeared as a hypoechogenic round–oval structure surrounded by a hyperechogenic rim. Technical feasibility and accuracy were assessed in six additional pig cadavers by injecting 0.15 mL kg−1 methylene blue dye bilaterally in direct proximity to the nerve. The needle was inserted caudoventral to the coxal tuber, traversing the ultrasound plane as it progressed towards the FN in dorsomedial direction. Staining of the nerve was evaluated by dissection. The injection was considered effective if the nerve was stained in its entire circumference over a length of 2 cm. FNs of all investigated individuals could be successfully stained. This ultrasound-guided subiliac approach allows feasible and accurate access to the FN and may be useful in producing a successful blockade in vivo.

Percutaneous Fluoroscopic-Guided Celiac Plexus Approach: Results in a Pig Cadaveric Model

“…The porcine model has been an accepted translational model for humans for decades [28], but even though the transcutaneous approach is the most used in humans [15], only laparoscopic [12] and endoscopic ultrasound-guided [13,14] techniques to block the CP have been described in experimental settings in this species.…”

Multimodal analgesic technique in a peacock (Pavo cristatus) anaesthetised for orthopaedic surgery

“…The femoral-sciatic nerve block is a regional anaesthetic technique well described in small and farm animals. 7,[46][47][48][49][50] At present, few case reports have described this locoregional technique in different avian species: d'Ovidio et al described a nerve stimulator-guided femoral-sciatic nerve block in raptors undergoing surgical treatment of pododermatitis, while Trujanovic et al reported the same block in a duck undergoing surgical fixation of a tibiotarsal fracture guided by both ultrasound and nerve stimulator. In the present case, due to the small size of the animal, the ultrasonography visualisation of the femoral nerve was challenging, hence the decision of using the nerve stimulator.…”

“…In the present case, we opted for a multimodal analgesic approach, which included the use of an opioid in premedication, as discussed above, combined with a local anaesthetic technique and ketamine infusion. The femoral‐sciatic nerve block is a regional anaesthetic technique well described in small and farm animals 7,46–50 . At present, few case reports have described this locoregional technique in different avian species: d'Ovidio et al.…”

Evaluating the Efficacy of a Peripheral Nerve Simulator-Guided Brachial Plexus Block in Rabbits Undergoing Orthopaedic Surgery Compared to Systemic Analgesia

“…The use of locoregional anaesthesia techniques for various surgical procedures, now commonplace in dogs and cats, has been reported in other species, including sheep [6], calves [7], goats [8,9], and pigs [10,11]. Local nerve blocks may be performed blind or guided by electrical nerve stimulation or ultrasound.…”