Stain distribution of a lidocaine-methylene blue solution in saphenous, obturator

and lateral femoral cutaneous nerve blocks

employing superficial anatomical landmark-based techniques in the dog
DF Echeverry1, JT Peláez1, EF Buriticá1 & FG Laredo 2
1Faculty of Veterinary Medicine and Zootechny, Tolima University, Ibagué, Colombia
2Faculty of Veterinary Medicine, Murcia University, Spain

contact mail: decheverry@ut.edu.co

Introduc)on:  
The  benefits  of  ultrasound  and  nerve  s2mula2on  to  guide  peripheral  nerve  block  have  been  described  in  dogs  (Echeverry  et  al.  
2010).  However  there  are  some  factors  that  could  limit  the  use  of  these  techniques  (Saranteas  et  al.  2008).  This  study  evaluated  
the  distribu2on  of  a  lidocaine-­‐methylene  blue  staining  solu2on  in  saphenous  (SN),  obturator  (ON)  and  lateral  femoral  cutaneous  
(LFCN)  nerve  blocks  employing  superficial  anatomical  landmarks  (SLM)  based  techniques  in  dog  cadavers.  

Materials  &  Methods:  

Fi]een   fresh   dog   cadavers   weighing   10-­‐30   Kg   were   randomly   assigned   to   3   groups   of   5   dogs   each   to   receive   perineurally   a  
mixture  of  2%  lidocaine  and  2%  methylene  blue  (50%  v/v)  at  doses  of  0.1,  0.2  or  0.3  mL  kg-­‐1.  The  injec2ons  were  performed  
using   an   insulated   needle   (50   mm   x   22   G)   for   the   SN   and   a   hypodermic   needle   (38mm   x   21G)   for   the   ON   and   LFCN.   The   SN   was  
approached  at  the  femoral  triangle  using  the  femoral  artery  as  SLM  and  employing  a  loss-­‐of-­‐resistance  technique  (Dolan  et  al.  
2008).   The   ON   was   located   within   the   fascial   planes   exis2ng   between   the   Pec2neus   and   Adductor   muscles   and   the   LFCN  
subcutaneously  using  the  transverse  process  of  the  seventh  lumbar  vertebra  as  SLM.  Necropsies  were  performed  15  minutes  
a]er  the  injec2ons.  A  staining  length  ≥  2  cm  along  the  target  nerve  was  considered  as  an  adequate  distribu2on  of  the  solu2on.  

Med  
A   Pm*   B   Cr   C  
Fa  

Am   Pm  
Cr   Cd   Cr  

Dor   Ven  

Fa  

penis   Icr   *  

Cd   Cd  

Figure 1. Superficial anatomical landmarks and location of the needle and the for the injection of the staining solutions in the periphery of: A. Saphenous
nerve; B. Obturator nerve; C. Lateral femoral cutaneous nerve. Cr= cranial, Cd= caudal, Med= medial, Dor= dorsal, Ven= ventral, Fa= Femoral artery, Pm=
Pectineous muscle, Pm*= Pectineous muscle’s origin, Am= Adductor muscle, Icr=Iliac crest, the index finger is in contact with the transverse process of the
seventh lumbar vertebra.. *
A   B   C  
Prx  
Cr  
FN  
Rm**   Adm   EAO  
FA  
SMc  
FV  
Gm  
Rm*   Pm   RF  
SN   Cr  
Cr  

Sk  
Sk  
Sk  

Dis   Dis   Cd   Dis  

Figure 2. Evaluation of this distribution of the stainig solution in the studied nerves: A. Saphenous nerve; B. Obturator nerve; C. Lateral femoral
cutaneous nerve. Cr= cranial, Cd= caudal, Dis= distal, Prx= proximal, FA= Femoral artery, FV= Femoral vein, FN= Femoral nerve, SN= Saphenous
nerve, Rm*= muscular branches of the FN for the Quadriceps muscle, Rm**=muscular branches of the FN for the Sartorious muscle, Pm= Pectineous
muscle, Adm= Adductor muscle, Gm= Gracilis muscle, SMc= Sartorious muscle (cranial part), RF= Rectus Femoris muscle, Sk= Skin (reflected), EAO=
External abdominal oblique muscle.

Results & conclusions

•  The techniques employed were effective to produce an adequate distribution of the staining solution over the 100% of the
studied nerves when using 0.2 (ON,LFCN) or 0.3 (SN) mL.Kg of staining solution. There was no gross evidence of
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intraneural injection in any case.

•  This study shows potentially useful techniques based on anatomical SLM to perform the anaesthetic blockade of the SN, ON
and LFCN nerves.

References  
•  Echeverry  DF,  Gil  F,  Laredo  F  et  al.  (2010)  Ultrasound-­‐guided  block  of  the  scia2c  and  femoral  nerves  in  dogs:  a  descrip2ve  
study.  Vet  J  186,  210  -­‐  215.    
•  Saranteas   T,   Karakitsos   D,   Alevizou   A   et   al.   (2008)   Limita2ons   and   technical   considera2ons   of   ultrasound-­‐guided  
peripheralnerve  blocks:  edema  and  subcutaneous  air.  Reg  Anesth  Pain  Med  33,  353  -­‐  356.    
•  Dolan  J,  Williams  A,  Murney  E  et  al.  (2008)  Ultrasound-­‐guided  fascia  iliaca  block:  a  comparison  with  the  loss  of  resistance  
technique.  Reg  Anesth  Pain  Med  33,  526-­‐531.