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Master's Dissertation
DOI
Document
Author
Full name
Luciano Cacciari Baruffaldi Almeida da Silva
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2016
Supervisor
Committee
Cortopassi, Silvia Renata Gaido (President)
Futema, Fábio
Hamaji, Adilson
Title in Portuguese
Imagens ultrassonográficas do plexo braquial pela via axilar em cães
Keywords in Portuguese
Anestesia regional
Bloqueio distal
Nervos periféricos
Ultrassom
Abstract in Portuguese
O uso da ultrassonografia na anestesia regional teve um crescimento vertiginoso nos últimos anos, devido ao grande progresso na resolução das imagens ultrassonográficas, permitindo a visibilização não só de vasos, mas de raízes nervosas e nervos periféricos. O objetivo do presente trabalho consistiu na avaliação ultrassonográfica do plexo braquial pela via axilar, bem como a identificação dos nervos em relação a artéria axilar. Foram utilizados 50 animais da espécie canina, sem distinção de raça, sexo e idade. Em todos os animais administrou-se propofol (3 mg/kg) através de um acesso venoso pré-instalado. Os animais foram mantidos sonolentos, porém facilmente despertáveis durante todo o procedimento. Após posicionamento do animal e iniciada a avaliação ultrassonográfica com a identificação das estruturas vasculares e nervosas, foi introduzida uma agulha eletricamente isolada guiada por estimulador de nervo periférico, obtendo-se, assim, resposta motora adequada para cada nervo visualizado por meio de uma corrente estimuladora de 0,5 mA. O exame teve como objetivo identificar a artéria axilar e os nervos radial, mediano e ulnar, e anotar suas posições. Para relacionar os nervos à artéria axilar, a região a ser estudada foi dividida em quatro setores. Em todos os pacientes estudados foram identificados os nervos: mediano localizado na região craniolateral (setor 4) em 8% dos pacientes e na região craniomedial (setor 1) em 92%; nervo radial na região craniomedial (setor 1) em 2% dos pacientes, caudomedial (setor 2) em 92% e caudolateral (setor 3) em 6%; nervo ulnar encontrado na região craniolateral (setor 4) em 2% dos animais e na região craniomedial (setor 1) em 98%. Diante dos resultados, conclui-se que a artéria axilar, na abordagem estudada, facilita a identificação e posicionamento dos nervos com o auxílio do estimulador de nervos periféricos e da ultrassonografia.
Title in English
Ultrasonographic images of the axillary brachial plexus in dogs
Keywords in English
Distal block
Peripheral nerves
Regional anesthesia
Ultrasound
Abstract in English
The use of ultrasonography in regional anesthesia has grown rapidly in recent years, due to the great progress in the resolution of ultrasound images, allowing the visualization not only of vessels, but of nerve roots and peripheral nerves. The objective of the present study consisted in the ultrasonography evaluation of the brachial plexus by the axillary way, as well as the identification of the nerves in relation to the axillary artery. Fifty animals of the canine species were used, without distinction of race, sex and age. Propofol (3 mg/kg) was given in all animals via pre-installed venous access. The animals were kept drowsy but easily aroused throughout the procedure. After the positioning of the animal and the ultrasound evaluation with the identification of the vascular and nervous structures, an electrically isolated needle guided by a peripheral nerve stimulator was introduced, thus obtaining adequate motor response for each nerve visualized through a stimulating current of 0.5 mA. The objective of the test was to identify the axillary artery and the radial, median and ulnar nerves, and note their positions. To relate the nerves to the axillary artery, the region to be studied was divided into four sectors. In all the patients studied, nerves were identified: median located in the craniolateral region (sector 4) in 8% of patients and in the craniomedial region (sector 1) in 92%; radial nerve in the craniomedial region (sector 1) in 2% of patients, caudomedial (sector 2) in 92% and caudolateral (sector 3) in 6%; ulnar nerve found in the craniolateral region (sector 4) in 2% of the animals and in the craniomedial region (sector 1) in 98%. In view of the results, it was concluded that the axillary artery, in the approach studied, facilitates the identification and positioning of the nerves with the aid of the peripheral nerve stimulator and the ultrasonography.
 
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Publishing Date
2017-05-30
 
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