Bloqueio do plexo braquial guiado por neuroestimulação elétrica em jabuti piranga (Chelonoidis carbonarius) submetido à intervenção cirúrgica em membro torácico: Relato de caso / Brachial plexus block guided by electrical neurostimulation in a tortoise (Chelonoidis carbonarius) undergoing surgical intervention in the forelimb: Case report

A anestesia local tem sido recomendada para intervenções cirúrgicas quando se procura evitar a anestesia geral do animal com o intuito de minimizar os riscos, que podem ocorrer durante o aprofundamento do plano anestésico, além de promover uma rápida recuperação. O presente trabalho descreve o caso de um jabuti piranga (C. carbonarius) submetido à contenção química associada a bloqueio anestésico em plexo braquial para realização da excisão cirúrgica de um abcesso em membro tórácico direito, sendo apresentadas considerações sobre a aplicabilidade desta técnica em quelônios com destaque para os cuidados a serem tomados pelo anestesista durante a intervenção.(AU)

Local anesthesia has been recommended for surgical interventions when trying to avoid the need of general anesthesia of the animal and to minimize any risks that may occur during the deepening of the anesthetic plane, in addition to promoting a quick recovery. The present work describes the case of a tortoise (C. carbonarius) submitted to chemical restraint associated whit anesthesic blockage in the brachial plexus during surgical intervention to remove an abscess in the right thoracic limb, presenting considerations about the applicability of this technique in chelonians, with emphasis on the care to be taken by the anesthesiologist during the intervention.(AU)

Anatomorphometry of the brachial plexus under high-definition system: an experimental study in rats

Purpose: To study the anatomorphometry of the plexus brachialis (PB) of rats under a high-definition video system. Methods: Ten male Wistar rats discarded from other research that did not interfere in the morphology of the animal, respecting the principle of reduction, were used. All animals were submitted to the same protocol. Initially, the cervical region was shaved. The animals were placed in a dorsal position. A single elbow-to-elbow incision was performed and dissection started at the deltopectoral sulcus. The procedures were performed under a video system. To measure the structures, the Image J software was used. Results: All the PB evaluated originated from the C5-T1 spinal nerves. C5 and C6 converged to form the truncus superior, the root of C7 originated the truncus medius, and the confluence of C8 and T1 originated the truncus inferior. It was found the union of C7, C8, and T1 to form truncus inferomedialis instead of separate medial and inferior truncus. C8 (1.31 mm) was the thickest root, the truncus inferior (1.80 mm) and the nerve radialis (1.02 mm), were the thickest. Conclusions: The anatomy of the PB is comparable to humans, admitting variations. The videomagnification system is useful to perform microsurgical dissection.

Bloqueio do plexo-braquial e peridural lombossacra em um quati (Nasua nasua) / Brachial plexus block and lumbosacral epidural in a South American coati (Nasua nasua)

Background: The South American coatis (Nasua nasua) are capable of adapting to different habitats, which allowed themto exchange between domestic and wild areas, increasing the occurrence of traumas. Procedures performed in this speciesdemand anesthetic protocols that take comorbidities into account and cause minimal cardiorespiratory depression as wellas rapid recovery. It is in such context that locoregional anesthesia has become an essential tool. Thus, we aim to reportthe use of two techniques of locoreginal block: brachial plexus block and lumbosacral epidural block, in a Nasua nasuasubmitted to osteosynthesis of the radius and caudectomy due to trauma.Case: A adult male coati weighing 2.3 kg was referred to the Veterinary Medical Teaching Hospital of the UniversidadeFederal do Paraná (UFPR) - Setor Palotina with a history of trauma. Physical examination showed crackling in the radius and ulnar region, and also abnormal angulation in the distal portion of the tail. After taking x-rays, fractures wereconfirmed in the distal radius and in the distal portion of the tail. The patient was referred for surgery. After 8 h of waterand food withdrawal, the animal was premedicated with a combination of ketamine (10 mg/kg), midazolam (0.3 mg/kg)and methadone (0.2 mg/kg), intramuscularly (IM). Induction of anesthesia was performed with propofol titrated to effect(total dose 4 mg/kg) and anesthesia was maintained with isoflurane in spontaneous ventilation using a non-rebreathingcircuit (Baraka). It was evaluated heart rate (HR), respiratory rate (RF), end-tidal CO2 (EtCO2), expired isoflurane fraction (FE´Iso), oxyhemoglobin saturation (SpO2), electrocardiography (ECG), systolic blood pressure (SBP) and coretemperature (CT) using a multiparametric monitor. After the stabilization period, the animal was positioned in lateral...

Bloqueio do plexo-braquial e peridural lombossacra em um quati (Nasua nasua) / Brachial plexus block and lumbosacral epidural in a South American coati (Nasua nasua)

Background: The South American coatis (Nasua nasua) are capable of adapting to different habitats, which allowed themto exchange between domestic and wild areas, increasing the occurrence of traumas. Procedures performed in this speciesdemand anesthetic protocols that take comorbidities into account and cause minimal cardiorespiratory depression as wellas rapid recovery. It is in such context that locoregional anesthesia has become an essential tool. Thus, we aim to reportthe use of two techniques of locoreginal block: brachial plexus block and lumbosacral epidural block, in a Nasua nasuasubmitted to osteosynthesis of the radius and caudectomy due to trauma.Case: A adult male coati weighing 2.3 kg was referred to the Veterinary Medical Teaching Hospital of the UniversidadeFederal do Paraná (UFPR) - Setor Palotina with a history of trauma. Physical examination showed crackling in the radius and ulnar region, and also abnormal angulation in the distal portion of the tail. After taking x-rays, fractures wereconfirmed in the distal radius and in the distal portion of the tail. The patient was referred for surgery. After 8 h of waterand food withdrawal, the animal was premedicated with a combination of ketamine (10 mg/kg), midazolam (0.3 mg/kg)and methadone (0.2 mg/kg), intramuscularly (IM). Induction of anesthesia was performed with propofol titrated to effect(total dose 4 mg/kg) and anesthesia was maintained with isoflurane in spontaneous ventilation using a non-rebreathingcircuit (Baraka). It was evaluated heart rate (HR), respiratory rate (RF), end-tidal CO2 (EtCO2), expired isoflurane fraction (FE´Iso), oxyhemoglobin saturation (SpO2), electrocardiography (ECG), systolic blood pressure (SBP) and coretemperature (CT) using a multiparametric monitor. After the stabilization period, the animal was positioned in lateral...(AU)

Description of brachial plexus of sloth (Bradypus variegatus) / Descrição do plexo braquial do bicho-preguiça (Bradypus variegatus)

The species Bradypus variegatus is known as the common sloth, an endemic mammal from neotropical regions, which has been suffering from devastating anthropogenic activities. Our study aimed to describe the brachial plexus of B. variegates, regarding the origin and distribution of nerves, through the sampling of 10 adult females. Analyses were carried out at the Anatomy Section, "Departamento de Morfologia e Fisiologia Animal", "Universidade Federal Rural de Pernambuco", under license no. 034/2015 of the Ethics Committee on the Use of Animals. The results determined that the brachial plexus of the common sloth starts from the fifth cervical spine segment until the second thoracic segment. This area contains the long and suprascapular thoracic nerves, which originate immediately from the medullary segment 5 and 6, respectively, and from the pectoral, subscapular, axillary, radial, musculocutaneous, medial, forearm and ulnar medial cutaneous nerves, arising from a trunk comprised of cervical spine nerves (C) 7, C8, C9, and thoracic (T) 1 and T2. Regarding other wild and domestic animals, different suggestions were observed about the origin of the plexus in B. variegatus, however, the constituent nerves and their innervation areas did not demonstrate any discrepancies.(AU)

A espécie Bradypus variegatus é conhecida como preguiça-comum. Trata-se de um mamífero endêmico de regiões neotropicais que vem sofrendo com a ação antrópica devastadora. Esses Bradipodídeos possuem três dedos nos membros torácicos e pélvicos, são arborícolas consagrados e descem ao solo apenas para excretar e trocar de árvore. O estudo teve como objetivo descrever o plexo braquial de B. variegatus em relação à origem e distribuição dos nervos. Para tal, utilizou-se 10 fêmeas adultas. As análises foram realizadas no Pavilhão de Anatomia do Departamento de Morfologia e Fisiologia Animal da Universidade Federal Rural de Pernambuco, sob a licença nº 034/2015 do Comitê de Ética no Uso de Animais. Os cadáveres foram obtidos após morte natural, fixados em formaldeído a 20%, conservados em solução salina a 30% em tanques e dissecados para a visualização dos nervos destinados a inervar os membros e músculos torácicos. Uma vez feito, constatou-se que o plexo braquial da preguiça-comum se origina do quinto segmento espinal cervical, se estendendo até o segundo segmento torácico. Sendo formado pelos nervos torácico longo e supraescapular, de origem imediatamente do segmento medular 5 e 6, respectivamente, e pelos nervos peitorais, subescapulares, axilar, radial, musculocutâneo, mediano, cutâneo medial do antebraço e ulnar, decorrentes de um tronco formado a partir de nervos espinais cervicais (C) 7, C8, C9, e torácicos (T) 1 e T2. Em comparação a outros animais silvestres e domésticos foram observadas diferentes disposições em relação à origem do plexo de B. variegatus, todavia, os nervos constituintes e suas áreas de inervação não apresentaram discrepâncias.(AU)

Description of brachial plexus of sloth (Bradypus variegatus) / Descrição do plexo braquial do bicho-preguiça (Bradypus variegatus)

The species Bradypus variegatus is known as the common sloth, an endemic mammal from neotropical regions, which has been suffering from devastating anthropogenic activities. Our study aimed to describe the brachial plexus of B. variegates, regarding the origin and distribution of nerves, through the sampling of 10 adult females. Analyses were carried out at the Anatomy Section, "Departamento de Morfologia e Fisiologia Animal", "Universidade Federal Rural de Pernambuco", under license no. 034/2015 of the Ethics Committee on the Use of Animals. The results determined that the brachial plexus of the common sloth starts from the fifth cervical spine segment until the second thoracic segment. This area contains the long and suprascapular thoracic nerves, which originate immediately from the medullary segment 5 and 6, respectively, and from the pectoral, subscapular, axillary, radial, musculocutaneous, medial, forearm and ulnar medial cutaneous nerves, arising from a trunk comprised of cervical spine nerves (C) 7, C8, C9, and thoracic (T) 1 and T2. Regarding other wild and domestic animals, different suggestions were observed about the origin of the plexus in B. variegatus, however, the constituent nerves and their innervation areas did not demonstrate any discrepancies.(AU)

A espécie Bradypus variegatus é conhecida como preguiça-comum. Trata-se de um mamífero endêmico de regiões neotropicais que vem sofrendo com a ação antrópica devastadora. Esses Bradipodídeos possuem três dedos nos membros torácicos e pélvicos, são arborícolas consagrados e descem ao solo apenas para excretar e trocar de árvore. O estudo teve como objetivo descrever o plexo braquial de B. variegatus em relação à origem e distribuição dos nervos. Para tal, utilizou-se 10 fêmeas adultas. As análises foram realizadas no Pavilhão de Anatomia do Departamento de Morfologia e Fisiologia Animal da Universidade Federal Rural de Pernambuco, sob a licença nº 034/2015 do Comitê de Ética no Uso de Animais. Os cadáveres foram obtidos após morte natural, fixados em formaldeído a 20%, conservados em solução salina a 30% em tanques e dissecados para a visualização dos nervos destinados a inervar os membros e músculos torácicos. Uma vez feito, constatou-se que o plexo braquial da preguiça-comum se origina do quinto segmento espinal cervical, se estendendo até o segundo segmento torácico. Sendo formado pelos nervos torácico longo e supraescapular, de origem imediatamente do segmento medular 5 e 6, respectivamente, e pelos nervos peitorais, subescapulares, axilar, radial, musculocutâneo, mediano, cutâneo medial do antebraço e ulnar, decorrentes de um tronco formado a partir de nervos espinais cervicais (C) 7, C8, C9, e torácicos (T) 1 e T2. Em comparação a outros animais silvestres e domésticos foram observadas diferentes disposições em relação à origem do plexo de B. variegatus, todavia, os nervos constituintes e suas áreas de inervação não apresentaram discrepâncias.(AU)

Bloqueio do plexo braquial em jumento - relato de caso / Brachial plexus block in donkey - case report

A anestesia locorregional reduz o requerimento de agentes inalatórios e diminui as respostas autonômicas a estímulos cirúrgicos nocivos. Objetiva-se descrever um bloqueio anestésico do plexo braquial guiado por neuroestimulador em jumento, submetido à amputação do membro anterior direito. Foi realizada medicação pré-anestésica com detomidina 0,01mg.kg-1, indução com diazepam 0,05mg.kg-1 e cetamina 2mg.kg-1, todos pela via intravenosa (IV), e a manutenção da anestesia com isoflurano. O plexo braquial foi bloqueado por acesso subescapular, sendo usado neuroestimulador. Utilizou-se 1mg.kg-1 de bupivacaína 0,5% sem vasoconstritor, associada a 1mg.kg-1 de lidocaína 2% sem vasoconstrictor. Os valores de FC e ƒ durante o procedimento cirúrgico variaram de 62 a 78bpm e de 24 a 32rpm, respectivamente. Foram coletadas quatro amostras de sangue para dosagem de cortisol. Este, antes da aplicação da medicação pré-anestésica, foi de 6,4µg/dL e, 30 minutos após a MPA, foi de 2,8µg/dL. A recuperação anestésica foi rápida e sem complicações. O bloqueio do plexo braquial guiado por neuroestimulador mostrou-se eficaz em jumentos, fornecendo analgesia e anestesia satisfatória.(AU)

Locoregional anesthesia reduces the requirement for inhaled agents and reduces the autonomic responses to noxious surgical stimuli. The aim of this study was to describe an anesthetic block of the brachial plexus guided by a neurostimulator in a donkey submitted to right limb amputation. Preanesthetic medication was performed with detomidine 0.01mg.kg-1 induction with diazepam 0.05mg.kg-1 and ketamine 2mg.kg-1 all intravenously, and maintenance of anesthesia with isoflurane. The brachial plexus was blocked by subscapular access, using a neurostimulator. For this purpose, 1mg.kg -1 of bupivacaine 0.5%, without vasoconstrictor, and 1mg.kg- 1 of lidocaine 2%, without vasoconstrictor were used. The values of HR and ƒ during the surgical procedure ranged from 62 to 78bpm, and 24 to 32bpm, respectively. Four blood samples were collected for cortisol dosing. This, prior to the application of the pre-anesthetic medication was 6.4µg/dL and 30 minutes was 2.8µg/dL. Anesthesia recovery was rapid and uncomplicated. Neurostimulator-guided brachial plexus blockade proved to be effective in donkeys, providing satisfactory analgesia and anesthesia.(AU)

Bloqueio do plexo braquial em jumento - relato de caso / Brachial plexus block in donkey - case report

A anestesia locorregional reduz o requerimento de agentes inalatórios e diminui as respostas autonômicas a estímulos cirúrgicos nocivos. Objetiva-se descrever um bloqueio anestésico do plexo braquial guiado por neuroestimulador em jumento, submetido à amputação do membro anterior direito. Foi realizada medicação pré-anestésica com detomidina 0,01mg.kg-1, indução com diazepam 0,05mg.kg-1 e cetamina 2mg.kg-1, todos pela via intravenosa (IV), e a manutenção da anestesia com isoflurano. O plexo braquial foi bloqueado por acesso subescapular, sendo usado neuroestimulador. Utilizou-se 1mg.kg-1 de bupivacaína 0,5% sem vasoconstritor, associada a 1mg.kg-1 de lidocaína 2% sem vasoconstrictor. Os valores de FC e ƒ durante o procedimento cirúrgico variaram de 62 a 78bpm e de 24 a 32rpm, respectivamente. Foram coletadas quatro amostras de sangue para dosagem de cortisol. Este, antes da aplicação da medicação pré-anestésica, foi de 6,4µg/dL e, 30 minutos após a MPA, foi de 2,8µg/dL. A recuperação anestésica foi rápida e sem complicações. O bloqueio do plexo braquial guiado por neuroestimulador mostrou-se eficaz em jumentos, fornecendo analgesia e anestesia satisfatória.(AU)

Locoregional anesthesia reduces the requirement for inhaled agents and reduces the autonomic responses to noxious surgical stimuli. The aim of this study was to describe an anesthetic block of the brachial plexus guided by a neurostimulator in a donkey submitted to right limb amputation. Preanesthetic medication was performed with detomidine 0.01mg.kg-1 induction with diazepam 0.05mg.kg-1 and ketamine 2mg.kg-1 all intravenously, and maintenance of anesthesia with isoflurane. The brachial plexus was blocked by subscapular access, using a neurostimulator. For this purpose, 1mg.kg -1 of bupivacaine 0.5%, without vasoconstrictor, and 1mg.kg- 1 of lidocaine 2%, without vasoconstrictor were used. The values of HR and ƒ during the surgical procedure ranged from 62 to 78bpm, and 24 to 32bpm, respectively. Four blood samples were collected for cortisol dosing. This, prior to the application of the pre-anesthetic medication was 6.4µg/dL and 30 minutes was 2.8µg/dL. Anesthesia recovery was rapid and uncomplicated. Neurostimulator-guided brachial plexus blockade proved to be effective in donkeys, providing satisfactory analgesia and anesthesia.(AU)

Bloqueio de plexo braquial guiado por neuroestimulador para amputação em bezerro / Nerve stimulator-guided brachial plexus block performed in the amputation of a calf’s forelimb

Background: Locoregional anesthesia techniques enable the performance of procedures in the distal portion of the limbs,through the parenteral administration of local anesthetic nerve block. There are devices that can increase the effectivenessof these blocks by accurately locating the nerves. These devices include peripheral nerve stimulators, which enable anesthetic to be injected near the plexus, thus reducing the volume of anesthetic required and allowing for the specific blockadeof a nerve branch by desensitizing exclusively the area of interest. This paper describes the use of nerve stimulator in thebrachial plexus block (BPB) of a calf subjected to amputation of the left foreleg.Case: A newborn calf weighing 30 kg, with a history of injury to the left foreleg, was treated at the Veterinary Hospital ofthe Federal Rural University of the Semi-Arid Region. Clinical and X-ray examinations revealed a fracture in the medialportion of the metacarpus and radiographic alterations indicative of osteomyelitis, so amputation of the affected limb wasrecommended. Prior the beginning, during and after the surgical procedure, the animal was submitted to the evaluation ofits physiological parameters (heart and respiratory rate, capillary refill time, diastolic, systolic and mean blood pressure andrectal temperature). Because it is a newborn animal, it was decided not to pre-operatively fast. After applying preanestheticmedication (xylazine 0.01 mg/kg IV), anesthesia was induced with ketamine (2 mg/kg IV) and midazolam (0.3 mg/kg IV)and maintained with isoflurane. For the brachial plexus block, 0.4 mL/kg (1.5 mg/kg) of 0.375% bupivacaine was usedand aided by a peripheral nerve stimulator to generate 10 mA current, 1 HZ frequency and 100 μs pulse duration, coupledto a nerve stimulation needle, it was possible to observe flexion movements...

Bloqueio de plexo braquial guiado por neuroestimulador para amputação em bezerro / Nerve stimulator-guided brachial plexus block performed in the amputation of a calfs forelimb

Background: Locoregional anesthesia techniques enable the performance of procedures in the distal portion of the limbs,through the parenteral administration of local anesthetic nerve block. There are devices that can increase the effectivenessof these blocks by accurately locating the nerves. These devices include peripheral nerve stimulators, which enable anesthetic to be injected near the plexus, thus reducing the volume of anesthetic required and allowing for the specific blockadeof a nerve branch by desensitizing exclusively the area of interest. This paper describes the use of nerve stimulator in thebrachial plexus block (BPB) of a calf subjected to amputation of the left foreleg.Case: A newborn calf weighing 30 kg, with a history of injury to the left foreleg, was treated at the Veterinary Hospital ofthe Federal Rural University of the Semi-Arid Region. Clinical and X-ray examinations revealed a fracture in the medialportion of the metacarpus and radiographic alterations indicative of osteomyelitis, so amputation of the affected limb wasrecommended. Prior the beginning, during and after the surgical procedure, the animal was submitted to the evaluation ofits physiological parameters (heart and respiratory rate, capillary refill time, diastolic, systolic and mean blood pressure andrectal temperature). Because it is a newborn animal, it was decided not to pre-operatively fast. After applying preanestheticmedication (xylazine 0.01 mg/kg IV), anesthesia was induced with ketamine (2 mg/kg IV) and midazolam (0.3 mg/kg IV)and maintained with isoflurane. For the brachial plexus block, 0.4 mL/kg (1.5 mg/kg) of 0.375% bupivacaine was usedand aided by a peripheral nerve stimulator to generate 10 mA current, 1 HZ frequency and 100 μs pulse duration, coupledto a nerve stimulation needle, it was possible to observe flexion movements...(AU)

Bloqueio do plexo braquial com uso de neuroestimulador em coruja-orelhuda (Asio clamator) submetida à amputação de asa / Brachial plexus block with use of a neurostimulator in a striped owl (Asio clamator) undergoing wing amputation

Background: The use of distinct drugs and techniques for establishing balanced anesthesia protocols has shown promisingresults in birds. The techniques of locoregional block can be incorporated to these protocols, thereby providing intra- andpost-operative analgesia and reducing the requirement for general anesthesia. Additionally, the use of neurostimulatorsincreases the chances of success and reduces the risk of toxicity; however, there are limited reports in the literature of itsapplicability in wild birds. Therefore, the aim of this study was to describe the brachial plexus block technique guidedusing a neurolocalizer in a striped owl (Asio clamator) submitted for right wing amputation.Case: A striped owl weighing 400 g with a history of exposed fracture of the right wing was supplied by the clinical sectorat the Veterinarian Hospital of the Federal University of Bahia. Following hydration and stabilization of vital signs, theanimal was referred to the surgical center for amputation of the limb. Dexmedetomidine (10 µg.kg−1 IM) was administeredas premedication, and after 20 min, anesthetic induction was performed using sevoflurane (FiO2 = 100%) via a mask followed by maintenance using the same drug. The animal was positioned in a left lateral decubitus position with access to thebrachial plexus determined by palpation and identification of the border of the following muscles: pectoral, cranial branchof the brachial biceps, and dorsal branch of the ventral serratus. The brachial plexus nerves are situated in the subcutaneous site craniodorsal to the axillary depression. For the block, a neurolocalizer was used, fixing the positive electrode toapproximately 5 cm from the needle insertion site (21G × 2’”) in the axillary depression, which remained connected to theneurostimulator by the second electrode. At first, the needle was attached to the peripheral nerve stimulator using a pulsefrequency of 1 Hz with an...

Bloqueio do plexo braquial com uso de neuroestimulador em coruja-orelhuda (Asio clamator) submetida à amputação de asa / Brachial plexus block with use of a neurostimulator in a striped owl (Asio clamator) undergoing wing amputation

Background: The use of distinct drugs and techniques for establishing balanced anesthesia protocols has shown promisingresults in birds. The techniques of locoregional block can be incorporated to these protocols, thereby providing intra- andpost-operative analgesia and reducing the requirement for general anesthesia. Additionally, the use of neurostimulatorsincreases the chances of success and reduces the risk of toxicity; however, there are limited reports in the literature of itsapplicability in wild birds. Therefore, the aim of this study was to describe the brachial plexus block technique guidedusing a neurolocalizer in a striped owl (Asio clamator) submitted for right wing amputation.Case: A striped owl weighing 400 g with a history of exposed fracture of the right wing was supplied by the clinical sectorat the Veterinarian Hospital of the Federal University of Bahia. Following hydration and stabilization of vital signs, theanimal was referred to the surgical center for amputation of the limb. Dexmedetomidine (10 µg.kg−1 IM) was administeredas premedication, and after 20 min, anesthetic induction was performed using sevoflurane (FiO2 = 100%) via a mask followed by maintenance using the same drug. The animal was positioned in a left lateral decubitus position with access to thebrachial plexus determined by palpation and identification of the border of the following muscles: pectoral, cranial branchof the brachial biceps, and dorsal branch of the ventral serratus. The brachial plexus nerves are situated in the subcutaneous site craniodorsal to the axillary depression. For the block, a neurolocalizer was used, fixing the positive electrode toapproximately 5 cm from the needle insertion site (21G × 2”) in the axillary depression, which remained connected to theneurostimulator by the second electrode. At first, the needle was attached to the peripheral nerve stimulator using a pulsefrequency of 1 Hz with an... (AU)

Paravertebral cervical block for osteosynthesis of humeral fracture in foal / Bloqueio paravertebral cervical para realização de ostessíntese de fratura de úmero em potro

A modified cervical paravertebral block of the brachial plexus was performed with the aid of a nerve stimulator for osteosynthesis with four intramedullary pins in a 5-month-old colt weighing 180 kg diagnosed with a closed, complete, and oblique humerus fracture. Xylazine 2% (0.5 mg kg-1 IV) was administered as the pre-anesthetic medication. Anesthesia was induced with ketamine 10% (2 mg kg-1 IV) and midazolam 0.5% (5 mg kg-1 IV) and maintained with isoflurane. The animal was on mechanical ventilation. The nerve block was induced with administration of ropivacaine 0.75% in the ventral branches of C6 (intervertebral space C5–C6) and C7 (intervertebral space C6–C7) and in the branches of C8 and T1 at their convergence at the cranial margin of the first rib. During the 130-min duration of the surgery, no analgesic rescue was required. In conclusion, this blockade can be performed safely and promotes numbness of the humeral and olecranon regions.

Realizou-se o bloqueio paravertebral cervical modicado do plexo braquial, com auxílio de estimulador de nervos, para execução de osteossíntese com quatro pinos intramedulares, em potro de 5 meses, com 180 kg, diagnosticado com fratura fechada, completa e oblíqua de úmero. O animal foi submetido a anestesia com medicação pré-anestésica, xilazina 2% (0,5 mg kg-1 IV) e indução anestésica com cetamina 10% (2 mg kg-1 IV) associada ao midazolam 0,5% (0,5 mg kg-1 IV). A manutenção anestésica foi feita com isoflurano, sendo sempre mantido em ventilação mecânica. O bloqueio foi feito com ropivacaína 0,75% nos ramos ventrais de C6 (espaço intervertebral C5 – C6), C7 (espaço intervertebral C6 – C7) e nos ramos de C8 e T1 em sua convergência na margem cranial da primeira costela. Durante os 130 minutos de duração da cirurgia, não foi necessário qualquer resgate analgésico. Conclui-se que esse bloqueio foi realizado de forma segura e promoveu insensibilidade da região de úmero e olecrano.

Brachial plexus in the Leopardus geoffroyi / Plexo braquial do Leopardus geoffroyi

Six thoracic limbs from four Leopardus geoffroyi specimens were dissected in order to describe origin and distribution of nerves forming the brachial plexuses. The brachial plexus is a result of connections between ventral branches of the last four cervical nerves (C5, C6, C7 and C8) and the first thoracic nerve (T1). These branches are the origin of the suprascapularis, subscapularis, axillary, musculocutaneous, radial, median and ulnar nerves to the intrinsic musculature, and form the brachiocephalicus, thoracodorsal, lateral thoracic, long thoracic, cranial pectoral and caudal pectoral nerves to the extrinsic musculature. The C7 ventral branch is mainly responsible for formation of nerves (70.5%), followed by C8 (47.4%), C6 (29.5%), T1 (19.2%) and C5 (7.7%). From 78 dissected nerves, 65.4% of nerves resulted from a combination of two or three branches, while only 34.6% of nerves originated from a single branch. Through comparison with other carnivoran species, the origin and innervation area of the Geoffroyi’s Cat brachial plexus were most similar to those of the domestic cat, particularly among those nerves extended to the intrinsic musculature. The results of this study suggest that nerve block techniques currently used in dogs and cats might be efficient in Geoffroyi’s Cat too.

Seis membros torácicos de quatro espécimes de Leopardus geoffroyi foram dissecados para descrever a origem e a distribuição dos nervos formadores do plexo braquial. O plexo braquial resultou das conexões entre os ramos ventrais dos últimos quatro ramos ventrais cervicais (C5, C6, C7 e C8) e do primeiro torácico (T1). Estes ramos formaram os nervos supra-escapular, subescapular, axilar, musculocutâneo, radial, mediano e ulnar para os músculos intrínsecos e originaram os nervos braquiocefálico, toracodorsal, torácico lateral, torácico longo, peitoral cranial e peitoral caudal para os músculos extrínsecos. O ramo ventral de C7 foi o que mais contribuiu para a formação dos nervos do plexo (70,5%), seguido por C8 (47,4%), C6 (29,5%), T1 (19,2%) e C5 (7,7%). Entre os 78 nervos dissecados, 65,4% resultaram da combinação de dois ou mais ramos, enquanto apenas 34,6% se originaram de um único ramo. Em comparação com outras espécies da ordem Carnivora, a origem e área de inervação do plexo braquial do gato-do-mato-grande se assemelhou mais com a do gato doméstico, especialmente no tocante aos nervos destinados à musculatura intrínseca. Os resultados do presente estudo sugerem que técnicas de bloqueio nervoso atualmente empregadas em cães e gatos podem ser também eficientes no gato-do-mato-grande.

Brachial plexus in the Leopardus geoffroyi / Plexo braquial do Leopardus geoffroyi

Six thoracic limbs from four Leopardus geoffroyi specimens were dissected in order to describe origin and distribution of nerves forming the brachial plexuses. The brachial plexus is a result of connections between ventral branches of the last four cervical nerves (C5, C6, C7 and C8) and the first thoracic nerve (T1). These branches are the origin of the suprascapularis, subscapularis, axillary, musculocutaneous, radial, median and ulnar nerves to the intrinsic musculature, and form the brachiocephalicus, thoracodorsal, lateral thoracic, long thoracic, cranial pectoral and caudal pectoral nerves to the extrinsic musculature. The C7 ventral branch is mainly responsible for formation of nerves (70.5%), followed by C8 (47.4%), C6 (29.5%), T1 (19.2%) and C5 (7.7%). From 78 dissected nerves, 65.4% of nerves resulted from a combination of two or three branches, while only 34.6% of nerves originated from a single branch. Through comparison with other carnivoran species, the origin and innervation area of the Geoffroyis Cat brachial plexus were most similar to those of the domestic cat, particularly among those nerves extended to the intrinsic musculature. The results of this study suggest that nerve block techniques currently used in dogs and cats might be efficient in Geoffroyis Cat too.(AU)

Seis membros torácicos de quatro espécimes de Leopardus geoffroyi foram dissecados para descrever a origem e a distribuição dos nervos formadores do plexo braquial. O plexo braquial resultou das conexões entre os ramos ventrais dos últimos quatro ramos ventrais cervicais (C5, C6, C7 e C8) e do primeiro torácico (T1). Estes ramos formaram os nervos supra-escapular, subescapular, axilar, musculocutâneo, radial, mediano e ulnar para os músculos intrínsecos e originaram os nervos braquiocefálico, toracodorsal, torácico lateral, torácico longo, peitoral cranial e peitoral caudal para os músculos extrínsecos. O ramo ventral de C7 foi o que mais contribuiu para a formação dos nervos do plexo (70,5%), seguido por C8 (47,4%), C6 (29,5%), T1 (19,2%) e C5 (7,7%). Entre os 78 nervos dissecados, 65,4% resultaram da combinação de dois ou mais ramos, enquanto apenas 34,6% se originaram de um único ramo. Em comparação com outras espécies da ordem Carnivora, a origem e área de inervação do plexo braquial do gato-do-mato-grande se assemelhou mais com a do gato doméstico, especialmente no tocante aos nervos destinados à musculatura intrínseca. Os resultados do presente estudo sugerem que técnicas de bloqueio nervoso atualmente empregadas em cães e gatos podem ser também eficientes no gato-do-mato-grande.(AU)

Bloqueio do plexo braquial em um tamanduá-mirim (Tamandua tetradactyla) utilizando estimulador de nervos periféricos: relato de caso / Brachial plexus block in a tamanduá-mirim (Tamandua tetradactyla) using a peripheral nerve stimulator: Case report

Objetivou-se relatar a utilização do neurolocalizador para bloqueio do plexo braquial bilateral em tamanduá-mirim (Tamandua tetradactyla). O animal, pesando 5kg, atendido pelo Centro de Reabilitação de Animais Silvestres, foi encaminhado ao Hospital Veterinário da Universidade Federal de Mato Grosso do Sul para realização de exames complementares, sendo, posteriormente, encaminhado para cirurgia de osteossíntese de úmero e rádio/ulna esquerdo e colocação de fio de cerclagem em olécrano direito. O paciente foi pré-medicado com cetamina S (5mg/kg) + midazolam (0,15mg/kg), indução anestésica com propofol (5mg/kg) e manutenção anestésica com isoflurano, com o auxílio de máscara. Os parâmetros cardiovasculares e respiratórios foram monitorados durante todo o procedimento. Realizou-se o bloqueio do plexo braquial em ambos os membros utilizando-se estimulador de nervos periféricos. Os anestésicos locais empregados foram lidocaína 2% sem vasoconstritor (3mg/kg) + ropivacaína 0,75% sem vasoconstritor (1mg/kg). O bloqueio foi realizado primeiramente no membro torácico direito, e, após realização do procedimento cirúrgico, o mesmo bloqueio foi realizado no membro contralateral. O paciente teve recuperação tranquila ausente de vocalização e expressão álgica, e a soltura ocorreu após 120 dias.(AU)

The aim of this study was to report the use of the neurolocalizer for blocking the bilateral brachial plexus in tamanduá-mirin. The subject weighing 5kg was attended by the Center for the Rehabilitation of Wild Animals and referred to the Veterinary Hospital of the Federal University of Mato Grosso do Sul for complementary tests. Through the examinations, the need to perform humerus and left radius/ulna osteosynthesis and cerclagem placement on right olecranon was established. For surgery performance, the patient was pre-medicated with ketamine S (5mg/kg-1) associated to midazolam (0.15mg/kg-1) via intramuscular and intravenous propofol (5mg/kg-1) was used for induction. The anesthetic maintenance was performed with isoflurane, provided by an oxygen mask. Cardiovascular and respiratory parameters were monitored throughout the procedure. Brachial plexus block was performed in both limbs using peripheral nerve stimulator. The local anesthetics used were lidocaine without vasoconstrictor (3mg/kg-1) plus 0.75% ropivacaine without vasoconstrictor (1mg/kg-1). Blocking was first performed on the right thoracic limb followed by the surgical procedure. The same blockage was performed on the contralateral limb. The patient had a smooth recovery, without vocalization and pain. The release to its natural habitat occurred after 120 days.(AU)

Bloqueio do plexo braquial em um tamanduá-mirim (Tamandua tetradactyla) utilizando estimulador de nervos periféricos: relato de caso / Brachial plexus block in a tamanduá-mirim (Tamandua tetradactyla) using a peripheral nerve stimulator: Case report

Objetivou-se relatar a utilização do neurolocalizador para bloqueio do plexo braquial bilateral em tamanduá-mirim (Tamandua tetradactyla). O animal, pesando 5kg, atendido pelo Centro de Reabilitação de Animais Silvestres, foi encaminhado ao Hospital Veterinário da Universidade Federal de Mato Grosso do Sul para realização de exames complementares, sendo, posteriormente, encaminhado para cirurgia de osteossíntese de úmero e rádio/ulna esquerdo e colocação de fio de cerclagem em olécrano direito. O paciente foi pré-medicado com cetamina S (5mg/kg) + midazolam (0,15mg/kg), indução anestésica com propofol (5mg/kg) e manutenção anestésica com isoflurano, com o auxílio de máscara. Os parâmetros cardiovasculares e respiratórios foram monitorados durante todo o procedimento. Realizou-se o bloqueio do plexo braquial em ambos os membros utilizando-se estimulador de nervos periféricos. Os anestésicos locais empregados foram lidocaína 2% sem vasoconstritor (3mg/kg) + ropivacaína 0,75% sem vasoconstritor (1mg/kg). O bloqueio foi realizado primeiramente no membro torácico direito, e, após realização do procedimento cirúrgico, o mesmo bloqueio foi realizado no membro contralateral. O paciente teve recuperação tranquila ausente de vocalização e expressão álgica, e a soltura ocorreu após 120 dias.(AU)

The aim of this study was to report the use of the neurolocalizer for blocking the bilateral brachial plexus in tamanduá-mirin. The subject weighing 5kg was attended by the Center for the Rehabilitation of Wild Animals and referred to the Veterinary Hospital of the Federal University of Mato Grosso do Sul for complementary tests. Through the examinations, the need to perform humerus and left radius/ulna osteosynthesis and cerclagem placement on right olecranon was established. For surgery performance, the patient was pre-medicated with ketamine S (5mg/kg-1) associated to midazolam (0.15mg/kg-1) via intramuscular and intravenous propofol (5mg/kg-1) was used for induction. The anesthetic maintenance was performed with isoflurane, provided by an oxygen mask. Cardiovascular and respiratory parameters were monitored throughout the procedure. Brachial plexus block was performed in both limbs using peripheral nerve stimulator. The local anesthetics used were lidocaine without vasoconstrictor (3mg/kg-1) plus 0.75% ropivacaine without vasoconstrictor (1mg/kg-1). Blocking was first performed on the right thoracic limb followed by the surgical procedure. The same blockage was performed on the contralateral limb. The patient had a smooth recovery, without vocalization and pain. The release to its natural habitat occurred after 120 days.(AU)

Neoplasia do plexo braquial com infiltração medular / Brachial plexus neoplasia with spinal cord infiltration: report case

Tumores originados no sistema nervoso periférico não são comuns na clínica veterinária e seu diagnóstico é difícil. Por ser uma patologia de curso lento e insidioso muitos profissionais demoram a suspeitar dos tumores de plexo braquial, retardando muito o diagnóstico e tratamento. Os sinais clínicos observados são claudicação, dor à palpação axilar,monoparesia e, em casos mais graves, com infiltração neoplásica na medula espinhal, o paciente pode apresentar tetraparesia. Foi atendida uma cadela fox paulistinha com 10 anos de idade apresentando tetraparesia não ambulatória. O exame clínico foi sugestivo de uma lesão de medula espinhal (C6-T2), suspeitando-se de doença do disco intervertebral ou neoplasia medular. A mielografia foi realizada e mostrou compressão caudal a C6. O animal foi então submetido àhemilaminectomia para descompressão, sendo observada infiltração neoplásica das raízes nervosas na medula espinhal impossível de ser resseccionada. O paciente foi eutanasiado. O plexo braquial, os nervos espinhais e a medula foram colhidos e enviados para examehistopatológico, confirmando-se o diagnóstico de tumor maligno de bainhade nervo periférico (TMNP). O presente relato mostrou um caso cujo curso clínico da doença foi atípico, dificultando o diagnóstico. Conclui-se que sempre se deve considerar a possibilidade de neoplasias de plexo braquial em pacientes com histórico de claudicação crônica de membros torácicos não responsiva a repouso e anti-inflamatórios.

Primary tumour of peripheral nerves are not common in veterinary practice and its diagnosis is difficult. Being a condition of slow and insidious course many professionals are slow to suspect the brachial plexus tumors, delaying diagnosis and treatment. The clinical signs observed in this disease are lameness, pain axillary palpation, monoparesis and in severe cases with neoplastic infiltration in the spinalcord, the patient may experience tertraparesia. A female dog Fox Paulistinha with 10-year-old was met with tetraparesia not ambulatory. Clinical examination was suggestive of a spinal cord injury (C6-T2),suspected presence of disc herniation and spinal cord cancer. The myelography was performed and showed compressive C6 flow. The animal was then subjected to a decompression Hemilaminectomy being observed neoplastic infiltration of the nerve roots in the spinal cord impossible to beresected. The patient was euthanized, the brachial plexus, the spinal nerves and the affected spinal cord were collected and sent for histopathological examination, confirming the diagnosis of malignantperipheral nerve sheath tumor (MPNST) in the brachial plexus. This report shows a brachial plexus tumors case whose clinical course of the disease was atypical making diagnosis difficult. The conclusion is that youshould always consider the brachial plexus tumors in patients with a history of chronic lameness forelimbs unresponsive to rest and anti-inflammatory.

Neoplasia do plexo braquial com infiltração medular / Brachial plexus neoplasia with spinal cord infiltration: report case

Tumores originados no sistema nervoso periférico não são comuns na clínica veterinária e seu diagnóstico é difícil. Por ser uma patologia de curso lento e insidioso muitos profissionais demoram a suspeitar dos tumores de plexo braquial, retardando muito o diagnóstico e tratamento. Os sinais clínicos observados são claudicação, dor à palpação axilar,monoparesia e, em casos mais graves, com infiltração neoplásica na medula espinhal, o paciente pode apresentar tetraparesia. Foi atendida uma cadela fox paulistinha com 10 anos de idade apresentando tetraparesia não ambulatória. O exame clínico foi sugestivo de uma lesão de medula espinhal (C6-T2), suspeitando-se de doença do disco intervertebral ou neoplasia medular. A mielografia foi realizada e mostrou compressão caudal a C6. O animal foi então submetido àhemilaminectomia para descompressão, sendo observada infiltração neoplásica das raízes nervosas na medula espinhal impossível de ser resseccionada. O paciente foi eutanasiado. O plexo braquial, os nervos espinhais e a medula foram colhidos e enviados para examehistopatológico, confirmando-se o diagnóstico de tumor maligno de bainhade nervo periférico (TMNP). O presente relato mostrou um caso cujo curso clínico da doença foi atípico, dificultando o diagnóstico. Conclui-se que sempre se deve considerar a possibilidade de neoplasias de plexo braquial em pacientes com histórico de claudicação crônica de membros torácicos não responsiva a repouso e anti-inflamatórios.(AU)

Primary tumour of peripheral nerves are not common in veterinary practice and its diagnosis is difficult. Being a condition of slow and insidious course many professionals are slow to suspect the brachial plexus tumors, delaying diagnosis and treatment. The clinical signs observed in this disease are lameness, pain axillary palpation, monoparesis and in severe cases with neoplastic infiltration in the spinalcord, the patient may experience tertraparesia. A female dog Fox Paulistinha with 10-year-old was met with tetraparesia not ambulatory. Clinical examination was suggestive of a spinal cord injury (C6-T2),suspected presence of disc herniation and spinal cord cancer. The myelography was performed and showed compressive C6 flow. The animal was then subjected to a decompression Hemilaminectomy being observed neoplastic infiltration of the nerve roots in the spinal cord impossible to beresected. The patient was euthanized, the brachial plexus, the spinal nerves and the affected spinal cord were collected and sent for histopathological examination, confirming the diagnosis of malignantperipheral nerve sheath tumor (MPNST) in the brachial plexus. This report shows a brachial plexus tumors case whose clinical course of the disease was atypical making diagnosis difficult. The conclusion is that youshould always consider the brachial plexus tumors in patients with a history of chronic lameness forelimbs unresponsive to rest and anti-inflammatory.(AU)

Mapeamento comparativo de nervos periféricos em caninos e bovinos / Comparative mapping of peripheral nerves in dogs and cattle

O estudo dos dados anatômicos é fundamental para possibilitar ao médico veterinário o reconhecimento de pequenas estruturas, como os nervos nos animais, oferecendo subsídio para construção do conhecimento do profissional principalmente em técnicas anestésicas e cirúrgicas. Para investigar e mapear os nervos do plexo braquial (nervo radial, nervo musculocutâneo, nervo ulnar, nervo mediano), nervo isquiático, nervo tibial, nervo femoral e os nervos para bloqueio paravertebral, foram utilizados um cadáver canino adulto, de peso aproximado de 8kg, e um cadáver de bezerro Holandês, de peso aproximado de 40kg. O mapeamento dos nervos é de grande importância, já que conhecer bem essas estruturas permite ao veterinário um bom desenvolvimento de suas atividades profissionais a fim de exercer funções mais complexas durante a anestesia e cirurgia veterinária, uma vez que, identificados os pontos de referência anatômicos, é possível trabalhar com mais clareza nas técnicas de bloqueios dos nervos periféricos.(AU)

Knowledge of animal anatomy is essential for the veterinarian to identify small structures such as nerves, thus providing a solid background for the professional especially for surgical and anesthetic techniques. To investigate and map the nerves of the brachial plexus (radial, musculocutaneous, ulnar, median), sciatic, tibial, femoral and the nerves for paravertebral blocking in bovine, embalmed specimens were used. One adult male dog weighing approximately 8kg and one 40kg male calf were used. Nerve mapping is fundamental due to its interdisciplinary nature, thus providing the veterinarian with a major improvement in his/her professional activities which permits allows one to perform complex tasks in anesthesia and veterinary surgery. Knowledge ofanatomical reference points increases clarity and precision in techniques involving peripheral nerve blocks.(AU)