American journal of veterinary research · 2026
Needle bevel orientation does not affect the cranial spread of injectate in a lumbosacral epidural in canine cadavers.
СтатьяНазвание и аннотация: Перевод в очереди
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Harris Olivia, Ferreira Tatiana Henriques, Loeber Samantha, Hughes Sarah, Bartholomew Kyle J
Аннотация
OBJECTIVE: To investigate the cranial and circumferential spread of iohexol (240 mg/mL) diluted 1:3 with saline injected at the lumbosacral junction in canine cadavers using 0.1- and 0.2-mL/kg volumes administered with a cranial- or caudal-facing Tuohy bevel direction.
METHODS: Lumbosacral epidurals were performed with a cranial- or caudal-facing needle bevel. The median vertebrae reached and the estimated percentage of the spinal cord surrounded with injectate were assessed via CT after administering two 0.1-mL/kg aliquots of injectate. Contrast medium was diluted to achieve physical properties closer to local anesthetics.
RESULTS: 5 cadavers in each group were assessed in August of 2024. The median vertebrae reached with a 0.1-mL/kg volume using a cranial bevel and 100%, ≥ 50%, and ≥ 1% circumferential epidural coverage contrast medium were 1, 7, and 10 bodies compared to a caudal bevel direction of 1, 7, and 9 bodies. For 0.2-mL/kg total volume using a cranial bevel and having 100%, ≥ 50%, and ≥ 1% circumferential epidural coverage, there were 2, 9, and 14 bodies compared to a caudal bevel direction being 2, 11, and 15 bodies.
CONCLUSIONS: The findings in this cadaveric study suggest that needle bevel direction does not affect the cranial epidural spread of injectate performed at the lumbosacral space.
CLINICAL RELEVANCE: While no benefit to performing a lumbosacral epidural with a caudally facing bevel in limiting cranial spread was found, further studies in live patients are required to adjust clinical recommendations.
METHODS: Lumbosacral epidurals were performed with a cranial- or caudal-facing needle bevel. The median vertebrae reached and the estimated percentage of the spinal cord surrounded with injectate were assessed via CT after administering two 0.1-mL/kg aliquots of injectate. Contrast medium was diluted to achieve physical properties closer to local anesthetics.
RESULTS: 5 cadavers in each group were assessed in August of 2024. The median vertebrae reached with a 0.1-mL/kg volume using a cranial bevel and 100%, ≥ 50%, and ≥ 1% circumferential epidural coverage contrast medium were 1, 7, and 10 bodies compared to a caudal bevel direction of 1, 7, and 9 bodies. For 0.2-mL/kg total volume using a cranial bevel and having 100%, ≥ 50%, and ≥ 1% circumferential epidural coverage, there were 2, 9, and 14 bodies compared to a caudal bevel direction being 2, 11, and 15 bodies.
CONCLUSIONS: The findings in this cadaveric study suggest that needle bevel direction does not affect the cranial epidural spread of injectate performed at the lumbosacral space.
CLINICAL RELEVANCE: While no benefit to performing a lumbosacral epidural with a caudally facing bevel in limiting cranial spread was found, further studies in live patients are required to adjust clinical recommendations.