• Anne H Kramer, Marcus G Doherr, Michael H Stoffel, Adrian Steiner, and Claudia Spadavecchia.
• Ruminant Clinic, Vetsuisse Faculty, University of Bern, Berne, Switzerland.
• Vet Anaesth Analg. 2014 Sep 1;41(5):534-42.

ObjectiveTo develop and evaluate a method for ultrasound-guidance in performing the proximal paravertebral block for flank anaesthesia in cattle through a cadaveric study, followed by clinical application.Study Designprospective experimental cadaveric study and clinical series.AnimalsPreviously frozen lumbar sections of cows without known spinal abnormalities were used. The clinical case group comprised of ten animals for which a right flank laparotomy was indicated.MethodsTwenty cow cadavers were used to perform ultrasound-guided bilateral injections of 1.0 mL dye (1.0 mL 1% Toluidine Blue in 1% Borax) at the intervertebral foramen at the level of T13, L1 and L2 spinal nerves. Distance and depth of injection, staining of the dorsal and ventral nerve branches, and deviation from the target were evaluated. The investigator's confidence as to visualisation and expected success at staining the nerve was assessed. Ten clinical cases received the ultrasound-guided proximal paravertebral anaesthesia. Analgesic success was evaluated using a 4-grade scoring system at 10 minutes after the injection and during surgery, respectively. Categorical variables were described using frequencies and proportions.ResultsBoth dorsal and ventral branches of the spinal nerves T13, L1 or L2 were at least partially stained in 41% of injections, while in 77% of injections one of the branches was stained. Five out of ten clinical cases had a satisfactory anaesthesia. There was no significant association between confidence at injection and either staining or analgesic success.ConclusionResults from the cadaveric and clinical study suggest no significant improvement using ultrasound guidance to perform proximal paravertebral block in cows compared to our previous clinical experience and to references in the literature using the blind method.Clinical RelevanceFurther research should be conducted to improve the ultrasound-guided technique described in this study.© 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

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