24. Distal lumbar paravertebral nerve block in cattle

Question 1

Indications?

Answer 1

Indications:

• Similar to the proximal one: ‘’In standing animal: any kind of right or left sided flank laparotomy’’: abomasal

displacement, cecarian, ruminal impaction

• Advantage of distal to proximal: the distal one doesn’t affect the latissimus dorsi so it doesn’t affect

movement

Question 2

Materials used?

Answer 2

Materials

• 2 different needles
• 2.5-inch, 16-18G needle= anesthetic injection, length of the needle is much shorter than in the proximal one

because the injection shouldn’t be done as deep.

• 1-inch, 14G guide needle to act as a cannula through the skin (preferred) or a bayonet-tip scalpel blade (for

skin stab incisions). The skin is of cattle is so hard which makes it difficult to puncture directly with an

injection needle without doing the skin puncture

• 20-ml syringe
• 2% lidocaine

Question 3

Basic technique?

Answer 3

Basic technique

1. Block the nerve:

o Quite similar to the proximal one; blocks the same nerves and also involves 3 injections. Positioning

different!

o Proximal= lateral process of L1,L2 in tot 3 places/ distal= 3 different vertebrae’s: close to L1, L2

o NT13 distal aspects of transverse vertebral processes L1

o NL1 distal aspects of transverse vertebral processes L2

o NL2 distal aspects of transverse vertebral processes L4

Question 4

Specific technique?

Answer 4

Specific technique

• Puncture the skin with 14-gauge needle and inject 3-5 ml lidocaine in a horizontal position to anesthetize the

skin

• Infuse 10-15 ml lidocaine above and below the lateral/transverse process in the same needle puncture.
• Repeat this at all 3 injection places.

Question 5

Advantages compared to proximal lumbar paravertebral block?

Answer 5

Advantages compared to proximal lumbar paravertebral block

• Preferred in private practice since it’s easier to locate the landmarks
• Longissimus dorsi not involved= scoliosis and locomotion problems unlikely

Question 6

Disadvantages compared with proximal anaesthetia?

Answer 6

Disadvantages compared with proximal anaesthesia

• 6 injections= expensive!
• Identification of landmarks harder in fatty animal