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Purpose:
Ultrasound-guided nerve blocks are expanding in veterinary medicine. There is limited knowledge regarding the safety and accuracy of ultrasound-guided retrobulbar nerve blocks in horses. The aim of this study was to compare these parameters between the blind and ultrasound-guided injection technique for the dorsal retrobulbar nerve block in horses.
Methods:
Equine cadaver heads were used to inject the retrobulbar space with contrast medium (CM). Injections were performed either blindly based on anatomic landmarks as described by Gilger et al.9 (group 1; n = 44) or under ultrasonographic guidance as described by Morath et al.10 (group 2, n = 44), equally divided between an experienced and inexperienced operator. Needle position and distribution of CM were assessed with computed tomography imaging and evaluated by a board-certified radiologist blinded to the technique. Safety and accuracy of both techniques were compared.
Results:
Major complications were rarely observed. No intrathecal, intraneural, or intravascular injections were seen. Ocular penetration was observed in two cases (n = 2/44) of group 1 and in none of the cases of group 2 (n = 0/44). Safety was significantly improved in group 2 (p < 0.05). There was no statistically significant difference between the injection techniques regarding accuracy of the injection. The CM reached the orbital fissure more often with the ultrasound-guided technique (n = 12/22) than with the blind technique (n = 7/22) when performed by the inexperienced operator, but this difference what not statistically significant.
Conclusion:
To prevent globe-threatening complications and improve safety and accuracy of the injection, we recommend using the ultrasound-guided injection technique for the retrobulbar nerve block, especially for inexperienced operators.