Evaluation of High-Volume Injections Using a Modified Dorsal Quadratus Lumborum Block Approach in Canine Cadavers

The quadratus lumborum (QL) block targets the fascial plane surrounding the QL muscle providing abdominal somatic and visceral analgesia. The extension of its analgesic effects is a subject of research, as it could not cover areas of the cranial abdomen in dogs. This study assesses in eight thawed canine cadavers, the distribution of high-volume injections (0.6 mL kg−1 of a mixture of methylene blue and iopromide) injected between the psoas minor muscle and the vertebral body of L1. Anatomical features of the area of interest were studied in two cadavers. In another six dogs, QL blocks were performed bilaterally under ultrasound-guidance. The distribution of contrast was evaluated by computed tomography (CT). Hypaxial abdominal muscles were dissected to visualize the dye spread (spinal nerves and sympathetic trunk) in 5 cadavers. The remaining cadaver was refrozen and cross-sectioned. CT studies showed a maximum distribution of contrast from T10 to L7. The methylene blue stained T13 (10%), L1 (100%), L2 (100%), L3 (100%), L4 (60%) and the sympathetic trunk T10 (10%), T11 (20%), T12 (30%), T13 (70%), L1 (80%), L2 (80%), L3 (60%) and L4 (30%). These findings may suggest that despite the high volume of injectate administered, this modified QL block could not produce somatic analgesia of the cranial abdomen, although it could provide visceral analgesia in dogs.

Retroperitoneal tumor of the sympathetic trunk

Sympathogoniomas account for 4.9% of all cases of malignant tumors in children (MV Volkov and MM Brzhezovsky). According to K.A. Moskaleva, sympathogonia were established in 2 out of 36 children who underwent nephrectomy for tumors.

Method of Macromicroscopic Preparation for Determination of Fetal Anatomical Variability of the Thoracic Part of the Aorta

To obtain data about the formation of fetal macroscopic structure and topography of the thoracic part of the aorta, which can be used for age-related mapping, it is necessary to determine a standard sequence of steps during the preparation of these structures. The purpose of the study was to determine the method of the best rational sequence of actions during the preparation of areas of the posterior mediastinum in human fetuses to obtain standard results, useful for comparing in the age aspect. Materials and methods. The study was performed on 35 human fetuses of 4-10 months by macromicroscopic preparation of organs, vessels, and nerves of the posterior mediastinum. Results and discussion. In the study of fetal anatomical variability of branches and nerves of the thoracic aorta in the age aspect, the algorithm of anatomical preparation of the posterior mediastinum becomes a priority. However, in the literary sources available to us, we did not find information about the sequence of actions during the preparation of the posterior mediastinum, including the thoracic aorta in human fetuses. The innervation of the thoracic part of aorta on both sides mainly involves the branches of the II-VI thoracic nodes of the sympathetic trunk, the great visceral nerve, and the branch of the vagus nerve. Adherence to the following sequence of actions during the preparation of the posterior mediastinum, and in particular, the branches and nerves of the thoracic aorta, in human fetuses, provides not only the scientific value of the results but also the rational use of biological material. Conclusion. The proposed and tested method of dissection of nerves, visceral and parietal branches of the thoracic aorta in human fetuses provides a standard for obtaining data about their typical, individual, and age anatomical variability. The innervation of the thoracic aorta mainly involves the branches of the II-VI thoracic nodes of the sympathetic trunk, the great visceral nerve, and the branch of the vagus nerve. Nerve branches leading to the thoracic aorta from various sources enter its wall either together with blood vessels or in isolation. In human fetuses, between the right and left sympathetic trunks and the thoracic part of the aorta, in addition to the intermediate plexus or collateral trunk, a paraaortic plexus is found, the branches of which participate in the innervation of the thoracic aorta. Bilateral asymmetry of the structure and topography of the plexuses of the thoracic aorta was detected. The sequence of actions used during the preparation of the thoracic aorta in human fetuses preserves the natural appearance and relationships between the branches and nerves of the object of the study

Cervical Sympathetic Trunk-Centered Inflammatory Myofibroblastic Tumor Complicated with Postoperative First Bite Syndrome

Inflammatory myofibroblastic tumors (IMTs) in the head and neck region are common, but those with sympathetic trunk involvement are extremely rare. Here we present a case of cervical sympathetic trunk-centered IMT which is also accompanied by ipsilateral carotid artery, internal jugular vein, and vagus nerve involvement. The patient initially complained of an episodic painful swelling on the right side of the neck and underwent surgery. Preoperative and postoperative serum IgG4 level during 3-year follow-up time is within normal limits. Immunohistochemical study of the tumor has also revealed negativity to IgG4. Postoperative first bite syndrome (FBS) was observed. Surgery seems to be first-line therapy in the patient with IgG4-negative IMT.