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Nerve Blocks: What Do They Mean?
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PALMAR DIGITAL NERVE BLOCK
Sack (1975) examined the neural anatomy of the distal forelimb and found that innervation to the DIPJ is provided by branches of the palmar digital nerves, not the dorsal digital nerves as had previously been assumed. Lameness caused by endotoxin-induced synovitis of the DIPJ was found by Easter et al. (2000) to be alleviated by anaesthesia of the palmar digital nerves immediately proximal to the heel bulbs. Lameness induced using a modified shoe with bolts that pressed onto the toe region of the sole was alleviated by anaesthesia of the palmar digital nerves performed at the proximal margin of the ungular cartilages (Schumacher et al. 2000). Based on these findings, a palmar digital nerve block will provide analgesia to the entire foot minus the dorsal laminae and dorsal coronary band. It is recommended that needles be placed through the skin at the proximal margin of the ungular cartilages in a distal-to-proximal direction and that a small volume (1–2 ml) of local anaesthetic solution is used to minimise the likelihood of local anaesthetic diffusion affecting either the dorsal digital nerves or sensation associated with the proximal interphalangeal joint (Schumacher et al. 2004).
ABAXIAL SESAMOID NERVE BLOCK
Anaesthesia of the palmar digital nerves at the level of the proximal sesamoid bones, proximal to the branching of the dorsal digital nerves (abaxial sesamoid nerve block), will desensitise the entire foot and pastern as well as the most palmar aspect of the metacarpophalangeal joint (Wyn-Jones 1988; Barr 1997). By introducing the needle at the base of the proximal sesamoid bones, directing it distally and using a low volume of local anaesthetic solution (1–2 ml) to perform the block, it is hoped that effects on the metacarpophalangeal joint are minimised (Wyn-Jones 1988; Barr 1997). [...]
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