title: Evaluation of electric neurostimulation to confirm correct placement of lumbosacral epidural injections in dogs.
abstract: OBJECTIVE
  To determine the minimal electric threshold (MET) of neurostimulation in and out of the lumbosacral epidural space necessary to cause muscle contraction of the hind limb or tail, determine an MET cutoff value that indicates epidural needle placement, and compare predictability of epidural needle placement attained by use of neurostimulation versus the standard technique that uses loss of resistance in dogs.
  
  
  METHODS
  96 healthy Beagles.
  
  
  METHODS
  Dogs received nonionic contrast medium (90 mg/kg) either in or out of the epidural space. Correct placement of the needle was evaluated by use of neurostimulation and loss of resistance of injection and confirmed by use of epidurography.
  
  
  RESULTS
  With the neurostimulator test, MET was significantly lower in dogs with needle placement in the epidural space (mean +/- SEM, 0.30 +/- 0.07 mA) than those with needle placement out of the epidural space (1.2 +/- 0.13 mA). When an electric current cutoff of < or = 0.28 mA for the neurostimulator test was used to suggest correct needle placement in the lumbosacral epidural space, sensitivity and specificity were 74% and 93%, respectively. The loss of resistance test had sensitivity of 63% and specificity of 90%. The combination of both tests yielded a sensitivity of 89% and specificity of 83%.
  
  
  CONCLUSIONS
  Neurostimulation is a useful tool to suggest correct lumbosacral epidural needle placement in dogs.
authors.affiliation: Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA. fgarcia@cvm.msu.edu
authors.forename: Fernando L
authors.initials: FL
authors.lastname: Garcia-Pereira
authors.forename: Joe
authors.initials: J
authors.lastname: Hauptman
authors.forename: Andre C
authors.initials: AC
authors.lastname: Shih
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Laird
authors.forename: Anthony
authors.initials: A
authors.lastname: Pease
mesh_terms: D015360:Analgesia, Epidural / Q000295:instrumentation; D000818:Animals; D002404:Catheterization / Q000295:instrumentation; D003287:Contrast Media / Q000008:administration & dosage / Q000494:pharmacology; D004285:Dogs; D004558:Electric Stimulation; D005260:Female; D007268:Injections, Epidural / Q000662:veterinary*; D007472:Iohexol / Q000008:administration & dosage / Q000494:pharmacology; D008161:Lumbosacral Region; D008297:Male; D009119:Muscle Contraction; D018482:Muscle, Skeletal
chemical_list: D003287:Contrast Media; D007472:Iohexol