Distribution of new methylene blue injected into the dorsolumbar epidural space in cows

Objective To describe the effect of injection volume and anatomy on the spread of new methylene blue (NMB) injected into the epidural space between the first and second lumbar vertebrae in cows. Study Design Prospective experimental study. Sample Population Thirteen nonpregnant cows. Methods Cows were randomly assigned to two groups. Group 1 received 5 mL and Group 2 received 10 mL of 0.12% NMB in 0.9% saline. The injection was made into the first interlumbar epidural space using a dorsal approach. The extent of cranial and caudal migration of the dye, as manifested by the staining of the epidural fat and dura mater, was measured. Results Mean ± SEM number (range) of stained vertebrae was significantly greater in the 10-mL group than in the 5-mL group, 4.4 ± 0.6 (T11 to L5) and 3.0 ± 0.2 (T12 to L3), respectively (p < 0.05). Linear regression analysis showed that the volume was significantly correlated with the number of stained vertebrae (R2 = 0.42, p = 0.016). In the dorsal and lateral aspect of the spinal cord, there were two types of distribution of NMB along the surface of the epidural fat: between the periosteum and epidural fat; and between the epidural fat and dura mater. Migration under the spinal cord occurred along the two longitudinal epidural veins. Conclusions and Clinical Relevance The larger the volume of solution injected into the first interlumbar epidural space, the greater the spread. Intrinsic anatomic factors, such as characteristics of epidural fat and veins, influence the epidural spread of injected solution and, consequently, epidural analgesia.