表面与深部侧肋间平面块:注射物传播的尸体评估
Rachel N Douglas1, Punnose Kattil2, Nirusha Lachman2
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
British journal of anaesthesia
|September 23, 2023
概括
深部巴斯特纳间肋间平面块为胸壁止痛提供了比表面块更大的扩散. 然而,由于内部乳腺动脉的接近,深层阻塞被认为是先进的,建议专注于表面阻塞优化.
科学领域:
- 麻醉学 麻醉学
- 人体解剖学 解剖学 解剖学
- 区域麻醉地区麻醉
背景情况:
- 横侧肋间平面块用于乳房和心脏手术中的前胸壁止痛.
- 评估深层和表面技术的传播和安全性对于临床应用至关重要.
研究的目的:
- 为了描述深层和表面的副侧侧侧间平面块的副侧侧扩散.
- 在深度阻塞期间评估针头接近内部乳腺动脉的位置.
- 为了比较两种技术之间的侧向注射扩散和直肠延伸.
主要方法:
- 在T3-4间隙中,在四个新鲜冷尸体中,进行了超声导向的深层和表面的副肋间平面块.
- 在距离胸骨2厘米的距离上施加了块,模仿临床程序.
主要成果:
- 与表面阻塞相比,深部副侧面阻塞显示了较大的副侧面注射物传播.
- 针与内部乳腺动脉的距离大约为3-5毫米.
- 侧面扩散到达了深层块的关节骨中间线,并通过表面块延伸到其他地方;都没有到达直肠外.
结论:
- 深部副侧侧侧肋间平面块每次注射覆盖更多的副侧侧侧间隙,而不是表面块.
- 靠近内部乳腺动脉的近距离表明深层阻塞被归类为先进的.
- 未来的研究应该专注于优化表面侧侧侧侧间肋间平面块的扩散.
相关概念视频
01:19Depolarizing Blockers: Pharmocokinetics
347
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
347
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
452
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
452