在上喉神经阻塞期间,在不同局部麻醉体积的扩散范围的比较
Yin Bao1, Huijun Wang1, Lifeng Li2
1Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, No.1 DongjiaoMinxiang, Dongcheng District, Beijing, 100730, China.
对于超声导向的上喉神经 (SLN) 阻塞,2-3毫升局部麻醉剂是最佳的,以平衡疼痛缓解和副作用. 较大的剂量可能会因溢出目标区域而导致并发症.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 超声波引导的程序 超声波引导的程序
背景情况:
- 超声导向的上喉神经 (SLN) 阻塞提供了一种实用的,无痛的方法,可以在输入管和喉外科手术后管理血液动力学反应.
- 确定最佳局部麻醉剂量对于平衡有效止痛与最小化潜在副作用至关重要.
研究的目的:
- 为了确定超声波引导SLN阻断的最佳局部麻醉剂量.
- 引导麻醉师在减轻不良事件的同时实现有效的止痛.
主要方法:
- 使用新鲜的喉标本 (n=20) 注射不同的利多卡因-蓝色染料体积 (2-5毫升) 来评估染料的传播,泄漏和周围组织的颜色.
- 对40名患者进行了超声波检查,以测量SLN内部分支 (iSLN) 和相邻的解剖结构之间的距离.
主要成果:
- 局部麻醉剂量增加 (4-5毫升) 导致染料扩散更大,特别是在内脏空间,以及更广泛的软骨染色.
- 发现2-3毫升的注射体积足以透SLN间隙,在较大的体积下观察到更高的泄漏率.
- 对iSLN相邻结构长度的样本和超声波测量之间没有发现显著差异.
结论:
- 对于中国人来说,2-3毫升局部麻醉剂是SLN阻断的安全有效剂量.
- 超过这个体积可能会导致溢出和潜在的并发症.
- 甲状腺膜和上喉动脉是超声导向麻醉中iSLN识别的可靠地标.
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