起器脊柱平面透和脊髓神经的前分支:一个尸体研究
Madeleine Luchsinger1, Victor Varela2,3, Sandeep Diwan4
1Human Anatomy and Embryology, Universitat de Barcelona, Barcelona, Spain.
Regional anesthesia and pain medicine
|July 1, 2024
概括
勃起器脊柱平面 (ESP) 阻塞主要影响脊髓神经的背脊分支,而不是腹部分支. 这项对尸体的研究发现ESP透在准脊椎肌肉中纵向扩散,没有到达腹腔分支.
科学领域:
- 麻醉学 麻醉学
- 人体解剖学 解剖学 解剖学
- 手术创新 在外科创新.
背景情况:
- 勃起器脊柱平面 (ESP) 块被广泛用于胸部,腹部和脊柱手术.
- 它的确切作用机制仍在争论中,最近的证据表明有限的腹腔分支参与.
研究的目的:
- 调查ESP块中的注射剂的分布.
- 为了确定ESP阻断是否接触细分脊髓神经的腹分支.
主要方法:
- 在T9级别的10具未经修复的尸体中进行了20次双边ESP透.
- 注射了20毫升0.2%的罗皮瓦卡因与0.01%的甲基蓝.
- 剖析以评估染料扩散到腹部和背部分支以及脊柱肌肉平面内.
主要成果:
- 在所有尸体的腹腔分支中没有观察到染料染色.
- 背部分支一直显示着染料染色.
- 通过准脊椎肌肉 (中位数为10个脊椎空间) 观察到染料的广泛纵向传播.
结论:
- 注射ESP阻断剂不能到达细分脊髓神经的腹分支.
- 基于这些发现,ESP阻断作为代理的副脊椎阻断的假设不太可能.
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