勃起器脊柱平面阻塞后局部麻醉剂的传播:一个随机的,三维重建,成像研究
Tao Shan1, Xiaodan Zhang1, Zhenyu Zhao2
1Department of Anaesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
British journal of anaesthesia
|January 9, 2025
概括
在勃起器脊柱平面阻塞 (ESPB) 后患者的定位会影响局部麻醉的传播. 倾斜的定位显著增强了对脊椎间空间,肋间间空间和神经孔隙的传播,这表明重力.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉 区域麻醉
- 胸部解剖学 胸部解剖学
背景情况:
- 勃起脊柱平面阻塞 (ESPB) 是一种区域麻醉技术.
- 在ESPB之后,局部麻醉剂在准脊椎空间的传播可能是可变的.
- 患者的位置可能会影响局部麻醉剂传播的程度.
研究的目的:
- 评估患者定位 (仰卧,俯卧,横卧) 对ESPB后局部麻醉剂传播的影响.
- 为了确定特定的患者位置是否可以改善准脊椎的扩散和分布到相邻的解剖结构.
主要方法:
- 84名患者在T7接受了ESPB,其中包括30毫升0.375%的罗皮瓦卡因和放射性对比剂.
- 患者被随机分配到躺着,倾斜或横侧的位置30分钟后封锁.
- 计算机断层扫描被用来评估局部麻醉剂的传播.
- 二次结局包括扩散到神经,肋间间和外周腔,以及感官阻塞评估.
主要成果:
- 在96.5%,94.2%和77.9%的患者中,局部麻醉对比剂分别达到准脊椎,肋间间和神经孔隙空间.
- 倾斜的位置显著增强了对脊柱体空间 (5.0级别对比3.1躺卧,P<0.001) 和肋间空间 (4.3级别对比2.6横向,P<0.001) 的传播.
- 在20例病例中发生了外周扩散; 感官阻塞是可变的.
结论:
- 在ESPB后躺着的位置显著增强局部麻醉的传播.
- 重力似乎在促进麻醉剂在准脊椎,肋间间和神经孔隙空间内的分布中发挥着重要作用.
- 优化患者的位置可能会提高ESPB的有效性.
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