勃起器脊柱平面阻塞在中间和侧面横向过程中执行的临床有效性的差异:一个随机对照试验
Chen Chen1, Hongyan Dai2, Xiaoyang Jiang1
1Department of Anaesthesiology, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
概括
勃起器脊柱平面阻塞 (ESPB) 位于中间胸部横向过程顶部,提供了更广泛的感觉阻塞范围. 这种提高的疗效可能是由于肌肉间分隔膜会影响麻醉剂的传播.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 胸部外科手术 胸部外科手术
背景情况:
- 勃起器脊柱平面阻塞 (ESPB) 是一种超声波引导的区域麻醉技术.
- 最佳ESPB疗效的精确解剖基准仍在调查中.
- 形平面在指导局部麻醉剂传播中的作用是研究的一个关键领域.
研究的目的:
- 为了比较ESPB的临床疗效,当在第五胸部横向过程 (TP) 顶部的中间与横向方面进行给药时.
- 为了研究肌肉间分区膜 (IMPF) 对局部麻醉剂扩散模式的影响.
- 为了确定ESPB的解剖位置是否会影响感官阻塞的程度.
主要方法:
- 一项随机对照试验,涉及20名接受胸部手术的患者.
- 患者被分配在T5水平的中间 (M组,n=10) 或横向 (L组,n=10) TP顶部接受ESPB.
- 在注射后30分钟评估了感官阻塞区域.
主要成果:
- 与横向组相比,中间TP顶部组 (M组) 显示出明显更广泛的感官阻塞 (10/10对0/10,p <0.001).
- 此外,M集团在T11-T12地区的封锁率也较高 (7/10对1/10,p=0.020).
- 解剖学分析显示,IMPF在TP顶部分离中间和侧面麻醉扩散通路.
结论:
- 在中介TP顶部进行ESPB的治疗会导致更广泛的感官阻塞.
- 肌肉间隔膜似乎在指导麻醉剂的传播方面发挥着作用,可能提高ESPB的疗效.
- 针对TP顶部的中间方面,可以优化ESPB用于胸部手术.
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