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表面和深层副侧侧间肋间平面块:染料扩散的解剖学证据
Alessandro De Cassai1, Andrea Porzionato2, Alessandra Maggiolo3
1Department of Medicine (DIMED), University of Padova, Padova, Italy; Anaesthesia and Intensive Care Unit, University Hospital of Padova, Padova, Italy.
Journal of cardiothoracic and vascular anesthesia
|December 17, 2025
概括
深侧侧侧肋间平面 (DPIP) 块比表面侧侧侧肋间平面 (SPIP) 块提供更大的尾注射分布. 这种增强的传播可能会提高临床疗效,但由于靠近重要结构,需要仔细考虑安全性.
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胸部止痛.
- 了解注射传播和解剖关系对于优化疗效和安全至关重要.
研究的目的:
- 为了比较表面 (SPIP) 和深层 (DPIP) 两侧侧间平面块之间的尾注射分布.
- 评估影响这些块安全性的解剖学因素.
主要方法:
- 解剖学尸体研究涉及五个新鲜冷的人类尸体 (10个半胸骨).
- 超声导向的SPIP和DPIP块在双边进行,在第三个肋间层进行.
- 注射了20毫升稀释的黑色染料,并通过粗剖和组织学评估了传播.
主要成果:
- 与SPIP块 (中间2个肋间空间;p <0.001) 相比,DPIP块显示了明显更广泛的尾分布 (中位数为4个肋间空间).
- 组织学分析显示,内胸动脉位于第四条肋骨中部1.9毫米处,仅由软组织分开.
结论:
- 与SPIP块相比,DPIP块提供了更大的注射物的尾分布,这可能会提高临床有效性.
- 由于DPIP阻塞与内胸动脉和胸膜紧密相连,因此需要严格的程序安全措施.
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