Naja M Z, Ziade M F, El Rajab M, El Tayara K, Lönnqvist P A
Department of Anaesthesia and Pain Medicine, Makassad General Hospital, Beirut, Lebanon.
Anaesthesia. 2004 May;59(5):459-63. doi: 10.1111/j.1365-2044.2004.03705.x.
The factors responsible for the spreading pattern of a single paravertebral injection are still uncertain. In this study, 28 patients were randomly assigned to receive a paravertebral injection of radio-opaque dye (10 ml, with or without co-administration of 20 ml of local anaesthetics) either dorsal or ventral to the endothoracic fascia. The point of injection was determined by use of a nerve-stimulator and the radiographic distribution pattern was assessed blindly by a radiologist. Injections made in the more ventral part of the thoracic paravertebral space, supposedly anterior to the endothoracic fascia, resulted in a multisegmental longitudinal spreading pattern, whereas injections made dorsal to the endothoracic fascia resulted in a less predictable cloud-like spreading pattern, with only limited distribution over adjacent segments. The use of a nerve stimulator-guided technique appears to enhance the likelihood of achieving the more desirable longitudinal spreading pattern.
导致单次椎旁注射扩散模式的因素仍不明确。在本研究中，28例患者被随机分配接受在胸内筋膜背侧或腹侧进行的不透射线染料椎旁注射（10毫升，加或不加20毫升局部麻醉剂）。注射点通过神经刺激器确定，放射科医生对放射学分布模式进行盲法评估。在胸段椎旁间隙更腹侧部位（推测在胸内筋膜前方）进行的注射导致多节段纵向扩散模式，而在胸内筋膜背侧进行的注射导致较不可预测的云雾状扩散模式，在相邻节段的分布有限。使用神经刺激器引导技术似乎增加了实现更理想的纵向扩散模式的可能性。
