Neuburger M, Hendrich E, Lang D, Dinse A, Wagner F, Freund W, Brinkmann A, Büttner J
Abteilung für Anästhesie, BG Unfallklinik, Prof.-Küntscher-Strasse 8, 82418 Murnau, Germany.
Anaesthesist. 2005 Sep;54(9):877-83. doi: 10.1007/s00101-005-0871-9.
In the present study we examined 41 volunteers using magnetic resonance imaging to obtain biometric data of the thigh used for a planned blockade of the sciatic nerve via the lateral approach. At a needle entry point 12 cm proximal to the gap of the knee joint at the posterior border of the M. vastus lateralis, the sciatic nerve lies on average at a depth of 5.2 cm (39% of the femoral diameter at this site) with an angle of 10.9 degrees to the horizontal in a dorsal direction. Here the popliteal artery lies on average at a depth of 6.4 cm (48% of the femoral diameter) with an angle of 4.7 degrees to the horizontal in a ventral direction. At the marked point in the middle between the gap of the knee joint and the trochanter major at the posterior border of the M. vastus lateralis, the sciatic nerve is at an average depth of 6.2 cm (40% of the femoral diameter at this site) with an angle of 8.2 degrees in a dorsal direction. At a marked point 5 cm distal of the trochanter major at the posterior border of the M. vastus lateralis, the sciatic nerve is at a depth of 9.1 cm at a dorsal angle of 15.5 degrees (49% of the femoral diameter). The lateral blockade of the sciatic nerve at different sites of the thigh is a technique which is easy to plan with the presented biometric data. The popliteal artery could be reached only at the distal puncture point using a deep puncture and an angle in the ventral direction.
在本研究中,我们使用磁共振成像检查了41名志愿者,以获取大腿的生物测量数据,用于计划通过外侧入路对坐骨神经进行阻滞。在股外侧肌后缘膝关节间隙近端12 cm处的进针点,坐骨神经平均深度为5.2 cm(该部位股骨直径的39%),与水平方向呈10.9度背侧夹角。此处腘动脉平均深度为6.4 cm(股骨直径的48%),与水平方向呈4.7度腹侧夹角。在股外侧肌后缘膝关节间隙与大转子中间的标记点,坐骨神经平均深度为6.2 cm(该部位股骨直径的40%),背侧夹角为8.2度。在股外侧肌后缘大转子远端5 cm处的标记点,坐骨神经深度为9.1 cm,背侧夹角为15.5度(股骨直径的49%)。利用所提供的生物测量数据,很容易规划在大腿不同部位对坐骨神经进行外侧阻滞。只有在远端穿刺点采用深穿刺并向腹侧倾斜角度时,才能触及腘动脉。