van Geffen G J, Rettig H C, Koornwinder T, Renes S, Gielen M J M
Department of Anaesthesiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Anaesthesia. 2007 Oct;62(10):1024-8. doi: 10.1111/j.1365-2044.2007.05192.x.
The application of ultrasonography in guiding and controlling the path of the stimulating needle to the brachial plexus via the posterior approach (Pippa technique) was studied. In 21 ASA physical status 1 and 2 patients, scheduled for surgery of the shoulder or upper arm, needle insertion was monitored by ultrasonography and the interaction between needle, surrounding structures and brachial plexus was followed. During injection, the spread of local anaesthetic was visualised and a prediction of block success was made. One failure was predicted. Complete block was achieved in 20 (95%) patients. One potential complication, puncture of the carotid artery, was prevented using ultrasound. Ultrasound is a useful tool in the training and performance of a neurostimulation-guided brachial plexus block by the posterior approach. Ultrasonographic guidance may prevent serious complications associated with this approach to the brachial plexus.
研究了超声检查在引导和控制刺激针经后路至臂丛神经的路径（皮帕技术）中的应用。在21例美国麻醉医师协会（ASA）身体状况为1级和2级、计划进行肩部或上臂手术的患者中，通过超声检查监测针刺入过程，并观察针、周围结构与臂丛神经之间的相互作用。在注射过程中，观察局部麻醉药的扩散情况，并预测阻滞是否成功。预测有1例失败。20例（95%）患者实现了完全阻滞。使用超声检查预防了1例潜在并发症，即颈动脉穿刺。超声是训练和实施神经刺激引导下经后路臂丛神经阻滞的有用工具。超声引导可预防与这种臂丛神经阻滞方法相关的严重并发症。
