Hord A H, Wang J M, Pai U T, Raj P P
Department of Anesthesiology, University of Cincinnati, Ohio.
Reg Anesth. 1991 Jan-Feb;16(1):13-6.
In a study designed to determine the spread of anesthetic solutions in the intercostal space, the spread of india ink was studied in fresh cadavers. They were turned prone and had epidural catheters placed at ribs 4, 6, 8 and 10, 7-8 cm lateral to the midline, by two different techniques. Group 1 had epidural catheters directed laterally into the subcostal groove. Group 2 had catheters directed medially into the intercostal space. A window was dissected in the anterior chest wall to visualize the location of the catheters and the spread of india ink. Catheters in Group 1 were observed to be lateral to the medial border of the intercostalis intimus muscle and injection of india ink resulted in spread entirely within a single intercostal space. Catheters in Group 2 were observed to be 2-3 cm medial to the border of the intercostalis intimus muscle and injection of ink resulted in concentric spread over 3-5 intercostal spaces. Posteroanterior and lateral radiographs taken with contrast material in live patients confirmed these patterns of spread. The catheters in Groups 1 and 2 were within the same tissue plane. The results indicate that the pattern of spread obtained by injection of fluid in the intercostal space is dependent upon the site of injection in relation to the angle of the rib.
在一项旨在确定麻醉溶液在肋间间隙扩散情况的研究中，研究人员在新鲜尸体上研究了印度墨水的扩散。将尸体俯卧放置，并通过两种不同技术在距中线外侧7 - 8厘米处的第4、6、8和10肋骨处放置硬膜外导管。第1组将硬膜外导管横向插入肋下沟。第2组将导管向内侧插入肋间间隙。在前胸壁切开一个窗口，以观察导管位置和印度墨水的扩散情况。观察到第1组的导管位于肋间内肌内侧缘外侧，注入印度墨水后，墨水完全在单个肋间间隙内扩散。观察到第2组的导管位于肋间内肌边界内侧2 - 3厘米处，注入墨水后，墨水呈同心圆状在3 - 5个肋间间隙扩散。对活体患者注入造影剂后拍摄的正位和侧位X线片证实了这些扩散模式。第1组和第2组的导管位于同一组织平面。结果表明，在肋间间隙注入液体所获得的扩散模式取决于注射部位与肋骨角度的关系。
