CT 引导下斜角肌前、中肌注射：技术与并发症。
CT-guided injection of the anterior and middle scalene muscles: technique and complications.
机构信息
Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
出版信息
AJNR Am J Neuroradiol. 2011 Mar;32(3):495-500. doi: 10.3174/ajnr.A2319. Epub 2011 Jan 13.
BACKGROUND AND PURPOSE
Anterior scalene block is a helpful diagnostic test for NTOS and a good predictor of surgical outcome. The purpose of this study was to describe the technique, success rate, and complications associated with CT-guided anesthetic and botulinum toxin injection of the ASM/MSM in patients with NTOS symptoms.
MATERIALS AND METHODS
One hundred six participants (mean age, 41.5 ± 10 years; 80 women) were identified via a retrospective review of medical records for CT-guided scalene blocks. The procedure was evaluated regarding the technical success, defined as satisfactory detection of the ASM/MSM; intramuscular needle placement; intramuscular injection of contrast; appropriate delivery of medication; and frequency of unintended BP block or other complications. We also determined the outcome of patients who underwent surgery following the block.
RESULTS
Study participants underwent 146 scalene injections, 83 blocks, and 63 chemodenervations, which were included in this investigation. In all cases, detection of the ASM/MSM and intramuscular needle placement was satisfactory. Postprocedural complications included 5 (3.4%) temporary BP blocks, 1 patient with (0.7%) Horner sign, 7 (4.8%) needle-induced pain reports, 1 (0.7%) case of dysphagia, and 2 (1.4%) instances of muscle weakness. There were no major complications reported. The rate of good outcome following surgery was the same in patients with positive versus negative blocks, 30/43 (70%) versus 5/7 (71%), respectively.
CONCLUSIONS
CT guidance is a useful adjunct in performing accurate ASM/MSM blocks with a low rate of minor complications.
背景与目的
前斜角肌阻滞是诊断非创伤性颈部疼痛综合征（NTOS）的有用诊断性测试，也是手术结果的良好预测指标。本研究的目的是描述 CT 引导下麻醉和肉毒毒素注射前斜角肌肌筋膜触发点（ASM/MSM）在 NTOS 症状患者中的技术、成功率和相关并发症。
材料与方法
通过对 CT 引导下斜角肌阻滞的病历进行回顾性分析，确定了 106 名参与者（平均年龄 41.5±10 岁；80 名女性）。该程序的评估指标包括技术成功，定义为满意地检测到 ASM/MSM；肌内针的放置；肌内注射造影剂；药物的适当输送；以及意外血压阻滞或其他并发症的频率。我们还确定了接受阻滞治疗后接受手术的患者的结果。
结果
研究参与者共接受了 146 次斜角肌注射、83 次阻滞和 63 次化学神经阻滞，这些都包括在本研究中。在所有情况下，ASM/MSM 的检测和肌内针的放置都令人满意。术后并发症包括 5 例（3.4%）短暂性血压阻滞、1 例（0.7%）霍纳征、7 例（4.8%）针诱导疼痛报告、1 例（0.7%）吞咽困难和 2 例（1.4%）肌肉无力。无重大并发症报告。手术结果良好的患者中，阳性和阴性阻滞的比例分别为 30/43（70%）和 5/7（71%）。
结论
CT 引导是一种有用的辅助方法，可进行准确的 ASM/MSM 阻滞，且并发症发生率低。
Zotero 插件