Philipps University, Department of Anaesthesiology and Intensive Care Therapy, University Hospital Giessen-Marburg, Campus Marburg, Baldingerstrasse, 35032 Marburg, Germany.
Anesth Analg. 2011 Aug;113(2):417-20. doi: 10.1213/ANE.0b013e31821b2227. Epub 2011 Apr 5.
In this study, we determined whether needle advancement during needle-nerve contact (forced needle-nerve contact) is associated with a higher risk of nerve injury compared with needle-nerve contact without needle advancement (nonforced needle-nerve contact).
In 8 anesthetized pigs, the brachial plexus nerves underwent forced (0.15 Newton) or nonforced (0.0 Newton) needle-nerve contact without nerve penetration. The grade of nerve injury was histologically assessed using an objective score ranging from 0 (no injury) to 4 (severe injury).
Sixty-nine nerves, including controls, were examined. Histology revealed a significant difference between forced and nonforced needle-nerve contact (median [interquartile range] 3 [2-4] vs 2 [1-2]; P = 0.004). Myelin damage and intraneural hematoma occurred only after forced needle-nerve contact.
The severity of structural nerve injury after needle-nerve contact was directly related to force exposure via needle advancement.
本研究旨在确定在针-神经接触时进针（强制针-神经接触）是否比不进针的针-神经接触（非强制针-神经接触）更易导致神经损伤。
在 8 只麻醉猪中，臂丛神经进行了强制（0.15 牛顿）或非强制（0.0 牛顿）的针-神经接触，但不穿透神经。使用 0（无损伤）至 4（严重损伤）的客观评分系统对神经损伤的程度进行组织学评估。
共检查了 69 根神经，包括对照组。组织学结果显示强制和非强制针-神经接触之间存在显著差异（中位数[四分位距] 3[2-4]与 2[1-2]；P=0.004）。只有在强制针-神经接触后才会出现髓鞘损伤和神经内血肿。
针-神经接触后结构神经损伤的严重程度与通过进针导致的力暴露直接相关。
