Department of Anesthesiology and Intensive Therapy, University Medical Center Ljubljana, Ljubljana, Slovenia.
Reg Anesth Pain Med. 2012 Mar-Apr;37(2):215-8. doi: 10.1097/AAP.0b013e31824451cb.
Anesthesia and analgesia with paravertebral block are reportedly variable. Existence of an endothoracic fascia has been proposed as one of the possible mechanisms leading to variability. We undertook an electron-microscopy imaging study to investigate the endothoracic fascia in the thoracic paravertebral space (TPS) in rats.
Male Wistar rats were studied in accordance with the principles of laboratory animal care. After the rats were euthanized in a CO2 chamber, the thoracic paravertebral tissues were removed en bloc and cut into consecutive transverse sections of approximately 3 mm. Stereomicroscopy and electron-microscopy assessments were performed by 2 independent observers.
The endothoracic fascia was consistently identified in all specimens. The fascia was located between the parietal pleura and the innermost intercostal muscles or ribs. Its thickness ranged from 15 to 27 μm (mean, 20 ± 3 μm). The endothoracic fascia divided the TPS in 2 compartments: one, extrapleural and anterolateral (EPC); another, subendothoracic and posteromedial (SETC). The spinal nerves with their ganglia were found within SETC, whereas the sympathetic ganglia were consistently located within the EPC.
The endothoracic fascia in rats appears to divide the TPS into EPC and SETC. These anatomic characteristics may have implications in thoracic paravertebral blockade.
据报道,椎旁阻滞的麻醉和镇痛效果存在差异。胸内筋膜的存在被认为是导致这种差异的可能机制之一。我们进行了一项电子显微镜成像研究,以调查大鼠胸段椎旁间隙(TPS)中的胸内筋膜。
根据实验室动物护理原则,对雄性 Wistar 大鼠进行研究。大鼠在 CO2 室中安乐死后,整块取出胸段椎旁组织,并切成约 3mm 的连续横切面。由 2 名独立观察者进行立体显微镜和电子显微镜评估。
所有标本中均一致识别出胸内筋膜。筋膜位于壁胸膜和最内层肋间肌或肋骨之间。其厚度范围为 15 至 27μm(平均值 20±3μm)。胸内筋膜将 TPS 分为两个隔室:一个是胸膜外和前外侧(EPC);另一个是胸内和后内侧(SETC)。带有神经节的脊神经位于 SETC 内,而交感神经节则始终位于 EPC 内。
大鼠的胸内筋膜似乎将 TPS 分为 EPC 和 SETC。这些解剖学特征可能对胸段椎旁阻滞有影响。