Department of Anaesthesia and Intensive Care, Copenhagen University Hospital Hillerød, Hillerød, Denmark.
Acta Anaesthesiol Scand. 2012 Aug;56(7):926-30. doi: 10.1111/j.1399-6576.2012.02677.x. Epub 2012 Mar 8.
The specific blocking of the axillary nerve has never been investigated clinically. We present four cases illustrating potential applications of the axillary nerve block in the perioperative setting and discuss possible directions for future research in this area. The axillary nerve blocks were all performed using a newly developed in-plane ultrasound-guided technique. In one patient undergoing arthroscopic shoulder surgery, we used the axillary nerve block as the only analgesic combined with propofol sedation and spontaneous breathing. Chronic shoulder pain was eliminated after the axillary nerve block in two patients. The pain score after arthroscopic shoulder surgery in these two patients remained low until termination of the nerve block. In a fourth patient, severe post-operative pain after osteosynthesis of a displaced proximal humerus fracture was almost eliminated after performing an axillary nerve block. These findings warrant larger clinical trials that investigate the pain-mediating role of the axillary nerve in the perioperative setting.
腋神经的具体阻滞在临床上从未被研究过。我们介绍了 4 个案例，说明了腋神经阻滞在围手术期的潜在应用，并讨论了该领域未来研究的可能方向。腋神经阻滞均采用新开发的平面内超声引导技术进行。在 1 例接受关节镜肩关节手术的患者中，我们使用腋神经阻滞作为唯一的镇痛方法，联合异丙酚镇静和自主呼吸。2 例慢性肩部疼痛患者在腋神经阻滞后得到缓解。这 2 例患者在神经阻滞结束前，关节镜肩关节手术后的疼痛评分一直较低。在第 4 例患者中，移位的肱骨近端骨折内固定术后剧烈的术后疼痛在进行腋神经阻滞后几乎得到消除。这些发现需要更大的临床试验来研究腋神经在围手术期的疼痛调节作用。
