Department of Cranio-, Maxillofacial and Oral Surgery, Medical University of Vienna, Austria.
Dentomaxillofac Radiol. 2013;42(2):29945724. doi: 10.1259/dmfr/29945724. Epub 2012 Aug 29.
We examined the application of an ultrasound-guided combined intermediate and deep cervical plexus nerve block for regional anaesthesia in patients undergoing oral and maxillofacial surgery.
A total of 19 patients receiving ultrasound-guided combined intermediate and deep cervical plexus anaesthesia followed by neck surgery were examined prospectively. The sternocleidomastoid and the levator of the scapula muscles as well as the cervical transverse processes were used as easily depicted ultrasound landmarks for the injection of local anaesthetics. Under ultrasound guidance, a needle was advanced in the fascial band between the sternocleidomastoid and the levator of the scapula muscles and 15 ml of ropivacaine 0.75% was injected. Afterwards, the needle was advanced between the levator of the scapula and the hyperechoic contour of the cervical transverse processes and a further 15 ml of ropivacaine 0.75% was injected. The sensory block of the cervical nerve plexus, the analgesic efficacy of the block within 24 h after injection and potential block-related complications were assessed.
All patients showed a complete cervical plexus nerve block. No patient required analgesics within the first 24 h after anaesthesia. Two cases of blood aspiration were recorded. No further cervical plexus block-related complications were observed.
Ultrasound-guided combined intermediate and deep cervical plexus block is a feasible, effective and safe method for oral and maxillofacial surgical procedures.
我们研究了超声引导下颈丛神经中深丛联合阻滞在口腔颌面手术中的应用。
前瞻性检查了 19 例行超声引导下颈丛神经中深丛联合阻滞及颈部手术的患者。胸锁乳突肌和肩胛提肌以及颈椎横突作为局部麻醉注射的易于描绘的超声标志。在超声引导下，将针推进胸锁乳突肌和肩胛提肌之间的筋膜带，注射 15 毫升 0.75%罗哌卡因。然后，将针推进肩胛提肌和颈椎横突的高回声轮廓之间，再注射 15 毫升 0.75%罗哌卡因。评估颈丛神经的感觉阻滞、注射后 24 小时内的阻滞镇痛效果和潜在的与阻滞相关的并发症。
所有患者均表现出完全的颈丛神经阻滞。麻醉后 24 小时内无 1 例患者需要镇痛药。记录到 2 例血吸。未观察到其他与颈丛神经阻滞相关的并发症。
超声引导下颈丛神经中深丛联合阻滞是口腔颌面外科手术一种可行、有效且安全的方法。
