Michalek Pavel, Donaldson William, McAleavey Francis, Johnston Paul, Kiska Rostislav
Department of Anaesthetics, Antrim Area Hospital, 45 Bush Road, Antrim, BT41 2RL, UK.
Surg Radiol Anat. 2013 May;35(4):319-22. doi: 10.1007/s00276-012-1039-3. Epub 2012 Nov 6.
Infraorbital nerve block is used for intraoperative and postoperative analgesia in nasal and oral surgery procedures, as well as in the chronic pain settings. Ultrasound guidance has not been described in the literature. The aim of the study was to assess the quality of ultrasound imaging of the infraorbital foramen and develop an "in-plane" technique of the block using a skull model.
The infraorbital foramina were assessed on five skull models immersed in the water bath. Ultrasound-guided simulation of an in-plane infraorbital nerve block was then performed. Slightly curved needle was placed close to the foramina and its visibility was recorded. Success rate and time to locate infraorbital foramina, success rate and time to insert the needle close to the foramina under ultrasound and correlation between the ultrasound and caliper measurements were evaluated and recorded. Data for the left and right foramen were compared.
The infraorbital foramina were successfully located using ultrasound in all 20 cases. Simulation of infraorbital nerve block was also successful in all measurements. The time difference between locating or simulating blockade of the left and right infraorbital foramina was not statistically significant. Correlation between ultrasound measurement and direct measurement using a caliper was satisfactory for the distances between the inferior orbital rim and the inferior margin of the infraorbital foramen but poor for the distances between the lower rim of the orbit and the superior margin of the foramen.
This experimental study suggests that the infraorbital foramen is easily located using ultrasound and an "in-plane" ultrasound-guided technique for infraorbital nerve blockade is feasible on the model.
眶下神经阻滞用于鼻腔和口腔手术的术中及术后镇痛，以及慢性疼痛治疗。文献中尚未描述超声引导。本研究的目的是评估眶下孔的超声成像质量，并使用颅骨模型开发一种“平面内”阻滞技术。
在浸泡于水浴中的五个颅骨模型上评估眶下孔。然后进行超声引导下的平面内眶下神经阻滞模拟。将稍弯曲的针靠近孔放置，并记录其可视性。评估并记录定位眶下孔的成功率和时间、在超声引导下将针靠近孔插入的成功率和时间，以及超声测量与卡尺测量之间的相关性。比较左右孔的数据。
在所有20例中均成功使用超声定位眶下孔。眶下神经阻滞模拟在所有测量中也均成功。左右眶下孔定位或模拟阻滞之间的时间差异无统计学意义。对于眶下缘与眶下孔下缘之间的距离而言，超声测量与使用卡尺直接测量之间的相关性良好，但对于眶下缘与孔上缘之间的距离而言，相关性较差。
本实验研究表明，使用超声可轻松定位眶下孔，并且在模型上“平面内”超声引导下的眶下神经阻滞技术是可行的。
