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前锯肌平面阻滞:一种新的超声引导的胸壁神经阻滞方法。

Serratus plane block: a novel ultrasound-guided thoracic wall nerve block.

机构信息

Anaesthetic Department, King's College Hospital, London, UK.

出版信息

Anaesthesia. 2013 Nov;68(11):1107-13. doi: 10.1111/anae.12344. Epub 2013 Aug 7.

Abstract

We present a novel ultrasound-guided regional anaesthetic technique that may achieve complete paraesthesia of the hemithorax. This technique may be a viable alternative to current regional anaesthetic techniques such as thoracic paravertebral and central neuraxial blockade, which can be technically more challenging and have a higher potential side-effect profile. We performed the serratus block at two different levels in the midaxillary line on four female volunteers. We recorded the degree of paraesthesia obtained and performed fat-suppression magnetic resonance imaging and three-dimensional reconstructions of the spread of local anaesthetic in the serratus plane. All volunteers reported an effective block that provided long-lasting paraesthesia (750-840 min). There were no side-effects noted in this initial descriptive study. While these are preliminary findings, and must be confirmed in a clinical trial, they highlight the potential for the serratus plane block to provide analgesia following surgery on the thoracic wall. We suggest that this novel approach appears to be safe, effective, and easy to perform, and is associated with a low risk of side-effects.

摘要

我们提出了一种新的超声引导区域麻醉技术,可能实现半胸廓的完全感觉阻滞。该技术可能是目前区域麻醉技术(如胸椎旁神经阻滞和中枢神经轴阻滞)的一种可行替代方法,这些技术在技术上可能更具挑战性,且潜在的副作用发生率更高。我们在四名女性志愿者的腋中线的两个不同水平进行了胸长神经阻滞。我们记录了获得的感觉阻滞程度,并进行了脂肪抑制磁共振成像和局部麻醉在胸长肌平面扩散的三维重建。所有志愿者均报告了有效的阻滞,可提供持久的感觉阻滞(750-840 分钟)。在这项初步描述性研究中未观察到副作用。虽然这些是初步发现,并且必须在临床试验中得到证实,但它们强调了胸长肌平面阻滞在胸壁手术后提供镇痛的潜力。我们认为这种新方法似乎安全、有效且易于实施,且副作用风险低。

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