Martin R, Dupuis J Y, Tetrault J P
Department of Anesthesia, CHU, Sherbrooke, Fleurimont, Quebec, Canada.
Reg Anesth. 1989 Mar-Apr;14(2):81-4.
Four local or regional anesthesia techniques for the insertion of cardiac pacemaker were studied prospectively in 40 patients. The four techniques studied were: local anesthesia, field block of the supraclavicular nerves, interscalene block at C4, and interscalene block at C6. The three goals of the study were to find the technique that gave the best quality of analgesia, the incidence of complications related to each technique, and the area of sensory innervation of C4. No technique was found to be superior to the others with regard to the quality of analgesia. Interscalene blocks at C4 and C6 were associated with complications and side effects more often than the two other techniques. The authors also suggest that the dermatome of C4 is not under the clavicle but above the clavicle. It was concluded that local anesthesia infiltration at the site of cardiac pacemaker insertion or field block of the supraclavicular nerves are the best techniques for cardiac pacemaker insertion.
对40例患者前瞻性研究了用于植入心脏起搏器的四种局部或区域麻醉技术。所研究的四种技术分别为：局部麻醉、锁骨上神经区域阻滞、C4水平的斜角肌间阻滞和C6水平的斜角肌间阻滞。该研究的三个目的是找出镇痛质量最佳的技术、每种技术相关并发症的发生率以及C4的感觉神经支配区域。在镇痛质量方面，未发现哪种技术优于其他技术。C4和C6水平的斜角肌间阻滞比其他两种技术更常伴有并发症和副作用。作者还指出，C4的皮节不在锁骨下方而是在锁骨上方。得出的结论是，心脏起搏器植入部位的局部麻醉浸润或锁骨上神经区域阻滞是心脏起搏器植入的最佳技术。
