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锁骨下阻滞时臂丛神经束受累情况的评估:未固定尸体研究

Evaluation of brachial plexus fascicles involvement on infraclavicular block: unfixed cadaver study.

作者信息

de Gusmão Luiz Carlos Buarque, Lima Jacqueline Silva Brito, Ramalho Jeane da Rosa Oiticica, Leite Amanda Lira dos Santos, da Silva Alberson Maylson Ramos

机构信息

Universidade Federal de Alagoas (UFAL), Maceió, AL, Brazil; Colégio Brasileiro de Cirurgiões, Maceió, AL, Brazil.

Universidade Federal de Alagoas (UFAL), Maceió, AL, Brazil.

出版信息

Braz J Anesthesiol. 2015 May-Jun;65(3):213-6. doi: 10.1016/j.bjane.2014.06.010. Epub 2015 Feb 17.

Abstract

BACKGROUND AND OBJECTIVES

This study shows how the diffusion of the anesthetic into the sheath occurs through the axillary infraclavicular space and hence proves the efficacy of the anesthetic block of the brachial plexus, and may thereby allow a consolidation of this pathway, with fewer complications, previously attached to the anesthesia.

MATERIALS AND METHODS

33 armpits of adult cadavers were analyzed and unfixed. We injected a solution of neoprene with latex dye in the infraclavicular space, based on the technique advocated by Gusmão et al., and put the corpses in refrigerators for three weeks. Subsequently, the specimens were thawed and dissected, exposing the axillary sheath along its entire length.

RESULTS AND DISCUSSION

Was demonstrated involvement of all fasciculus of the plexus in 51.46%. In partial involvement was 30.30%, 18.24% of cases the acrylic was located outside the auxiliary sheath involving no issue.

CONCLUSIONS

The results allow us to establish the infraclavicular as an effective and easy way to access plexus brachial, because the solution involved the fascicles in 81.76% partially or totally, when it was injected inside the axillary sheath. We believe that only the use of this pathway access in practice it may demonstrate the efficiency.

摘要

背景与目的

本研究展示了麻醉剂如何通过腋部锁骨下间隙扩散至鞘内,从而证明了臂丛神经麻醉阻滞的有效性,进而可能巩固这一途径,减少先前麻醉相关的并发症。

材料与方法

对33具成年尸体的腋窝进行分析且未固定。基于古斯芒等人倡导的技术,我们在锁骨下间隙注射了含有乳胶染料的氯丁橡胶溶液,并将尸体置于冰箱中三周。随后,将标本解冻并解剖,沿腋鞘全长暴露腋鞘。

结果与讨论

51.46%的病例显示神经丛所有束均受累。部分受累的占30.30%,18.24%的病例中丙烯酸位于腋鞘外,未累及任何组织。

结论

结果使我们能够确定锁骨下途径是一种有效且简便的进入臂丛神经的方法,因为当溶液注入腋鞘内时,81.76%的束部分或全部受累。我们认为只有在实际操作中使用这一途径才能证明其有效性。

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