Nowakowski Piotr, Bieryło Andrzej
Department of Anesthesiology and Intensive Care, Czerniakowski Hospital, Warsaw, Poland.
Anaesthesiol Intensive Ther. 2015;47(4):409-16. doi: 10.5603/AIT.2015.0052.
Axillary brachial plexus block is one of the most popular and widely used approaches for brachial plexus blocks. Its main advantages are its versatility and high safety. Brachial block facilitates analgesia for the distal arm, elbow, forearm and hand. Numerous upper limb procedures, particularly orthopedic ones, can be carried out under axillary block. Axillary block is well suited for the ultrasound-guided technique. Because the brachial plexus in the axillary region is located superficially, the nerves, block needle, and local anesthetic spread are all relatively easy to visualize. A high-frequency linear probe can be used during block procedure, so the quality and resolution of the ultrasound images are excellent. An important feature of the axillary approach is its high level of safety. In the axillary area, there are no anatomical structures other than vessels, to which damage during block placement could pose a risk for the patient. For this reason, axillary block is one of the techniques that are recommended for learning ultrasound-guided regional anesthesia. This paper summarizes anatomical fundamentals and provides basic sonoanatomic knowledge that is essential for successful ultrasound-guided axillary block.
腋路臂丛神经阻滞是臂丛神经阻滞最常用且应用广泛的方法之一。其主要优点是具有多功能性和高安全性。臂丛神经阻滞有利于为上臂远端、肘部、前臂和手部提供镇痛。许多上肢手术,尤其是骨科手术,可在腋路阻滞下进行。腋路阻滞非常适合超声引导技术。由于腋区的臂丛神经位置表浅,神经、阻滞针和局麻药的扩散都相对易于可视化。在阻滞过程中可使用高频线性探头,因此超声图像的质量和分辨率都非常出色。腋路法的一个重要特点是其安全性高。在腋区,除血管外没有其他解剖结构,在阻滞操作过程中对这些结构造成损伤不会给患者带来风险。因此,腋路阻滞是推荐用于学习超声引导区域麻醉的技术之一。本文总结了解剖学基础,并提供了成功进行超声引导腋路阻滞必不可少的基本超声解剖学知识。