Kikuchi Masaru, Takaki Shunsuke, Nomura Takeshi, Goto Takahisa
Masui. 2016 Mar;65(3):314-7.
Pectoral nerve block (PECS block) is first reported by Blanco et al, and mainly used for analgesia for breast surgery in Japan. However, the spread of PECS block is unclear.
Ultrasound guided PECS I and II blocks were performed in a cadaver, and the cadaver was dissected for evaluation of the spread of coloring matter.
The coloring matter by PECS I block was spread to the axillary region between the major and minor pectoral muscles, while PECS II block remained over the fascia of the serratus muscle from mid-clavicular line to middle axillary line. Two possible routes to the axillary region by PECS I include: dorsal to the pectoral minor muscle through the clavipectoral fascia, and over the pectoral minor muscle to the axillary sheath.
Our cadaveric evaluation suggests that PECS I block produces more analgesia of the axillary region than PECS II. Further evaluation is needed in more cadavers.
胸神经阻滞(PECS阻滞)最早由布兰科等人报道,在日本主要用于乳腺手术的镇痛。然而,PECS阻滞的扩散情况尚不清楚。
在一具尸体上进行超声引导下的PECS I和II阻滞,然后解剖尸体以评估色素的扩散情况。
PECS I阻滞的色素扩散到胸大肌和胸小肌之间的腋窝区域,而PECS II阻滞的色素则保留在锁骨中线至腋中线的锯肌筋膜上。PECS I到达腋窝区域的两条可能途径包括:通过锁胸筋膜在胸小肌后方,以及越过胸小肌到达腋鞘。
我们的尸体评估表明,PECS I阻滞比PECS II能产生更多的腋窝区域镇痛效果。需要在更多尸体上进行进一步评估。