From the *Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI; †Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea; and ‡Clement Zablocki VA Medical Center, Milwaukee, WI.
Reg Anesth Pain Med. 2017 May/Jun;42(3):377-391. doi: 10.1097/AAP.0000000000000591.
The autonomic nervous system is composed of the sympathetic and parasympathetic nervous systems. The sympathetic nervous system is implicated in situations involving emergent action by the body and additionally plays a role in mediating pain states and pathologies in the body. Painful conditions thought to have a sympathetically mediated component may respond to blockade of the corresponding sympathetic fibers. The paravertebral sympathetic chain has been targeted for various painful conditions. Although initially injected using landmark-based techniques, fluoroscopy and more recently ultrasound imaging have allowed greater visualization and facilitated injections of these structures. In addition to treating painful conditions, sympathetic blockade has been used to improve perfusion, treat angina, and even suppress posttraumatic stress disorder symptoms. This review explores the anatomy, sonoanatomy, and evidence supporting these injections and focuses on ultrasound-guided/assisted technique for the performance of these blocks.
自主神经系统由交感神经系统和副交感神经系统组成。交感神经系统涉及身体的紧急行动，并在介导身体的疼痛状态和病理方面发挥作用。被认为具有交感神经介导成分的疼痛状况可能对相应的交感神经纤维阻断有反应。椎旁交感神经链已被用于各种疼痛状况。尽管最初是使用基于地标技术进行注射，但透视和最近的超声成像已经允许更好地可视化和促进这些结构的注射。除了治疗疼痛状况外，交感神经阻断还被用于改善灌注、治疗心绞痛，甚至抑制创伤后应激障碍症状。本文综述了这些注射的解剖、超声解剖和支持证据，并重点介绍了这些阻滞的超声引导/辅助技术。
