Department of Anatomy, Sefako Makgatho Health Sciences University, Pretoria, Gauteung, South Africa
Department of Anatomy, University of Pretoria, Pretoria, Gauteng, South Africa.
Reg Anesth Pain Med. 2020 May;45(5):386-388. doi: 10.1136/rapm-2019-100985. Epub 2020 Feb 10.
The aim of this article was to provide a detailed description of the neonatal anatomy related to the erector spinae plane block and to report the spread of the dye within the fascial planes and potential dermatomal coverage.
Using ultrasound guidance, the bony landmarks and anatomy of the erector spinae fascial plane space were identified. The erector spinae plane block was then replicated unilaterally in two fresh unembalmed neonatal cadavers. Using methylene blue dye, the block was performed at vertebral levels T5-using 0.5 mL in cadaver 1-and T8-using 0.2 mL in cadaver 2. The craniocaudal spread of dye was tracked within the space on the ultrasound screen and further confirmed on dissection.
Craniocaudal spread was noted from vertebral levels T3 to T6 when the dye was introduced at vertebral level T5 and from vertebral levels T7 to T11 when the dye was introduced at vertebral level T8. Furthermore, the methylene blue spread was found anteriorly in the paravertebral and epidural spaces, staining both the dorsal and ventral rami of the spinal nerves T2 to T12. Small amounts of dye were also found in the intercostal spaces.
In two neonatal fresh cadavers, the dye was found to spread to multiple levels and key anatomic locations.
本文旨在详细描述与竖脊肌平面阻滞相关的新生儿解剖结构，并报告染料在筋膜平面内的扩散情况和潜在的皮节覆盖范围。
使用超声引导，确定竖脊肌筋膜平面空间的骨性标志和解剖结构。然后，在 2 具未经防腐处理的新鲜新生儿尸体的单侧复制竖脊肌平面阻滞。在尸体 1 中，在 T5 椎体水平使用 0.5ml 亚甲蓝，在尸体 2 中在 T8 椎体水平使用 0.2ml 亚甲蓝进行阻滞。在超声屏幕上跟踪染料在空间内的头尾向扩散，并在解剖时进一步确认。
当在 T5 椎体水平引入染料时，染料从 T3 到 T6 椎体水平扩散，当在 T8 椎体水平引入染料时，染料从 T7 到 T11 椎体水平扩散。此外，亚甲蓝在前侧的椎旁和硬膜外间隙扩散，染色了 T2 至 T12 脊神经的背侧和腹侧支。少量染料也在肋间空间发现。
在 2 具新生儿新鲜尸体中，染料被发现扩散到多个水平和关键的解剖部位。
