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颈部周围神经阻滞:从解剖到超声引导技术。

Peripheral nerve blocks in the cervical region: from anatomy to ultrasound-guided techniques.

机构信息

Second Department of Anesthesiology, National and Kapodistrian University of Athens, Medical School, Athens, Greece.

First Department of Orthopaedics, National and Kapodistrian University of Athens, University Medical School, Athens, Greece.

出版信息

Dentomaxillofac Radiol. 2020 Dec 1;49(8):20190400. doi: 10.1259/dmfr.20190400. Epub 2020 Mar 16.

Abstract

Cervical plexus nerve blocks have been employed in various head and neck operations. Both adequate anaesthesia and analgesia are attained in clinical practice. Nowadays, ultrasound imaging in regional anaesthesia is driven towards a certain objective that dictates high accuracy and safety during the implementation of peripheral nerve blocks. In the cervical region, ultrasound-guided nerve blocks have routinely been conducted only for the past few years and thus only a small number of publications pervade the current literature. Moreover, the sonoanatomy of the neck, the foundation stone of interventional techniques, is very challenging; multiple muscles and fascial layers compose a complex of compartments in a narrow anatomic region, in which local anaesthetics are injected. Therefore, this review intends to deliver new insights into ultrasound-guided peripheral nerve block techniques in the neck. The sonoanatomy of the cervical region, in addition to the cervical plexus, cervical ganglia, superior and recurrent laryngeal nerve blocks are comprehensively discussed.

摘要

颈丛神经阻滞已应用于各种头颈部手术中。在临床实践中,可达到充分的麻醉和镇痛效果。目前,超声影像在区域麻醉中的应用旨在实现一定的目标,即在实施外周神经阻滞时保证高度的准确性和安全性。在颈部,超声引导下的神经阻滞仅在过去几年中常规进行,因此当前文献中只有少数出版物涉及该领域。此外,颈部的超声解剖学,即介入技术的基石,极具挑战性;多个肌肉和筋膜层构成了一个在狭窄解剖区域中包含多个腔室的复杂结构,局部麻醉剂就在这些腔室中注入。因此,本文旨在对颈部超声引导下的外周神经阻滞技术提供新的见解。本文全面讨论了颈部的超声解剖学,包括颈丛、颈神经节、喉上神经和喉返神经阻滞。

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