Department of Anesthesiology, Shanxi Provincial People's Hospital, No. 29 Shuangtasi Street, Yingze District, Taiyuan, 030012, China.
J Orthop Surg Res. 2021 Jan 12;16(1):48. doi: 10.1186/s13018-020-02195-3.
This study aimed to explore the distribution of the erector spinal muscle plane block of the thoracic 12 vertebral body (T12) in the dorsal region guided by ultrasound.
A total of 28 patients, who underwent elective lumbar surgery, were enrolled in the present study. These patients were aged between 18 and 65 years, and the American Society of Anesthesiologists (ASA) grade was 1 or 2. The block of the T12 transverse process erector spinal muscle was performed under the guidance of ultrasound, and each side was injected with 25 ml of 0.4% ropivacaine hydrochloride + 2 mg of dexamethasone. The back areas were measured using the cold-warm method (the back area was divided into 11 areas [T7-S1] with the body surface marker). At 10, 20, 30, 40, 50, and 60 min after the drug injection, the effectiveness of the regional block was recorded. The presence of puncture hematoma, local anesthesia drug poisoning, nausea, vomiting, headache, and dizziness after the block was recorded.
The range of the T12 transverse process block was basically fixed at 30 min after the single injection. No pneumothorax, hematoma, or local anesthetic poisoning occurred in any of the patients.
The effective longitudinal plane of the T12 transverse process erector spinal muscle block was mainly distributed in the T9-L5 dorsal cutaneous branches, and the distribution of the block area was safe and stable.
本研究旨在探讨超声引导下胸椎 12 椎体(T12)竖脊肌平面阻滞在背部的分布。
本研究共纳入 28 例行择期腰椎手术的患者,年龄 18~65 岁,美国麻醉医师协会(ASA)分级为 1 级或 2 级。在超声引导下对 T12 横突竖脊肌进行阻滞,每侧注射 25ml0.4%罗哌卡因盐酸盐+2mg 地塞米松。使用冷温法(用体表标志物将背部区域分为 11 个区域[T7-S1])测量背部区域。在药物注射后 10、20、30、40、50 和 60min 记录区域阻滞的效果。记录阻滞后穿刺血肿、局部麻醉药物中毒、恶心、呕吐、头痛和头晕的发生情况。
单次注射后 30min 内,T12 横突阻滞的范围基本固定。所有患者均未发生气胸、血肿或局部麻醉中毒。
T12 横突竖脊肌平面阻滞的有效纵向平面主要分布在 T9-L5 背部皮支,阻滞区域的分布安全稳定。