Lalloo James, Gupta Pawan
Department of Anaesthesia, Airedale NHS Foundation Trust, Steeton, West Yorkshire, UK.
Department of Anaesthesia, Leeds Teaching Hospitals Trust, Leeds, West Yorkshire, UK.
Local Reg Anesth. 2021 Nov 20;14:161-166. doi: 10.2147/LRA.S334618. eCollection 2021.
Studies demonstrate variations in the size and position of the nerves in the brachial plexus. The objective of this pilot study was to determine the effect of age, gender, BMI and side of body on the size and position of these nerves and to determine the feasibility of a further study.
Twenty healthy volunteers were recruited. The ultrasound position of the nerves was confirmed by a dynamic scan. The size of the nerves was calculated using the freehand calliper tool. A graph was designed to study the position of the nerves. ImageJ was used to analyse the position of the nerves. Student's t-tests were carried out to compare the gender and side of arm with the size of the nerve. Pearson's correlation coefficients were calculated to determine the correlation between BMI and age with the size of the nerves. The position of the nerves was compared between male and female, and left and right sides of the body.
The mean size of the median nerve, musculocutaneous nerve, radial nerve and ulnar nerve was 0.099, 0.032, 0.179 and 0.076 cm2 (males) and 0.091, 0.022, 0.128 and 0.026 cm2 (females), respectively. There were significant differences between the size of nerves and gender in the musculocutaneous, radial and ulnar nerves (P <0.05). The correlations between the sizes of the nerves with BMI and age were not significant. The position of the radial nerves was found to be variable within the same genders and between males and females. The position of the nerves was variable between the left and right hand side.
The position and size of brachial plexus branches in axilla is very variable. This pilot study highlights the need for further research with larger sample sizes to fully understand the extent and implication of this variability.
研究表明臂丛神经的大小和位置存在差异。本初步研究的目的是确定年龄、性别、体重指数（BMI）和身体侧别对这些神经大小和位置的影响，并确定进一步研究的可行性。
招募了20名健康志愿者。通过动态扫描确认神经的超声位置。使用徒手卡尺工具计算神经的大小。设计了一张图表来研究神经的位置。使用ImageJ分析神经的位置。进行学生t检验以比较性别和手臂侧别与神经大小的关系。计算皮尔逊相关系数以确定BMI和年龄与神经大小之间的相关性。比较了男性和女性以及身体左右两侧神经的位置。
正中神经、肌皮神经、桡神经和尺神经的平均大小在男性中分别为0.099、0.032、0.179和0.076平方厘米，在女性中分别为0.091、0.022、0.128和0.026平方厘米。肌皮神经、桡神经和尺神经的大小在性别之间存在显著差异（P<0.05）。神经大小与BMI和年龄之间的相关性不显著。发现桡神经在相同性别内以及男性和女性之间的位置存在差异。神经在左手和右手侧之间的位置也存在差异。
腋窝处臂丛神经分支的位置和大小变化很大。本初步研究强调需要进行更大样本量的进一步研究，以充分了解这种变异性的程度和影响。
