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大鼠超声引导下星状神经节阻滞的建立。

Establishment of ultrasound-guided stellate ganglion block in rats.

作者信息

Lin Shi-Zhu, Chen Lu, Tang Yi-Jie, Zheng Cheng-Jie, Ke Peng, Chen Meng-Nan, Wu Hai-Xing, Chen Yu, Qiu Liang-Cheng, Wu Xiao-Dan, Zeng Kai

机构信息

Department of Anesthesiology, Anesthesiology Research Institute, The First Affiliated Hospital of Fujian Medical University, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.

Department of Anesthesiology, Fujian Provincial Hospital, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou, Fujian, China.

出版信息

Front Neurosci. 2023 Jan 12;16:1061767. doi: 10.3389/fnins.2022.1061767. eCollection 2022.

Abstract

BACKGROUND

A novel protocol for accurate stellate ganglion block under ultrasound guidance was designed in rats. This technique raises the success rate of stellate ganglion block and reduces the incidence of brachial plexus and vagus nerve block.

METHODS

Fifty-six Sprague-Dawley were randomly divided into an ultrasound-guided group ( = 28) and a blind technique group ( = 28). The rats in the blind technique group were injected with 1.5% lidocaine mixed with methylene blue after signs of brachial plexus stimulation were elicited. The lateral side of the cephalic brachial vein was located under the first rib, where lidocaine was injected into the rats in the ultrasound-guided group. The up-and-down sequential method of Dixon was used to determine the minimum effective volume for stellate ganglion block in rats. Furthermore, we calculated the required operative duration of the two methods and observed the difference in the lidocaine diffusion range between the two groups.

RESULTS

The minimum effective volume for stellate ganglion block in the ultrasound-guided group was 0.040 ml, and the 95% CI was 0.026-0.052 ml. In the blind technique group, the minimum effective volume was 0.639 ml, and the 95% CI was 0.490-0.733 ml. Within the 95% CI of the lowest effective volume, the incidence of brachial plexus block as a complication of stellate ganglion block under ultrasound guidance was 10.00%.

CONCLUSION

Stellate ganglion block under ultrasound guidance is more accurate than blind detection, which the incidence of complications of stellate ganglion block under ultrasound guidance was significantly lower than under blind detection; the rate of methylene blue staining in the vagus nerve was significantly lower under ultrasound guidance.

摘要

背景

设计了一种在大鼠中进行超声引导下准确星状神经节阻滞的新方案。该技术提高了星状神经节阻滞的成功率,并降低了臂丛神经和迷走神经阻滞的发生率。

方法

将56只Sprague-Dawley大鼠随机分为超声引导组(n = 28)和盲法组(n = 28)。在引出臂丛神经刺激体征后,向盲法组大鼠注射1.5%利多卡因与亚甲蓝的混合液。在超声引导组中,将头臂静脉外侧定位在第一肋下方,在此处向大鼠注射利多卡因。采用Dixon上下序贯法确定大鼠星状神经节阻滞的最小有效容量。此外,我们计算了两种方法所需的手术时间,并观察了两组之间利多卡因扩散范围的差异。

结果

超声引导组星状神经节阻滞的最小有效容量为0.040 ml,95%CI为0.026 - 0.052 ml。在盲法组中,最小有效容量为0.639 ml,95%CI为0.490 - 0.733 ml。在最低有效容量的95%CI范围内,超声引导下星状神经节阻滞作为并发症的臂丛神经阻滞发生率为10.00%。

结论

超声引导下星状神经节阻滞比盲目探测更准确,超声引导下星状神经节阻滞的并发症发生率显著低于盲目探测;超声引导下迷走神经亚甲蓝染色率显著降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e2d/9877532/d8d53eec090b/fnins-16-1061767-g001.jpg

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