Yoshida Takayuki, Nakamoto Tatsuo
Department of Anesthesiology, Kansai Medical University Medical Center, 10-15 Fumizono-Cho, Moriguchi City, Osaka, 570-8507, Japan.
JA Clin Rep. 2023 Aug 4;9(1):49. doi: 10.1186/s40981-023-00641-9.
The intercostobrachial nerve blockade is required, in addition to brachial plexus block, to anesthetize the entire upper arm. No studies have described the use of erector spinae plane (ESP) block for an intercostobrachial nerve block.
A 72-year-old man was scheduled to undergo left brachial vein transposition-arteriovenous fistula creation for hemodialysis access. An ultrasound-guided infraclavicular brachial plexus block was performed using a mixture of 0.5% levobupivacaine (12.5 ml) and 2% lidocaine (12.5 ml). An ESP block was implemented using 10 ml of the same local anesthetic at the T2 level. A pinprick test showed that the entire upper arm and lateral aspect of the left upper chest wall were anesthetized 20 min after the blocks. Surgery was successfully performed without the need for general anesthesia.
In the present case, an ESP block performed at the T2 level provided sensory loss of the area innervated by the intercostobrachial nerve.
除臂丛神经阻滞外，还需要进行肋间臂神经阻滞才能麻醉整个上臂。尚无研究描述竖脊肌平面（ESP）阻滞用于肋间臂神经阻滞的情况。
一名72岁男性计划接受左肱静脉转位-动静脉内瘘造术以建立血液透析通路。使用0.5%左旋布比卡因（12.5毫升）和2%利多卡因（12.5毫升）的混合液进行超声引导下锁骨下臂丛神经阻滞。在T2水平使用10毫升相同的局部麻醉药进行ESP阻滞。针刺试验显示，阻滞20分钟后，整个上臂和左上胸壁外侧均被麻醉。手术成功进行，无需全身麻醉。
在本病例中，在T2水平进行的ESP阻滞导致了肋间臂神经支配区域的感觉丧失。
