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锁骨中段骨折中 clavipectoral 筋膜平面阻滞:尸体研究。

Clavipectoral fascia plane block in midshaft clavicle fractures: A cadaveric study.

机构信息

Human Anatomy and Embryology Unit, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.

Anesthesia, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.

出版信息

J Clin Anesth. 2024 Sep;96:111469. doi: 10.1016/j.jclinane.2024.111469. Epub 2024 Apr 27.

DOI:10.1016/j.jclinane.2024.111469
PMID:38678917
Abstract

STUDY OBJECTIVE

The objective of this anatomical study was to investigate the distribution of a solution administered using the Clavipectoral Fascia Plane Block (CPB) technique in a series of cadaveric models with midshaft clavicular fractures. The study aimed to address the knowledge gap regarding the impact of clavicular fractures on the distribution pattern of the CPB-administered solution.

DESIGN

Observational cadaveric study.

SETTING

The research was conducted in the laboratory setting of the University of Barcelona, adhering to the institution's ethical guidelines and standards.

PATIENTS

Five unembalmed human cadavers were used, generating ten clavicle samples.

INTERVENTIONS

A postmortem fracture was induced in the middle third of the clavicle using a blunt-edged hammer, simulating a midshaft clavicular fracture.

MEASUREMENTS

Anatomical dissection was performed in three layers: the superficial muscle plane, deep muscle plane, and clavicular periosteum plane. Dye staining with methylene blue was utilized to assess the distribution pattern.

MAIN RESULTS

In the superficial muscular plane, methylene blue was observed in the deltoid (100%), pectoralis major (100%), sternocleidomastoid (SCM) (70%), and trapezius muscles (100%). Conversely, the deep muscular plane, including the subclavius muscle, pectoralis minor, and Clavipectoral Fascia (CPF), exhibited no staining. At the clavicular periosteum plane, methylene blue distributed predominantly to the antero-superior region (57.3%), with a minimal impact on the postero-inferior area (6.5%).

CONCLUSIONS

The study reveals that the presence of a midshaft clavicular fracture does not significantly alter the diffusion pattern of the CPB-administered solution, maintaining a consistent distribution in both intact and fractured clavicle models.

摘要

研究目的

本解剖学研究的目的是调查在一系列锁骨中段骨折的尸体模型中,使用 Clavipectoral Fascia 平面阻滞(CPB)技术给予溶液的分布。该研究旨在解决锁骨骨折对 CPB 给药溶液分布模式影响的知识空白。

设计

观察性尸体研究。

设置

该研究在巴塞罗那大学的实验室环境中进行,遵循机构的伦理准则和标准。

患者

使用五个未经防腐处理的人体尸体,产生十个锁骨样本。

干预措施

使用钝边锤在锁骨中段引起死后骨折,模拟锁骨中段骨折。

测量

进行解剖学 dissection 分为三层:浅层肌肉平面、深层肌肉平面和锁骨骨膜平面。使用亚甲蓝染料染色来评估分布模式。

主要结果

在浅层肌肉平面中,肩袖(100%)、胸大肌(100%)、胸锁乳突肌(SCM)(70%)和斜方肌(100%)中观察到亚甲蓝。相反,包括锁骨下肌、胸小肌和 Clavipectoral Fascia(CPF)在内的深层肌肉平面没有染色。在锁骨骨膜平面,亚甲蓝主要分布在前上区域(57.3%),对后下区域的影响最小(6.5%)。

结论

研究表明,锁骨中段骨折的存在不会显著改变 CPB 给药溶液的扩散模式,在完整和骨折锁骨模型中保持一致的分布。

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引用本文的文献

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Fascial plane blocks as the main anesthetic method: A narrative review.以筋膜平面阻滞作为主要麻醉方法:一项叙述性综述。
Saudi J Anaesth. 2025 Apr-Jun;19(2):198-208. doi: 10.4103/sja.sja_844_24. Epub 2025 Mar 25.
2
Ultrasound-Guided Clavipectoral Fascial Plane Block Combined With Intermediate Cervical Plexus Block for Surgery on a Displaced Midshaft Clavicular Fracture in an Adolescent Athlete: A Case Report.超声引导下锁胸筋膜平面阻滞联合颈丛中间支阻滞用于青少年运动员移位型锁骨中段骨折手术:一例报告
Cureus. 2024 Jul 14;16(7):e64504. doi: 10.7759/cureus.64504. eCollection 2024 Jul.