不同注射容量的股神经超支和股神经下支阻滞的染料扩散模式和神经累及的比较:尸体评估。

Comparison of Dye Spread Pattern and Nerve Involvement between Suprainguinal and Infrainguinal Fascia Iliaca Blocks with Different Injectate Volumes: A Cadaveric Evaluation.

机构信息

Department of Anatomy, College of Korean Medicine, Semyung University, Jecheon-si 27136, Republic of Korea.

Translational Research Unit for Anatomy and Analgesia, Seoul 03722, Republic of Korea.

出版信息

Medicina (Kaunas). 2024 Aug 25;60(9):1391. doi: 10.3390/medicina60091391.

Abstract

: Fascia iliaca compartment block (FICB) is an effective and relatively safe technique in perioperative pain management for hip surgery. However, blockade of the obturator nerve (ON) using this technique remains controversial. This study aimed to compare dye spread patterns and nerve involvement in the suprainguinal FICB (S-FICB) and infrainguinal FICB (I-FICB) approaches using different volumes of dye. : Following randomization, 6 S-FICBs and 6 I-FICBs were performed on the left or right sides of 6 unembalmed cadavers. For each block, 30 mL or 60 mL of dye solution was injected. The extent of dye spreading and the staining pattern in the lumbar plexus branches were investigated using anatomical dissection. : Twelve injections were successfully completed. The lateral femoral cutaneous nerve (LFCN) and femoral nerve (FN) were consistently stained in all injections. Extended dye spread toward lumbar plexus branches was observed volume-dependently in S-FICBs. However, I-FICBs with an increased volume only showed dye spreading in the caudad direction limited to within the fascia iliaca. When 30 mL of dye was used, the ON was not stained with either approach. A stained ON was only observed in S-FICBs when 60 mL of dye was used. : In this cadaveric evaluation, the ON was not stained in either FICB approach with the volume of injectate commonly used in clinical practice. The S-FICBs but not I-FICBs using a high volume of injectate resulted in extended spreading to the lumbar plexus branches.

摘要

: 股外侧筋膜间隙阻滞(FICB)在髋关节手术围手术期疼痛管理中是一种有效且相对安全的技术。然而,使用这种技术阻滞闭孔神经(ON)仍然存在争议。本研究旨在比较不同容量染料在股外侧筋膜间隙阻滞(S-FICB)和股内侧筋膜间隙阻滞(I-FICB)两种方法中的染料扩散模式和神经受累情况。 : 在随机分组后,在 6 具未经防腐处理的尸体的左侧或右侧进行了 6 次 S-FICB 和 6 次 I-FICB。对于每个阻滞,注射了 30 mL 或 60 mL 的染料溶液。使用解剖学方法研究了腰椎丛分支中染料的扩散范围和染色模式。 : 12 次注射均成功完成。所有注射均一致染色了股外侧皮神经(LFCN)和股神经(FN)。在 S-FICB 中,观察到染料向腰椎丛分支的扩展扩散与容量有关。然而,增加容量的 I-FICB 仅显示向尾侧方向的染料扩散,局限于股外侧筋膜内。当使用 30 mL 染料时,两种方法均未染色 ON。当使用 60 mL 染料时,仅在 S-FICB 中观察到染色的 ON。 : 在这项尸体评估中,在临床实践中常用的注射容量下,两种 FICB 方法均未染色 ON。使用高容量注射剂的 S-FICB 而非 I-FICB 导致向腰椎丛分支的扩展扩散。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6ce/11433574/11626bcde81f/medicina-60-01391-g001.jpg

相似文献

本文引用的文献

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索