Wilk Mateusz, Chowaniec Małgorzata, Jędrasiak Karol, Suwalska Aleksandra, Gałązka Mariusz, Wodarski Piotr
Collegium Medicum, WSB University, 41-300 Dabrowa Gornicza, Poland.
Department of Anesthesiology and Intensive Care, University Clinical Center, 40-055 Katowice, Poland.
J Clin Med. 2025 Jul 18;14(14):5112. doi: 10.3390/jcm14145112.
The accurate localization of interfascial planes is critical for effective regional anesthesia, yet current techniques relying on ultrasound guidance can be challenging, especially in obese or pediatric patients. Previous cadaveric and clinical studies have suggested that injection pressure varies depending on needle placement relative to fascial and neural structures. This pilot study aimed to evaluate whether the continuous monitoring of injection pressure can reliably differentiate interfascial spaces from surrounding anatomical structures in a porcine tissue model. A custom-built pressure monitoring system was used to continuously measure saline injection pressure during regional block procedures performed on porcine thighs. Injections were guided by ultrasound and conducted using an infusion pump. Needle positions were classified as intramuscular, resting on fascia, or interfascial. Statistical comparisons of pressure levels, variability, and temporal trends were conducted using Wilcoxon signed-rank tests and regression analysis. Mean intramuscular pressure was significantly higher than the mean interfascial pressure ( < 1 × 10). Interfascial injections demonstrated lower pressure variability ( = 2.1 × 10) and an increasing trend in pressure over time ( = 2.1 × 10), whereas intramuscular injections exhibited a decreasing pressure trend ( = 3.15 × 10). Continuous pressure monitoring effectively distinguishes interfascial from intramuscular and fascial penetration phases during regional anesthesia. The method demonstrates potential as a real-time, objective tool for enhancing needle guidance and improving the safety and accuracy of interfascial plane blocks. Further cadaveric and clinical studies are warranted to validate these findings.
筋膜间隙的准确定位对于有效的区域麻醉至关重要，但目前依赖超声引导的技术可能具有挑战性，尤其是在肥胖或儿科患者中。先前的尸体和临床研究表明，注射压力会因针相对于筋膜和神经结构的位置而异。这项初步研究旨在评估在猪组织模型中，连续监测注射压力是否能够可靠地区分筋膜间隙与周围解剖结构。使用定制的压力监测系统在对猪大腿进行区域阻滞操作期间连续测量盐水注射压力。注射由超声引导，并使用输液泵进行。针的位置分为肌肉内、位于筋膜上或筋膜间。使用Wilcoxon符号秩检验和回归分析对压力水平、变异性和时间趋势进行统计比较。平均肌肉内压力显著高于平均筋膜间压力（<1×10）。筋膜间注射显示出较低的压力变异性（=2.1×10）和压力随时间增加的趋势（=2.1×10），而肌肉内注射则呈现压力下降趋势（=3.15×10）。连续压力监测在区域麻醉期间有效地区分了筋膜间与肌肉内及筋膜穿透阶段。该方法显示出作为一种实时、客观工具的潜力，可增强针引导并提高筋膜间隙阻滞的安全性和准确性。需要进一步的尸体和临床研究来验证这些发现。
