Postel J, März P
Reg Anaesth. 1984 Jul;7(3):104-8.
A technique for sub-axillary blockade of the brachial plexus by means of a special catheter set is presented. A plastic self-retaining cannula is placed within the vasomotor nerve sheath, using the advantages of electric nerve stimulation. In our opinion the decisive advantages of this procedure lie in the fact that the user is not dependent on the cooperation of the patient and anatomical orientation takes place on the basis of clear and objective criteria through the muscle contractions induced in this way. If required, a catheter can be inserted into the vasomotor nerve sheath, without any additional expenditure of time, through the small-lumen puncture cannula by the Seldinger technique. If this procedure is carried out properly there is practically no danger of neural and vascular injuries. This method makes subsequent injections into the vasomotor nerve sheath through repeated puncture unnecessary. The catheter technique makes it possible to operate on the upper extremity using regional anaesthesia, whose effects can be prolonged beyond those of long-acting anaesthetics. The possibility of incomplete blockade resulting from individual variations in the amounts of local anaesthetics needed, is excluded and the anaesthetist can, if necessary, carry out pre- and post-operative pain therapy.
介绍了一种通过特殊导管装置进行臂丛神经腋路阻滞的技术。利用电神经刺激的优势，将一个塑料自固定套管置于血管运动神经鞘内。我们认为该操作的决定性优势在于使用者不依赖患者的配合，并且通过以这种方式诱发的肌肉收缩，能基于清晰且客观的标准进行解剖定位。如果需要，可通过Seldinger技术经小腔穿刺套管将导管插入血管运动神经鞘，无需额外花费时间。如果正确执行此操作，几乎不存在神经和血管损伤的风险。该方法无需通过重复穿刺对血管运动神经鞘进行后续注射。导管技术使得使用区域麻醉进行上肢手术成为可能，其效果可以延长至超过长效麻醉剂的效果。排除了因所需局部麻醉剂用量的个体差异导致阻滞不完全的可能性，并且麻醉师在必要时可以进行术前和术后疼痛治疗。
