Evenepoel M C, Blomme A
Acta Anaesthesiol Belg. 1981 Dec;32(4):317-22.
The concept of a closed peri-neurovascular space surrounding the cervicobrachial plexus, introduced by A. Winnie, allows the blockade of the cervical and brachial plexuses by means of a single puncture technique. The single puncture has positive advantages: 1. The rapidity of the blockade; 2. The simplicity of the blockade; 3. Comfort for the patient. The landmarks are easy to make. As with epidural blockade, the injection level and the volume of local anesthetic determine the quality and extent of the block. The traditional indication is surgery of the shoulder and of the supraclavicular area. A new indication seems to be the implantation of a cardiac pacemaker. Complications often quoted in literature are Horner syndrome-a minor complication-and blockade of the ascending branches of the recurrent laryngeal nerve and of the phrenic nerve. The risk of a pneumothorax is almost nil.
A. 温妮提出的围绕颈臂丛神经的封闭性神经血管周围间隙的概念，使得通过单一穿刺技术就能对颈丛和臂丛进行阻滞。单一穿刺具有以下积极优点：1. 阻滞迅速；2. 阻滞操作简单；3. 患者感觉舒适。体表标志易于确定。与硬膜外阻滞一样，注射部位和局麻药的用量决定了阻滞的质量和范围。传统适应证是肩部和锁骨上区域的手术。一项新的适应证似乎是心脏起搏器植入。文献中经常提到的并发症是霍纳综合征（一种轻微并发症）以及喉返神经和膈神经升支的阻滞。气胸的风险几乎为零。
