Fitzgibbon D R, Debs A D, Erjavec M K
Department of Anesthesiology, University of Washington School of Medicine, Seattle, USA.
Reg Anesth. 1995 May-Jun;20(3):239-41.
Regional anesthesia of the upper extremity may be achieved by the infraclavicular approach to the brachial plexus.
Advantages of this approach include profound anesthesia of the upper extremity with minimal risk of complications.
Isolated block of the musculocutaneous nerve may result by this approach if biceps muscle contractions are accepted as evidence of brachial plexus location by peripheral nerve stimulation.
Stimulation of the musculocutaneous nerve in the infraclavicular region results in biceps muscle contraction. Inadequate anesthesia of the upper extremity may result due to exiting of the musculocutaneous nerve outside the axillary sheath in this region. Evidence of more distal stimulation (finger/wrist flexion) improves the likelihood of successful block of the brachial plexus by the infraclavicular route.
上肢区域麻醉可通过锁骨下臂丛神经阻滞法实现。
该方法的优点包括上肢麻醉效果确切且并发症风险极小。
如果将肱二头肌收缩作为周围神经刺激法定位臂丛神经的证据，采用此方法可能导致肌皮神经单独阻滞。
在锁骨下区域刺激肌皮神经会引起肱二头肌收缩。由于该区域肌皮神经穿出腋鞘，可能导致上肢麻醉不充分。更远处刺激（手指/手腕屈曲）的证据可提高锁骨下途径成功阻滞臂丛神经的可能性。
