Maruyama M
Department of Orthopaedic Surgery, Chushin Matsumoto National Hospital, Japan.
Reg Anesth. 1997 Mar-Apr;22(2):157-60. doi: 10.1016/s1098-7339(06)80035-0.
Needle trauma may cause peripheral nerve injuries during performance of peripheral nerve block.
Four types of 21-gauge needles for regional anesthesia were compared: a beveled nerve block needle (Quincke type); a short-tapered needle with a side orifice (Whitacre type); a long-tapered needle with a side orifice (Sprotte type); and a long-tapered double needle combining an inner pencil-point fine needle with an outer truncated conical needle (a new type). This new needle was developed to reduce the potential for nerve injury while retaining a suitable flow rate of anesthetic solution and the ability to inject the solution precisely at the point of paresthesia elicited by the tip. Each type of needle was used to produce puncture injuries to rabbit sciatic nerves. Eighteen specimens were studied within each needle group. The beveled needle was used to produce two different types of nerve injuries by inserting it either transverse or longitudinal to the nerve fibers. Each histologic specimen of the nerve with the needle puncture was surface-stained with hematoxylin-eosin and Bodian's method. Subsequently, the number of damaged axons was histomorphologically counted and statistically evaluated.
Both long-tapered needles produced significantly fewer transected axons than the beveled needle inserted with the bevel longitudinal to the nerve fibers.
The long-tapered needles produced the least number of transected nerve fibers after sciatic nerve puncture.
在进行外周神经阻滞时，穿刺针创伤可能导致外周神经损伤。
比较了四种用于区域麻醉的21号穿刺针：斜面神经阻滞针（Quincke型）；带有侧孔的短斜面针（Whitacre型）；带有侧孔的长斜面针（Sprotte型）；以及一种新型的长斜面双针，其内部为铅笔尖细针，外部为截锥形针。开发这种新型针是为了在保持合适的麻醉药溶液流速以及能够在针尖引出异感的点精确注射溶液的同时，降低神经损伤的可能性。每种类型的针都用于对兔坐骨神经造成穿刺损伤。每个针组研究18个标本。斜面针通过与神经纤维横向或纵向插入来造成两种不同类型的神经损伤。对每个带有针刺的神经组织学标本进行苏木精-伊红和博迪安氏法表面染色。随后，对受损轴突的数量进行组织形态学计数并进行统计学评估。
两种长斜面针造成的横断轴突数量均显著少于斜面与神经纤维纵向插入的斜面针。
坐骨神经穿刺后，长斜面针造成的横断神经纤维数量最少。
