Nitta K, Yamamoto K, Itoh H, Ohmura S, Kobayashi T
Department of Anesthesiology and Intensive Care Medicine, School of Medicine, Kanazawa University.
Masui. 1998 Feb;47(2):156-60.
Axillary brachial plexus blocks were established in 40 patients using transarterial technique (n = 20) or paresthesia technique (n = 20). Sensory and motor blockades of nerves supplying the upper extremity were compared at 10, 20 and 30 minutes after the injection of local anesthetics (1.5% plain mepivacaine 40 ml). Sensory blockades of the radial nerve and axillary nerve were significantly higher with transarterial technique than paresthesia technique. The incidence of analgesia of the radial nerve at 30 min was 100% with transarterial technique and 70% with paresthesia technique. Sensory blockades of the other nerves and motor blockades of all nerves did not show any significant differences between the two techniques. Proximal and distal spreads of the local anesthetic-contrast medium mixture within the axillary neurovascular sheath were studied in 20 patients. No statistically significant difference was observed in the spread of contrast agent between the two techniques. Transarterial technique is a recommendable method for hand surgery and especially indicated for the surgery of the area supplied by the radial nerve.
采用经动脉技术(n = 20)或异感技术(n = 20)对40例患者实施腋路臂丛神经阻滞。在注射局部麻醉药(1.5% 单纯甲哌卡因40 ml)后10、20和30分钟,比较上肢神经的感觉和运动阻滞情况。经动脉技术对桡神经和腋神经的感觉阻滞明显高于异感技术。30分钟时,经动脉技术桡神经镇痛发生率为100%,异感技术为70%。两种技术在其他神经的感觉阻滞和所有神经的运动阻滞方面均未显示出任何显著差异。在20例患者中研究了局部麻醉药 - 造影剂混合物在腋神经血管鞘内的近端和远端扩散情况。两种技术在造影剂扩散方面未观察到统计学显著差异。经动脉技术是手部手术的一种推荐方法,尤其适用于由桡神经供应区域的手术。