Wilson J L, Brown D L, Wong G Y, Ehman R L, Cahill D R
Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55906, USA.
Anesth Analg. 1998 Oct;87(4):870-3.
Infraclavicular brachial plexus block is a technique well suited to prolonged continuous catheter use. We used a coracoid approach to this block to create an easily understood technique. We reviewed the magnetic resonance images of the brachial plexus from 20 male and 20 female patients. Using scout films, the parasagittal section 2 cm medial to the coracoid process was identified. Along this oblique section, we located a point approximately 2 cm caudad to the coracoid process on the skin of the anterior chest wall. From this point, we determined simulated needle direction to contact the neurovascular bundle and measured depth. At the skin entry site, the direct posterior insertion of a needle will make contact with the cords of the brachial plexus where they surround the second part of the axillary artery in all images. The mean (range) distance (depth along the needle shaft) from the skin to the anterior wall of the axillary artery was 4.24 +/- 1.49 cm (2.25-7.75 cm) in men and 4.01 +/- 1.29 cm (2.25-6.5 cm) in women. Hopefully, this study will facilitate the use of this block.
We sought a consistent, palpable landmark for facilitation of the infraclavicular brachial plexus block. We used magnetic resonance images of the brachial plexus to determine the depth and needle orientation needed to contact the brachial plexus. Hopefully, this study will facilitate the use of this block.
锁骨下臂丛神经阻滞是一种非常适合长时间连续使用导管的技术。我们采用喙突入路进行该阻滞，以创建一种易于理解的技术。我们回顾了20例男性和20例女性患者臂丛神经的磁共振图像。利用定位片，确定喙突内侧2 cm的矢状旁切面。沿着这个斜切面，我们在前胸壁皮肤上找到一个位于喙突尾侧约2 cm处的点。从这个点出发，我们确定模拟针的方向以接触神经血管束并测量深度。在皮肤进针点，在所有图像中，针直接向后插入都会接触到臂丛神经束，它们围绕腋动脉第二段。男性从皮肤到腋动脉前壁的平均（范围）距离（沿针轴的深度）为4.24±1.49 cm（2.25 - 7.75 cm），女性为4.01±1.29 cm（2.25 - 6.5 cm）。希望这项研究将有助于该阻滞的应用。
我们寻找一个一致、可触及的标志以方便锁骨下臂丛神经阻滞。我们利用臂丛神经的磁共振图像来确定接触臂丛神经所需的深度和针的方向。希望这项研究将有助于该阻滞的应用。
