『麻醉科』超声引导肩胛上神经和腋神经阻滞( 四 )

  • 从近端到远端 , 臂丛和膈神经的距离越来越远 , HDP(半膈麻痹)的几率也会降低 。
  • 研究证实喙突旁锁骨下臂丛(20ml)+后路肩胛上神经阻滞(10ml) , 以及肋锁间隙臂丛神经阻滞(20ml) , 镇痛效果与肌间沟臂丛相当 , 且未出现HDP 。
  • 研究证实前路肩胛上神经阻滞(15ml) , 可以更好保留肺功能 , 前路肩胛上神经阻滞(10ml)可以更好保留握力 , 患者更满意 , 是否可以避免HDP需要证实 。

  • 原文链接:
    https://app.nysora.com/courses/shoulder-block/lessons/anatomy-21/
    推荐阅读
    腾讯视频:张宏业教授~《肩关节手术的神经阻滞》
    腾讯视频:超声引导肩胛上神经阻滞2
    Lee S M , Park S E , Nam Y S , et al. Analgesic effectiveness ofnerve block in shoulder arthroscopy: comparison between interscalene,suprascapular and axillary nerve blocks[J]. Knee Surgery SportsTraumatology Arthroscopy, 2012, 20(12):2573-2578.
    Feigl G, Aichner E, Mattersberger C, Zahn PK, Avila Gonzalez C, LitzR Ultrasound-guided anterior approach to the axillary andintercostobrachial nerves in the axillary fossa: an anatomicalinvestigation. Br J Anaesth 2018; 121: 883-9.
    Hun K S , Do C S , Chil L C , et al. Comparison of ArthroscopicallyGuided Suprascapular Nerve Block and Blinded Axillary Nerve Block vs.Blinded Suprascapular Nerve Block in Arthroscopic Rotator CuffRepair: A Randomized Controlled Trial[J]. Clinics in OrthopedicSurgery, 2017, 9(3):340-347.
    Blasco L, Pierre L, Tibbo M, et al. Ultrasound-Guided Proximal andDistal Suprascapular Nerve Blocks: A Comparative CadavericStudy[J].Pain Med 2019 Jul 24;
    Zhang H, Miao Y, Qu Z.Ultrasound-guided subomohyoid suprascapularnerve block and phrenic nerve involvement: a cadaveric dye study: apromising nerve block for shoulder surgery[J]. Reg Anesth Pain Med2019 Jun 07;
    【『麻醉科』超声引导肩胛上神经和腋神经阻滞】Neuts A, Stessel B, Wouters P F, et al. Selective Suprascapular andAxillary Nerve Block Versus Interscalene Plexus Block for PainControl After Arthroscopic Shoulder Surgery: A NoninferiorityRandomized Parallel-Controlled Clinical Trial[J]. Reg Anesth PainMed, 2018:1.