尸体模型上肌间沟臂丛染色后的扩散范围观察

To observe the spread of interscalene brachial plexus after staining in cadaver model

目的在尸体模型中观察肌间沟神经阻滞后染料的扩散范围,为临床应用超声评估局麻药扩散方式及观察局麻药体积的动态变化提供理论依据。方法选取2例经过防腐处理的尸体,仰卧位行超声引导下双侧肌间沟臂丛神经阻滞染色,2h后对尸体进行逐层解剖,暴露出染料的着色区域,记录并描述其扩散范围。结果解剖颈外侧区及颈根部后观察到染料上端扩散至斜角肌间隙三角顶端,下端扩散至锁骨上臂丛段,向前扩散至前斜角肌后缘及锁骨下动脉第一段内侧缘,向后扩散至后斜角肌后缘,向后扩散到后斜角肌背侧面和第4~6颈椎椎体前缘。结论肌间沟臂丛神经染色后染料主要沿前中斜角肌筋膜及其间隙和臂丛神经干向两端并向后呈立体式扩散,形状类似三角锥体。

Obective To observe the diffusion range after interscalene nerve block in cadaver model,in order to provide a theoretical basis for clinical application of ultrasound to evaluate the diffusion mode of local anesthetics and observe the dynamic change of local anesthetics volume.Methods Two cases of embalmed cadavers were selected for supine ultrasound guided staining of brachial plexus in bilateral intermuscular sulcus.After 2 hours,the cadavers were dissected layer by layer to reveal the staining area of dye,and the diffusion area was recorded and described.Results The anatomy of the lateral neck area and the upper cervical roots was observed after dye spread scalene triangle tip clearance,the bottom spread supraclavicular brachial plexus and spread forward scalene trailing edge and subclavian artery before the first period of the medial edge,backward diffusion to scalene muscle after trailing edge,backward scalene muscle after spread to the back side and 4~6 cervical vertebral devices for rim.Conclusion After dyeing the intermuscular groove brachial plexus,the dye mainly spreads along the anterior middle scalene fascia and its interstitial and brachial plexus extend to both ends and backwards,and its shape resembles a triangular pyramid.