北京哪里专业治疗白癜风的医院 http://yyk.39.net/bj/zhuanke/89ac7.html

Ultrasound-GuidedSupraclavicularBrachialPlexusNerveBlock

超声引导锁骨上臂丛神经阻滞

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作者

ThomasF.Bendtsen,AnaM.Lopez,andCatherineVandepitte

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FACTS事实

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Indications:Arm,elbow,forearm,handsurgery;anesthesiaforshouldersurgeryisalsopossible(Figure1).

Transducerposition:Transverseontheneck,superiortotheclavicleatthemidpoint(Figure1)

Goal:Localanestheticspreadaroundthebrachialplexus,posteriorandsuperficialtothesubclavianartery

Localanesthetic:20–25mL

适应症：手臂，肘部，前臂，手的手术；肩关节手术的麻醉同样可能（图1）

探头位置：横向置于颈部，锁骨中点上方（图1）

目标：局麻药在锁骨下动脉的后上方的臂丛周围扩散。

局部麻醉药：20–25mL

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FIGURE1.Expectedsensorydistributionofthesupraclavicularbrachialplexusnerveblock.

图1.锁骨上臂丛神经阻滞期望的感觉阻滞。

GENERALCONSIDERATIONS一般考虑

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Atthislocation,theproximityofthebrachialplexustothechestcavityandpleurahadbeenofconcern(Figure2)untilultrasound(US)guidancerenewedinterestinthesupraclavicularapproachtothebrachialplexusnerveblock.Theabilitytoimagetheplexus,rib,pleura,andsubclavianarterywithUShasincreasedsafetyduetoimprovedmonitoringofanatomyandneedleplacement.Becausethetrunksanddivisionsofthebrachialplexusarerelativelycloseastheypassoverthefirstrib,theextensionandqualityofanesthesiaarefavorable.Forthesereasons,thesupraclavicularnerveblockhasbe