腋路臂丛神经阻滞的新进展

腋路臂丛神经阻滞是前臂和手部手术很常用的麻醉方法。传统的定位方法以人体的解剖标志、穿刺针触及神经时引发的异感来寻找神经,故成功率较低,且易损伤神经、血管引起并发症。近年来由于神经刺激器和超声引导技术在临床的应用,大大提高了神经阻滞的成功率,减少了并发症。周围神经刺激器(PNS)可辅助定位目标神经,高频超声可以清晰显示腋路臂丛神经的结构和周围相应的组织,两者联合应用可以更精确地定位目标神经,避免损伤血管和神经。本文从定位技术的发展,探讨腋路臂丛神经阻滞的新进展。

New progress of axillary brachial plexus block

The axillary brachial plexus block anesthetize method is commonly used in the forearm and hand surgery.The traditional positioning method located the nerve according to the anatomic landmark and paresthesia when nerve was stabbed,with low achievement ratio and common complications of neurovascular injury.In recent years,nerve stimulation and ultrasound-guided technique has been gradually used in clinic,with greatly increased achievement ratio and decreased complications.Peripheral nerve stimulator(PNS) can locate the target nerve.High-frequency ultrasound can show a clear image about axillary brachial plexus structure and surrounding corresp tissue.The association of the above two methods can accurately locate the target nerve and avoid the injury of nerve and blood vessel.This research explore the new progress of axillary brachial plexus block from the development of position technique.