隆乳术肋间神经阻滞麻醉的临床解剖学

目的为乳房局部手术提供乳房神经的解剖学依据。方法对15具(30侧)成年女性标本胸部进行解剖，观测第2～6(T2～T6)肋间神经前支外侧皮支(LCAIN)及前皮支(ACAIN)分布情况。结果T2～T6穿出点至前正中线的距离逐渐增大，穿出点横径依次递减，穿出点至腋前线距离亦逐渐增大。T2～T6 ACAIN位置较为恒定，于前正中线2．5cm处，穿出点横径逐渐减小。且肋间神经前支呈节段性、重叠性分布于乳房区的皮肤及皮下组织。结论采用阻滞ACAIN和LCAIN，完全可以满足隆乳术及乳房缩小术等乳房局部手术的镇痛要求。

Clinical anatomy of breast augmentation in intercostal block anesthesia

Objective To provide the anatomic base of the breast n erves for the regional surgery. Methods A total of 15 ca daveric specimens (30 sides) were dissected to observe the distribution of T 2~ T 6 laterial cutaneous branch of the anterior branch of intercostal nerves (LCA IN) and anterior cutaneous branch of the anterior branch of intercostal nerves ( ACAIN).Results The distances from the site of LCAIN perfo rating to the anterior middle one were gradually increased from T 2 to T 6, wh ile the diameters of the nerves were decreased. The sites of T 2~T 6 ACAIN wer e consistedt and situated 2.5 cm on the anterior middle line, which gradually de creased in diameter at the perforation sites. The skin and cutaneous tissues of the breast were segmentally overlapped by anterior branches of intercostal nerve s.Conclusions The nerve to breast includes superclavicula r nerve, breast branches of ACAIN and LCAIN. It is possible to block ACAIN and L CAIN to obtain analgetic effect.