文档介绍：超声引导穿刺技术
概论
How about the peripheral nerve block?
“Peripheral nerve block is an economical techniques that can be used not only for intraoperative anesthesia but also for perioperative analgesia without any major risks for the patients.”
术中麻醉/术后镇痛
Graf BM, Anaesthesist 2001 May;50(5):312
安全/经济
外周神经阻滞
解剖变异
The use of anatomic information from textbook that does not include this inform-ation may not only be inadequate, but also misleading.
Chris P. Tountas, MD & Ronald A. Bergman, Ph. D.
教科书往往仅提供
理想化解剖图像!
锁骨下动脉、臂丛的解剖变异
C5神经根位于前斜角肌内
C5神经根位于肌间沟外
ASM,前斜角肌 SCM,胸锁乳突肌
肌间沟水平臂丛
神经横断面变异情况
肥胖患者解剖标志不易识别
传统外周神经阻滞技术
No paresthesia,
no anesthesia !
无异感即无麻醉!
I’m your regional anesthesiologist and he’s my back-up man”
1978年,超声技术首次应用于区域阻滞麻醉,当时利用超声血流探测技术定位锁骨下动脉,间接完成了锁骨上臂丛神经阻滞,但对神经结构显示非常模糊。
1994年,第一次真正在超声引导下完成锁骨上臂丛神经阻滞。
la Grange P, Foster PA, Pretorius LK. Application of the Doppler ultrasound bloodflow detector in supraclavicular brachial plexus block. Br J Anaesth. 1978, 50: 965–957.
发展历史