Advances in ultrasound-guided thoracic nerve block in big animals
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摘要: 近年来, 大型动物区域麻醉的研究领域有了较快的发展, 并出现了多种胸部神经阻滞的新技术。这些技术在兽医临床实践中的常规实施, 使围手术期全身镇痛药物的用量大大减少, 为多模式麻醉镇痛策略提供了有价值的参考; 同时, 这些技术对大型动物模型的建立和人类医学科研领域的发展也做出了较大的贡献。本文对近年来已经发表的与大型动物胸部脊柱旁神经阻滞方法的相关文献进行整理, 并结合相关解剖学、神经刺激器定位方法以及精准超声辅助技术, 对犬胸椎旁阻滞、肋间神经阻滞以及竖脊肌平面阻滞进行综述, 为大型动物区域麻醉时提供适当的参考资料, 最终服务于科研事业的发展。Abstract: In recent years, the research of regional anesthesia in big animals has been greatly developed. A variety of new techniques of thoracic block have emerged. The routine implementation of technique in veterinary clinical practice provides a valuable reference for Multi-mode analgesic strategy. It reduces the consumption of systemic analgesics during perioperative period. At the same time, these technologies have also made great contributions to the establishment of big animal models and the development of human medical research. This paper combined the relevant anatomy, localization methods of nerve stimulators and accurate ultrasound-assisted technology to sort out the literatures published with big animals chest near the spinal nerve block methods in recent years. We reviewed thoracic paravertebral blocks, intercostal nerve blocks and erector spinae plane blocks, so as to provide appropriate reference materials for regional anesthesia in big animals and ultimately serve the development of scientific research.
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图 2 超声引导下的TPV阻滞[20]
A:定位犬和传感器位置; B:脱敏的解剖区域; C: TPV间隙和针轨迹的超声图像; D:图C的示意图; Cd:尾侧; Cr:颅侧; EI:肋间外肌; Ⅱ:肋间内肌; L:外侧; LC:肋提肌; M:内侧; TP:横突
Figure 2. Ultrasound-assisted TPV block
图 1 NS引导下的TPV阻滞的顺序[20]
A:针从背中线旁开1~2 cm处进针, 直到它接触到横突这一目标水平; B：将针抽出并调整它的角度; C:重新定位针的方向, 将针向头侧倾斜, 继续前进, 直到引起肋间肌肉抽搐
Figure 1. Sequence of NS-guided TPV block
图 3 超声引导下肋间神经阻滞[20]
A:定位犬和传感器位置; B:脱敏的解剖区域; C:肋间间隙的超声图像; D:图C的示意图; Cd:尾侧; Cr:头颅; L:外侧; M:内侧
Figure 3. Ultrasound-assisted Intercostal nerve block
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