神经电刺激不能正确预测臂丛神经阻滞肌间沟路径针尖到神经距离及局麻药的扩散范围
本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见
Electric Nerve Stimulation Does Not Correctly Predict Needle-Nerve Distance and Potential Local Anesthetic Spread for Interscalene Brachial Plexus Blockade
背景与目的
神经电刺激为一种神经定位手段，本项研究对其进行了评估。
方 法
在接受肩关节手术的43例患者中引出运动反应后，使用超声成像评估距离神经最近的针尖位置及生理盐水的扩散范围。
结 果
在21例患者中，针尖位于距离神经最近处1至4毫米，在7例患者中存在直接接触，在15名患者中位于距离神经最近处6至18毫米。随后对盐水分布进行解剖分析发现21例患者中未达到臂丛。
结 论
因此，电刺激对正确的针-神经距离识别的成功率为48.8％，仅在51.2％的患者中观察到了正确的液体扩散范围。
原始文献摘要
Anesth Analg. 2017 Aug;125(2):632-634. doi: 10.1213/ANE.0000000000001982.Fielmuth S1, Szalata M, Sievert H, Beier D
This study evaluated electric nerve stimulation as a nerve location tool. After eliciting motor response in 43 patients undergoing shoulder surgery, the needle tip's position, distance from the closest nerve, and spread of saline were evaluated using ultrasound imaging. The needle's tip resided 1 to 4 mm from the closest nerve in 21, in direct contact with it in 7, and 6 to 18 mm away in 15 patients. In 21 patients, subsequent saline dissection did not reach the brachial plexus. Thus, the success rate of electric nervestimulation for correct needle-nerve distance identification was 48.8%, with correct fluid spread reached in only 51.2% of patients.
麻醉学文献进展分享