PDF(Pubmed)
Abstract：
UNASSIGNED: The method of blocking the brachial plexus at the level of the upper trunk has been gaining popularity as a phrenic nerve-sparing alternative for interscalene block. We aimed to measure the distance of the phrenic nerve from the upper trunk and compare it with the distance between the phrenic nerve and the brachial plexus at the classic interscalene point by using ultrasound.
UNASSIGNED: In this study, after ethical approval and trial registration, 100 brachial plexus of 50 volunteers were scanned from the emergence of the ventral rami and its course was traced to the supraclavicular fossa. The distance of the phrenic nerve from the brachial plexus was measured at two levels: the interscalene groove along the cricoid cartilage (classic interscalene block point) and from the upper trunk. The presence of anatomical variations of the brachial plexus, the classic traffic light sign, vessels across the plexus, and the location of the cervical oesophagus were also noted.
UNASSIGNED: At the classic interscalene point, the C5 ventral ramus was observed to be just emerging or to have fully emerged from the transverse process. The phrenic nerve was identified in 86/100 (86%) of scans. The median (IQR) distance of the phrenic nerve from the C5 ventral ramus was 1.6 (1.1-3.9) mm and that of the phrenic nerve from the upper trunk was 17 (12-20.5) mm. Anatomical variations of the brachial plexus, the classic traffic light sign, and vessels across the plexus were seen in 27/100, 53/100, and 41/100 scans respectively. The oesophagus was consistently located on the left side of the trachea.
UNASSIGNED: There was a 10-fold increase in the distance of the phrenic nerve from the upper trunk when compared to that from the brachial plexus at the classic interscalene point.
UNASSIGNED: In this study, after ethical approval and trial registration, 100 brachial plexus of 50 volunteers were scanned from the emergence of the ventral rami and its course was traced to the supraclavicular fossa. The distance of the phrenic nerve from the brachial plexus was measured at two levels: the interscalene groove along the cricoid cartilage (classic interscalene block point) and from the upper trunk. The presence of anatomical variations of the brachial plexus, the classic traffic light sign, vessels across the plexus, and the location of the cervical oesophagus were also noted.
UNASSIGNED: At the classic interscalene point, the C5 ventral ramus was observed to be just emerging or to have fully emerged from the transverse process. The phrenic nerve was identified in 86/100 (86%) of scans. The median (IQR) distance of the phrenic nerve from the C5 ventral ramus was 1.6 (1.1-3.9) mm and that of the phrenic nerve from the upper trunk was 17 (12-20.5) mm. Anatomical variations of the brachial plexus, the classic traffic light sign, and vessels across the plexus were seen in 27/100, 53/100, and 41/100 scans respectively. The oesophagus was consistently located on the left side of the trachea.
UNASSIGNED: There was a 10-fold increase in the distance of the phrenic nerve from the upper trunk when compared to that from the brachial plexus at the classic interscalene point.
摘要：
■在上躯干水平阻断臂丛神经的方法已越来越受欢迎，作为用于肌间沟阻滞的保留膈神经的替代方法。我们旨在测量膈神经与上干的距离，并通过使用超声将其与经典的肌间点的膈神经和臂丛神经之间的距离进行比较。
■在这项研究中，经过伦理批准和试用登记，从腹侧rami的出现开始，扫描了50名志愿者的100个臂丛神经，并将其病程追溯到锁骨上窝。在两个水平上测量the神经与臂丛神经的距离：沿环状软骨的肌间沟（经典的肌间沟阻滞点）和上躯干。臂丛的解剖变异的存在，经典的交通灯标志，穿过神经丛的血管，并记录了宫颈食管的位置。
■在经典的间隔点，观察到C5腹侧支刚刚出现或完全从横突中出现。在86/100（86％）的扫描中确定了the神经。膈神经与C5腹支的中位距离（IQR）为1.6（1.1-3.9）mm，膈神经与上干的中位距离为17（12-20.5）mm。臂丛神经的解剖变异，经典的交通灯标志，和穿过神经丛的血管分别在27/100、53/100和41/100扫描中看到。食管始终位于气管的左侧。
■与经典肌间点的臂丛相比，膈神经与上干的距离增加了10倍。
■在这项研究中，经过伦理批准和试用登记，从腹侧rami的出现开始，扫描了50名志愿者的100个臂丛神经，并将其病程追溯到锁骨上窝。在两个水平上测量the神经与臂丛神经的距离：沿环状软骨的肌间沟（经典的肌间沟阻滞点）和上躯干。臂丛的解剖变异的存在，经典的交通灯标志，穿过神经丛的血管，并记录了宫颈食管的位置。
■在经典的间隔点，观察到C5腹侧支刚刚出现或完全从横突中出现。在86/100（86％）的扫描中确定了the神经。膈神经与C5腹支的中位距离（IQR）为1.6（1.1-3.9）mm，膈神经与上干的中位距离为17（12-20.5）mm。臂丛神经的解剖变异，经典的交通灯标志，和穿过神经丛的血管分别在27/100、53/100和41/100扫描中看到。食管始终位于气管的左侧。
■与经典肌间点的臂丛相比，膈神经与上干的距离增加了10倍。
