PDF(Pubmed)
Abstract：
We investigated the distribution of injected dye after deep serratus anterior plane and superficial parasternal intercostal plane blocks in 15 Thiel embalmed cadavers. We injected 0.4 ml.kg-1 of 0.25% aqueous methylene blue solution into the deep serratus anterior and superficial parasternal intercostal planes using real-time ultrasound needle visualisation followed by posterior dissection to observe the distribution of the injected dye in the chest wall. The two blocks were performed bilaterally in 15 cadavers at the T5/T6 level, comprising 60 blocks in 30 hemithoraces in total. At dissection, the intercostal nerve territories were observed to be dyed completely from T2 to T6 in 28 of 30 hemithoraces, and extending caudal to T6 in 10 hemithoraces. Following the deep serratus anterior plane blocks in all cadavers, the dye was found to have spread to the axillae. Following the superficial parasternal intercostal plane blocks, the dye reached T7 in four cadaver dissections. We concluded that the territories innervated by the intercostal nerves (T2-T6 dermatomes) are dyed following the combination of the two blocks when performed at the T5-T6 intercostal space level. These techniques might provide an effective option for anaesthesia in breast surgery.
摘要：
我们调查了15具Thiel防腐尸体中深锯齿前平面和浅胸骨旁肋间平面阻滞后注射染料的分布。我们注射了0.4毫升。kg-1的0.25％亚甲蓝水溶液进入深锯肌前部和胸骨旁肋间平面，使用实时超声针可视化，然后进行后部解剖，以观察注射染料在胸壁中的分布。这两个区块在T5/T6级别的15具尸体中进行了双侧，总共30个半山脉中的60个街区。在解剖时，在30个半胸中的28个中，从T2到T6观察到肋间神经区域完全染色，并在10个半胸中延伸到T6。在所有尸体的深前锯肌平面块之后，发现染料已经扩散到腋窝。在浅层胸骨旁肋间平面阻滞后，在四个尸体解剖中染料达到T7。我们得出的结论是，当在T5-T6肋间空间水平上进行两种阻滞结合后，肋间神经支配的区域（T2-T6皮组）被染色。这些技术可能为乳房手术中的麻醉提供有效的选择。
