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Axillary Brachial Plexus Block英文文献资料
HindawiPublishingCorporation
AnesthesiologyResearchandPractice
Volume2011,ArticleID173796,5pages
doi:10.1155/2011/173796
ReviewArticle
AxillaryBrachialPlexusBlock
AshishR.SatapathyandDavidM.Coventry
DepartmentofAnaesthesia,NinewellsHospitalandMedicalSchool,DundeeDD19SY,UK
CorrespondenceshouldbeaddressedtoDavidM.Coventry,david.coventry@
Received23December2010;Accepted13March2011
AcademicEditor:SridharKollipara
Copyright?2011A.R.SatapathyandD.M.Coventry. Thisisanopenaccessarticledistributed undertheCreative Commons
AttributionLicense,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkis
properlycited.
Theaxillaryapproachtobrachialplexusblockadeprovidessatisfactoryanaesthesiaforelbow,forearm,andhandsurgeryandalso
providesreliablecutaneousanaesthesiaoftheinnerupperarmincludingthemedialcutaneousnerveofarmandintercostobrachial
nerve,areasoftenmissedwithotherapproaches.Inaddition,theaxillaryapproachremainsthesafestofthefourmainoptions,as
itdoesnotriskblockadeofthephrenicnerve,nordoesithavethepotentialtocausepneumothorax,makingitanidealoptionfor
daycasesurgery.Historically,single-injectiontechniqueshavenotprovidedreliableblockadeinthemusculocutaneousandradial
nerveterritories,butsuccessrateshavegreatlyimprovedwithmultiple-injectiontechniqueswhetherusingnervestimulationor
ultrasoundguidance.Complete,reliable,rapid,andsafeblockadeofthearmisnowachievable,andthepapersummarizesthe
currentpositionwithparticularreferencetoultrasoundguidance.
1.Introduction
of the arm, respectively. Anterior divisions of the upper
and middle trunk unite to form the lateral cord, anterior
divisionofthelowertrunkcontinuesasthemedialcord,and
posteriordivisionsofallthethreetrunksassembletofrom
theposteriorcord.Thethreecordsentertheaxillaattheapex
andarearranged,accordingtothenames,aroundthesecond
andthirdpartsoftheaxillaryartery.Inrelationtothe?rst
partoftheartery,however,thelateralandposteriorcordsare
lateral,andthemedialcordliesposteriortotheartery.
At
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