Anatomical assessments of injectate spread stratified by the volume of the intertransverse process block at the T2 level.

Autor:	Kim JY; Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea., Lee UY; Department of Anatomy, Catholic University of Korea College of Medicine, Seoul, Korea., Kim DH; Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea., Han DW; Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea., Kim SH; Department of Anatomy, Catholic University of Korea College of Medicine, Seoul, Korea., Jeong Y; Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea., Cho SY; Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea., Han S; The Catholic University of Korea Uijeongbu St Mary's Hospital, Uijeongbu, Gyeonggi-do, Korea., Ryu JH; The Catholic University of Korea Uijeongbu St Mary's Hospital, Uijeongbu, Gyeonggi-do, Korea., Park HJ; Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea huejung@catholic.ac.kr.
Jazyk:	angličtina
Zdroj:	Regional anesthesia and pain medicine [Reg Anesth Pain Med] 2024 Dec 02; Vol. 49 (12), pp. 867-870. Date of Electronic Publication: 2024 Dec 02.
DOI:	10.1136/rapm-2023-104998
Abstrakt:	Background: This cadaveric study aimed to analyze injectate spread to target nerves during a single-injection, ultrasound-guided intertransverse process block. Methods: An ultrasound-guided intertransverse process block with three different injectate volumes was administered to 12 cadavers. Each hemithorax was subjected to computer-generated random allocation of 10, 15, or 20 mL ultrasound-guided, single-injection intertransverse process block at the T2 vertebral level. Latex dye solution was injected into each hemithorax in accordance with the allocated volume. The presence of dye at the nerve root in the sympathetic chain and intercostal nerves at various injection levels was examined via dissection. Results: Injectate spread into the dorsal rami was observed in seven of eight (87.5%), seven of eight (87.5%), and all eight (100%) of the 10, 15, and 20 mL specimens, respectively. In all 20 mL specimens, consistent staining of the dorsal rami, spinal nerve, and dorsal root ganglion was observed. Conclusions: An injectate volume of 20 mL was required for consistent staining of the dorsal rami, spinal nerve, and dorsal root ganglion in an intertransverse process block. Although an augmented injectate volume was associated with an increased likelihood of target nerve staining, consistent staining of the sympathetic ganglion, rami communicans, and ventral ramus was not observed, even at a volume of 20 mL. The current study presents initial findings suggesting that as opposed to a sympathetic ganglion block, a 20 mL intertransverse process block may act as a feasible substitute for dorsal root ganglion, spinal nerve, and medial branch blocks within a clinical context. Competing Interests: Competing interests: None declared. (© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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