躯干神经阻滞ppt课件

,躯干神经阻滞在胸腹手术中的应用,肖颖,胸壁手术镇痛方式的比较,Riskpotential,胸壁神经支配,Intercostalnervesensorydistribution,Neuralinnervationofchestwall,硬膜外阻滞,胸椎旁阻滞,前锯肌平面阻滞（肋间神经侧皮支）,肋间神经阻滞,胸骨旁肋间神经阻滞(肋间神经前皮支),ThoracicParavertebralBlock,ThoracicParavertebralBlock,ThoracicParavertebralBlock,Thoracicwallblock:PECS1+PECS2+PECS3,Neuralinnervationofanteriorchestwallandbreast,SupraclavicularnerveC3-C4,Neuralinnervationofanteriorchestwallandbreast,LateralpectoralnerveC5-C7,MedialpectoralnerveC8-T1,Neuralinnervationofanteriorchestwallandbreast,LongthoracicnerveC5-C7,Neuralinnervationofanteriorchestwallandbreast,ThoracodorsalnerveC6-C8,Neuralinnervationofanteriorchestwallandbreast,LateralintercostalcutaneoousnerveT2-T6,AnteriorintercostalcutaneoousnerveT2-T6,Neuralinnervationofanteriorchestwallandbreast,Thoracicwallblock:PECS1+PECS2+PECS3,Indication:postoperativeAnalgesiaPECS1:BreastexpanderorsubpectoralprosthesesPECS2:+PECS1:Tumorresection,Mastectomy+axillarylymphnodeclearancePECS3+PECS1:Mastectomy+axillarylymphnodeclearance+reconstruction,BlancoR,Anaesthesia.2011Sep;66(9):847-8BlancoRetal,RevEspAnestesiolReanim.2012Nov;59(9):470-5BlancoRetal,Anaesthesia2013,68,11071113,Thoracicwallblock:PECS1+PECS2+PECS3,PECS1:interfascialplanebetweenpectoralismajorandminorN.pectoralesmedialis+lateralis(M.pectoralismajor),BlancoR,Anaesthesia.2011Sep;66(9):847-8BlancoRetal,RevEspAnestesiolReanim.2012Nov;59(9):470-5BlancoRetal,Anaesthesia2013,68,11071113,.,19,GeorgThiemeVerlag,PECS1,.,20,PECS1,.,21,PECS1:Injection,.,22,AstderA.thoracoacromialis,Thoraxwallblock:PECS1+PECS2+PECS3,PECS1N.pectoralesmedialis+lateralis(M.pectoralismajor)PECS2LateralcutaneousbranchofthoracicintercostalneervenerveT2-T6+N.thoracicuslongus(M.serratusanterior),BlancoR,Anaesthesia.2011Sep;66(9):847-8BlancoRetal,RevEspAnestesiolReanim.2012Nov;59(9):470-5BlancoRetal,Anaesthesia2013,68,11071113,.,24,GeorgThiemeVerlag,M.serratusanterior,.,25,N.spinalis,Putz/Pabst:Sobotta.AtlasderAnatomiedesMenschen,21.Aufl.Urban66(9):847-8BlancoRetal,RevEspAnestesiolReanim.2012Nov;59(9):470-5BlancoRetal,Anaesthesia2013,68,11071113,GeorgThiemeVerlag,.,33,GeorgThiemeVerlag,.,34,PECS3,.,35,.,36,PECS3:sensoryBlockade,BlancoRetal,Anaesthesia2013,68,11071113,.,38,腹壁手术术后镇痛方式的比较,Riskpotential,.,40,QudratusLumborumBlock,N.spinalis,Putz/Pabst:Sobotta.AtlasderAnatomiedesMenschen,21.Aufl.Urban32(Suppl1):130,.,46,HebbardPD,JCanAnesth(2009)56:618620,M.erectorspinae,M.psoas,M.Quadratuslumborum,RectussheathB.,TAPB.,QuadratuslumborumB.,.,47,Ultrasound-GuidedTransmuscularQuadratusLumborumBlockade,.,48,QuadratuslumborumBlockade,TransmuscularQuadratuslumborumBlockade,M.psoas,M.Quadratuslumborum,TransversusAbdominisplaneblockade,.,49,.,50,ventral,posterior,anterior,dorsal,Wirbelkrper,M.psoas,Processtransversus,M.erectorspine,M.Quadratuslumborum,.,51,TansversusAbdominsPlaneBlockade,.,52,Ultrasound-GuidedTransversusAbdominsPlan