躯干神经阻滞课件

躯干神经阻滞,1,躯干神经阻滞在胸腹手术中的应用,肖颖,躯干神经阻滞,2,胸壁手术镇痛方式的比较,Riskpotential,躯干神经阻滞,3,胸壁神经支配,躯干神经阻滞,4,Intercostalnervesensorydistribution,躯干神经阻滞,5,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),躯干神经阻滞,6,躯干神经阻滞,7,ThoracicParavertebralBlock,躯干神经阻滞,8,ThoracicParavertebralBlock,躯干神经阻滞,9,ThoracicParavertebralBlock,躯干神经阻滞,10,Thoracicwallblock:PECS1+PECS2+PECS3,躯干神经阻滞,11,Neuralinnervationofanteriorchestwallandbreast,SupraclavicularnerveC3-C4,躯干神经阻滞,12,Neuralinnervationofanteriorchestwallandbreast,LateralpectoralnerveC5-C7,MedialpectoralnerveC8-T1,躯干神经阻滞,13,Neuralinnervationofanteriorchestwallandbreast,LongthoracicnerveC5-C7,躯干神经阻滞,14,Neuralinnervationofanteriorchestwallandbreast,ThoracodorsalnerveC6-C8,躯干神经阻滞,15,Neuralinnervationofanteriorchestwallandbreast,LateralintercostalcutaneoousnerveT2-T6,AnteriorintercostalcutaneoousnerveT2-T6,躯干神经阻滞,16,Neuralinnervationofanteriorchestwallandbreast,躯干神经阻滞,17,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,躯干神经阻滞,18,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,躯干神经阻滞,19,GeorgThiemeVerlag,PECS1,躯干神经阻滞,20,PECS1,躯干神经阻滞,21,PECS1:Injection,躯干神经阻滞,22,AstderA.thoracoacromialis,躯干神经阻滞,23,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,躯干神经阻滞,24,GeorgThiemeVerlag,M.serratusanterior,躯干神经阻滞,25,N.spinalis,Putz/Pabst:Sobotta.AtlasderAnatomiedesMenschen,21.Aufl.Urban66(9):847-8BlancoRetal,RevEspAnestesiolReanim.2012Nov;59(9):470-5BlancoRetal,Anaesthesia2013,68,11071113,躯干神经阻滞,32,GeorgThiemeVerlag,躯干神经阻滞,33,GeorgThiemeVerlag,躯干神经阻滞,34,PECS3,躯干神经阻滞,35,躯干神经阻滞,36,PECS3:sensoryBlockade,BlancoRetal,Anaesthesia2013,68,11071113,躯干神经阻滞,37,躯干神经阻滞,38,躯干神经阻滞,39,腹壁手术术后镇痛方式的比较,Riskpotential,躯干神经阻滞,40,QudratusLumborumBlock,躯干神经阻滞,41,N.spinalis,Putz/Pabst:Sobotta.AtlasderAnatomiedesMenschen,21.Aufl.Urban32(Suppl1):130,躯干神经阻滞,46,HebbardPD,JCanAnesth(2009)56:618620,M.erectorspinae,M.psoas,M.Quadratuslumborum,RectussheathB.,TAPB.,QuadratuslumborumB.,躯干神经阻滞,47,Ultrasound-GuidedTransmuscularQuadratusLumborumBlockade,躯干神经阻滞,48,QuadratuslumborumBlockade,TransmuscularQuadratuslumborumBlockade,M.psoas,M.Quadratuslumborum,TransversusAbdominisplaneblockade,躯干神经阻滞,49,躯干神经阻滞,50,ventral,posterior,anterior,dorsal,Wirbelkrper,M.psoas,Processtransversus,M.erectorspine,M.Quadratuslumborum,躯干神经阻滞,51,TansversusAbdominsPlaneBlockade,躯干神经阻滞,52,Ultrasound-GuidedTransversusAbdominsPl