Daim Ntawv Thov Ntawm Echogenic Nerve Block Needles nyob rau hauv Upper Limb Orthopedic Surgery Anesthesia

https://www.nature.com/articles/s41598-024-72620-8

1. Cov Ntsiab Lus Kho Mob

Upper limb orthopedic surgeries nrog rau tes kho mob, dab teg arthroscopy, forearm fracture fixation thiab lub xub pwg ob leeg phais feem ntau yog cia siab rau brachial plexus thiab sab sauv qaum.paj hlwb thaiv anesthesia. Hauv kev kho mob, kev ua haujlwm ntawm cov paj hlwb ib txwm ntsib teeb meem tseem ceeb: cov hlab ntsha sab sauv ntawm lub paj hlwb tau nthuav dav nrog cov ceg me me, thiab cov koob zoo tib yam muaj cov nyhuv ultrasound tsis zoo, ua rau nws nyuaj rau qhov txawv ntawm cov paj hlwb los ntawm ib puag ncig fascia thiab cov ntaub so ntswg rog. Kev taw qhia ib leeg ultrasound tsis tuaj yeem txiav txim qhov kev ua haujlwm sib thooj ntawm cov koob taub thiab cov hlab ntsha, uas ua rau muaj kev cuam tshuam tsis tiav thiab cov tshuaj loog tsis sib xws. Rov ua dua puncture kho tau yooj yim ua rau vascular raug mob thiab los ntshav hauv zos, cuam tshuam rau qhov chaw phais mob. Tsis tas li ntawd, rau cov neeg mob uas nyias subcutaneous rog thiab cov hlab ntsha me me, qhov sib txawv ntawm qhov tob tob yuav ua rau cov hlab ntsha tsis tuaj yeem ua rau puas tsuaj. Kev siv thev naus laus zis niaj hnub muaj kev ua haujlwm siab ntev, tsis muaj kev siv tshuaj loog tsis ruaj khov, thiab tsis tuaj yeem ua tau raws li qhov tseeb thiab kev nyab xeeb tshuaj loog xav tau ntawm niaj hnub minimally invasive sab qaum kev phais.

2. Cov Khoom Siv Ua Haujlwm

Echogenic Needle rau Nerve Blocks yoog rau cov yam ntxwv ntawm lub cev ntawm lub cev sab sauv ntawm lub paj hlwb los ntawm dual -cov txiaj ntsig thev naus laus zis. Cov txheej txheem laser npav tshuab ua cov qauv micro-echo qauv ntawm stainless hlau koob nto, uas tuaj yeem nthuav tawm qhov pom tseeb siab - cov duab ci ntsa iab hauv cov ntaub mos mos ntawm cov ceg tawv, ua kom pom tseeb - lub sij hawm taug qab ntawm cov koob me me trajectory. Txoj kev kho electropolishing ua rau lub cev koob ultra- du, txo cov ntaub so ntswg kev sib txhuam thiab tsis txhob muaj qhov sib txawv txav los ntawm cov ntaub so ntswg tiv thaiv thaum lub sij hawm puncture. Cov ua tau - nyob rau hauv hluav taws xob paj hlwb stimulation technology outputs adjustable low- zaus tam sim no. Thaum lub koob taub hau mus txog brachial plexus, nruab nrab paj hlwb, ulnar paj hlwb thiab radial paj hlwb, nws induces lub hom phiaj sab sauv leeg nqaij contraction teb. Cov kws kho mob tuaj yeem txiav txim siab qhov chaw txheeb ze ntawm lub taub hau thiab cov hlab ntsha me me los ntawm kev tawm tswv yim hluav taws xob. Kev sib xyaw ua ke ntawm - lub sij hawm ultrasound kev pom kev pom thiab cov paj hlwb hluav taws xob teb cov ntaub ntawv pov thawj pom tau tias ultra-txoj hauj lwm meej ntawm cov hlab ntsha sab sauv sab sauv, tshem tawm qhov tsis xws luag ntawm kev taw qhia ib leeg.

3. Khoom Specification Classification

Raws li qhov tob tob thiab cov hlab ntsha refinement℃ntawm sab sauv ceg phais, echogenic paj block koob yog tsim nyog cais. 22G-26G ultra- cov lus tshwj xeeb zoo yog cov qauv nyiam rau tes thiab dab teg ntawm lub dab teg ntawm lub paj hlwb, nrog lub cev nyias nyias, cov ntaub so ntswg me me thiab kev ua haujlwm zoo hauv qis qis, ua kom haum rau kev ua haujlwm me me me me. 18G-21G nruab nrab specifications muaj ntau dua cov qauv kev ruaj ntseg thiab muaj zog ncha nkag mus, haum rau sib sib zog nqus brachial plexus thaiv nyob rau hauv lub xub pwg nyom thiab sab caj npab phais. Tag nrho cov khoom yog ua los ntawm cov kev kho mob zoo stainless hlau, nrog rau lub cev ruaj khov thiab zoo biocompatibility. Tom qab kev kho kom tsis muaj menyuam, lawv ua tau raws li cov qauv kev kho mob pov tseg. Cov khoom txhawb kev hloov kho me me, thiab siv cov txheej txheem ntim khoom lossis cov txheej txheem ntim cov neeg siv khoom, uas yooj yim rau kev tswj hwm hauv tsev kho mob thiab kev kho mob yooj yim.

4. Cov txheej txheem kho mob raws li txheej txheem

Ua ntej sab sauv ntawm lub paj hlwb thaiv, xaiv cov koob sib txuam raws li qhov chaw phais: ultra-zoo 24G-26G koob rau tes thiab dab teg, 19G-21G koob rau lub xub pwg brachial plexus thaiv. Tom qab niaj hnub tshuaj tua kab mob ntawm daim tawv nqaij thiab sterile draping, tso tus neeg mob nyob rau hauv lub supine txoj hauj lwm thiab tag nrho nthuav tawm lub sab sauv qaum teb cheeb tsam. Tig rau lub siab- zaus ultrasound sojntsuam txhawm rau tshuaj xyuas lub hom phiaj paj hlwb khiav thiab cov hlab ntsha nyob ib puag ncig, qhia meej txog cov txheej txheem anatomical. Txais cov txheej txheem hauv dav hlau txhawm rau txhawm rau txhawm rau txhawm rau echogenic koob maj mam thiab ruaj khov, saib xyuas cov koob nkag mus rau lub sijhawm tiag tiag los ntawm cov duab ultrasound siab. Pib lub paj hlwb stimulation system nrog qis pib tam sim no siv, kho kom tsim nyog raws li cov leeg nqaij contraction tawm tswv yim kom txog rau thaum cov paj hlwb zoo sib xws hauv xeev tau lees paub. Tom qab tsis zoo siab aspiration proves tsis muaj vascular nkag mus, txhaj tshuaj loog hauv zos uniformly thiab maj mam, soj ntsuam cov tshuaj tag wrapping cov hlab ntsha nyob rau hauv ultrasound xyuas, thiab paub meej tias ruaj khov block nyhuv kom tiav cov hauj lwm.

5. Kev siv tau zoo thiab muaj txiaj ntsig

Ntev - daim ntawv thov kev kho mob nyob rau hauv lub sab sauv ceg orthopedic phais ua pov thawj tias dual - tshuab echogenic koob zoo heev optimize tshuaj loog zoo. Piv nrog rau cov koob tshuaj ib txwm siv, cov ntaub so ntswg ntiav cov koob paub txog tus nqi tau nce ntau dua 70%, thiab ib qho - lub sij hawm puncture qhov kev vam meej ntawm sab sauv paj hlwb yog stabilized saum 97%. Cov paj hlwb ua haujlwm tau zoo txheeb xyuas cov ceg ntoo me me uas nyuaj rau kev paub qhov txawv ntawm cov duab ultrasound ntshiab, txo qhov tshwm sim ntawm cov tshuaj loog tsis tiav los ntawm 55%. Lub ultra- rab koob lub cev du ua tiav los ntawm electropolishing txo cov ntaub so ntswg thiab fascia puas, thiab tom qab phais hauv zos o thiab mob cov tshuaj tiv thaiv ntawm cov neeg mob tau txo qis. Qhov tseeb qhov chaw txo qis cov pov tseg ntawm cov tshuaj loog hauv zos, ua rau cov tshuaj loog pib sai dua thiab qhov kev siv tshuaj loog ua kom ruaj khov dua, ua kom tsis txhob mob sai sai thaum phais. Kev ua haujlwm tom qab ua haujlwm tom qab- qhia tau hais tias cov neeg mob tau rov qab sai dua ntawm cov ceg tawv sab sauv thiab lub cev muaj zog, nyob hauv tsev kho mob luv dua thiab txaus siab rau kev kho mob ntau dua.

6. Summary thiab Technical Sublimation

Upper limb nerve block anesthesia is characterized by dense nerve branches, shallow distribution and high precision requirements. Cov cuab yeej xuas nrig ntaus ib txwm cia siab rau ib qho kev kuaj ultrasound, uas yog qhov nyuaj rau kev ua tiav qhov tseeb ntawm cov hlab ntsha me me, nrog rau kev ua haujlwm siab thiab tsis ruaj khov. Echogenic paj hlwb thaiv koob cia siab rau ob qhov zoo ntawm laser echo visualization thiab hluav taws xob paj hlwb tawm tswv yim, zoo kawg nkaus txuam cov anatomical thiab kho cov yam ntxwv ntawm sab sauv ceg hlab ntsha thaiv. Nws paub meej, qhov tsawg kawg nkaus invasive thiab muaj kev nyab xeeb tshuaj loog ua haujlwm, daws cov kev mob tshwm sim ntawm cov hlab ntsha me me ntawm qhov nyuaj ntawm cov hlab ntsha me me thiab qhov tsis ua haujlwm siab ntawm kev phais mob sab sauv, thiab muab kev txhawb nqa kev ntseeg siab rau kev txhim kho ntawm kev phais me me thiab meej sab sauv qaum orthopedic.

7. Kev Lag Luam Daim Ntawv Thov Kev Pom Zoo thiab Cov Lus Qhia

Nrog rau txoj kev loj hlob sai ntawm hnub kev phais thiab kev siv tshuab orthopedic tsawg tsawg, qhov kev thov rau siab -precision sab sauv qaum paj thaiv cov tshuaj loog txuas ntxiv nthuav dav. Nws tau pom zoo tias cov tuam tsev kho mob orthopedic thiab tshuaj loog ua kom nrov nrov dual - thev naus laus zis echogenic koob thiab maj mam tshem tawm cov koob txhaj tshuaj zoo tib yam. Cov kws kho mob yuav tsum ntxiv dag zog rau kev cob qhia dual- hom kev sib koom tes ua haujlwm kev txawj ntse, txhim kho lub peev xwm ntawm lub sijhawm tiag tiag - hloov lub sijhawm ntawm lub kaum ntse ntse ua ke nrog ultrasound thiab cov lus txhawb nqa paj hlwb. Cov neeg tsim khoom yuav tsum txuas ntxiv ua kom zoo dua cov txheej txheem laser npav ntawm ultra- koob zoo, ntxiv txhim kho lub ncha lub ntsiab lus ntawm cov lus qhia me me, thiab nthuav tawm cov lus qhia tshwj xeeb tshwj xeeb rau kev phais mob rau menyuam yaus. Nyob rau tib lub sijhawm, txhim kho cov ntim khoom thiab cov qauv tswj kom tsis muaj menyuam kom ua tau raws li qib siab - cov qauv kev thov ntawm cov tsev kho mob qib siab thiab cov tsev kho mob tshwj xeeb.