Use of Continuous Electrical Impedance Measurement for Accurate Nerve Block in Rabbits
Use of Continuous Electrical Impedance Measurement for Accurate Nerve Block in Rabbits
复制标题
使用连续电阻抗测量精确进行兔神经阻滞
DOI：
10.1093/pm/pnaa433
复制
发表时间：
2021
期刊：
影响因子：
3.1
通讯作者：
Koyama Yuki
中科院分区：
文献类型：
--
作者：
Ootaki Chiyo;Kobayashi Yo;Koyama Yuki
目的进行安全有效的神经阻滞时，必须将针置于靶神经附近，同时避免神经损伤。我们的目的是进行动物研究，以确定电阻抗（EI）的变化是否可以用来引导针，实现安全，准确的nerve block.MethodsWe测量EI的兔组织在超声引导下坐骨神经阻滞使用双极针通过在平面针的方法。超声监视器上的EI值和针轨迹被视频记录。当EI发生变化时，停止针推进，并注射染色麻醉剂。随后，动物被安乐死，麻醉染色的组织进行检查，通过解剖，而其他组织保存在-80 ° C的显微镜analysis.ResultsThe EI保持稳定的针通过肌肉（神经外膜）前进，但是，它显着下降时，针尖接触神经或轻微刺破神经外膜（神经旁）。平均神经外和神经旁EI分别为4.92 ± 1.31 kΩ（范围：2.39-9.67 kΩ）和2.86 ± 0.96 kΩ（范围：1.66-5.13 kΩ）。检查的解剖和cryostat切片显示麻醉交付周围的nerve.ConclusionsEI值之间不同的extra和paraneural网站，并监测这些值允许相对于目标神经的针尖位置的预测。实时EI测量可改善神经阻滞效果。
ObjectiveTo perform an effective and safe nerve block, the needle must be placed near the target nerve while avoiding nerve damage. Our objective was to conduct an animal study to determine whether changes in electrical impedance (EI) could be used to guide the needle and achieve a safe and accurate nerve block.MethodsWe measured the EI of rabbit tissues during ultrasound-guided sciatic nerve block using a bipolar needle via the in-plane needle approach. The EI values and needle track on the ultrasound monitor were video-recorded. When there was a change in the EI, the needle advancement was stopped, and a stained anesthetic was injected. Subsequently, the animals were euthanized, and the anesthetic-stained tissue was examined via dissection, while the other tissue was preserved at –80°C for microscopic analysis.ResultsThe EI remained stable as the needle advanced through the muscle (extraneural); however, it markedly decreased when the needle tip contacted the nerve or slightly punctured the epineurium (paraneural). The mean extra- and paraneural EIs were 4.92 ± 1.31 kΩ (range, 2.39–9.67 kΩ) and 2.86 ± 0.96 kΩ (range, 1.66–5.13 kΩ), respectively. Examination of the dissections and cryostat sections showed anesthetic delivery around the nerve.ConclusionsEI values differed between extra- and paraneural sites, and monitoring these values allowed prediction of the needle tip location with respect to the target nerve. Real-time EI measurement could improve the nerve block.