Course of the thoracic nerves around the umbilicus within the posterior layer of the rectus sheath: a cadaver study
Course of the thoracic nerves around the umbilicus within the posterior layer of the rectus sheath: a cadaver study
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DOI：
10.1007/s00540-020-02863-y
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发表时间：
2020-10-16
影响因子：
2.8
通讯作者：
Hara, Tetsuya
中科院分区：
文献类型：
--
作者：
Sakai-Tamura, Akiko;Murata, Hiroaki;Hara, Tetsuya
直肌鞘阻滞用于麻醉脐部周围的胸神经。然而，直肌鞘阻滞术中麻醉注射的合适位置尚未从解剖学上确定。在此，我们在福尔马林固定的成人身体上观察了胸神经T10在直肌鞘后层的走行，以及该神经与腹直肌和腹横肌的解剖关系。胸神经T10穿脐水平线至胸神经T10穿过腹直肌鞘后层处的头尾距离为33.8±14.4(标准差)mm，穿脐水平线至腹直肌外侧缘与腹横肌交叉内侧缘的距离为33.1±17.1 mm。腹直肌外侧缘与腹横肌内侧缘相交的位置与胸神经T10穿过腹直肌鞘后层的位置相近。我们的结果找出了有效的标志物来指导直肌鞘阻滞的表现。
Rectus sheath block is used to anesthetize thoracic nerves around the umbilicus. However, the appropriate point for anesthetic injection during rectus sheath block has not been determined anatomically. Here, we examined the course of thoracic nerve T10 at the posterior layer of the rectus sheath and the anatomical relationship between the nerve and the rectus abdominis and transversus abdominis muscles in formalin-fixed adult cadavers. The cranio-caudal distance from a horizontal line running through the umbilicus to where the thoracic nerve T10 passes through the posterior layer of the rectus sheath was 33.8 +/- 14.4 (mean +/- standard deviation) mm, while that from the horizontal line running through the umbilicus to the position where the lateral edge of the rectus abdominis muscle and the medial border of the transversus abdominis muscle cross was 33.1 +/- 17.1 mm. The position where the lateral edge of the rectus abdominis muscle and the medial border of the transversus abdominis muscle cross approximates the position where thoracic nerves T10 passes through the posterior layer of the rectus sheath. Our results identify effective landmarks to guide the performance of rectus sheath block.