兰州大学学报（医学版）2024，Vol.50Issue(8)：25-30,47,7.DOI:10.13885/j.issn.1000-2812.2024.08.004
超声引导膝周神经丛阻滞的解剖学和临床研究
Ultrasound-guided knee pericapsular plexus block:A cadaver and a volunteer study
摘要
Abstract
Objective To investigate into the feasibility of ultrasound-guided knee pericapsular plexus block and to test its block area.Methods The study was designed in two parts involving cadavers and volunteers.First,the four nerves constituing the knee pericapsular plexus,including the anterior branch of the lateral fem-oral cutaneous nerve,intermediate femoral cutaneous nerve,inferior patellar branch of the saphenous nerve,and anterior branch of the medial femoral cutaneous nerve,were identified and followed on the lower limbs of ten cadavers under ultrasound guidance.Then a solution of 0.01%methylene blue was injected into the most optimal imaging location,followed by cadaver dissection to evaluate nerve staining.Second,ultrasound-guided knee pericapsular plexus block was performed on one lower limbs of every 25 volunteers,followed by a recording of the block area and lower limb mobilization of the affected leg.Results The cadaver study revealed that all four nerves could be clearly identified under ultrasound.The intermediate femoral cutaneous nerve,inferior patellar branch of the saphenous nerve,and anterior branch of the medial femoral cutaneous nerve pierced or wound around the sartorius muscle and then ran superficial to it followed by being superficial to the junction of the sartorius muscle and vastus medialis muscle.The lateral femoral cutaneous nerve primar-ily ran superficial to the rectus femoris muscle in the anterior thigh.After dye injection,the knee pericapsular plexus of all cadavers were stained,while the femoral and saphenous nerves remained unstained.The volun-teer study showed that the block area after knee pericapsular plexus block extended from the tibial tuberosity to the upper end of the thigh,medially to the inner edge of the medial condyle and laterally to the outer edge of the lateral condyle,covering the entire anterior knee area.The average blocking duration was 14.72 h,and no volunteers experienced motor weakness in the lower limbs.Conclusion Ultrasound-guided knee pericapsu-lar plexus block is a feasible nerve block technique with a block area covering the entire anterior knee without motor weakness.关键词
膝周神经丛/股神经/隐神经/超声引导/神经阻滞/缝匠肌Key words
knee pericapsular plexus/nervus femoralis/saphenous nerve/ultrasound guidance/nerve block/sartorius muscle分类
医药卫生引用本文复制引用
李娜,李静,张修文,焦俊峰,殷文渊,巩文怡,李晨光..超声引导膝周神经丛阻滞的解剖学和临床研究[J].兰州大学学报（医学版）,2024,50(8):25-30,47,7.基金项目
上海市老龄化和妇儿健康研究专项资助项目(2020YJZX0127) （2020YJZX0127）
