The 68th
Scientific Meeting
초록접수 미리보기
| 19S-032 |
Novel technique for distal selective accessory nerve blockade; relationship to the transverse cervical artery
1Department of Anatomy, Wonkwang University School of Medicine, Iksan,
Korea
2Department of Anesthesiology and Pain Medicine, Wonkwang University
School of Medicine, Wonkwang University Hospital, Iksan, Korea
3Jesaeng-Euise Clinical Anatomy Center, Wonkwang University School of
Medicine, Iksan, Korea
4Wonkwang Institute of Science, Wonkwang University School of Medicine, Iksan, Korea
Background: The aim of this study was to clarify the topographical relationship between the accessory nerve (AN) and transverse cervical artery (TCA) below the trapezius muscle to provide safe and convenient injection points for accessory nerve blockade.
Materials and Methods: This study included 21 and 30 shoulders of 14 embalmed Korean adult cadavers and 15 patients, respectively, for dissection and ultrasound (US) examination.
Results: The courses of the TCA and AN in the scapular region were classified into four types based on their positional relationships. Type A indicated the nerve that was medial to the artery and ran parallel without changing its location in the whole course (38% of all specimens). In type B (38%), the nerve was lateral to the artery and ran parallel without changing its location in the whole course. In type C (19%), the nerve or artery traversed each other only once during the whole course. In type D (5%), the nerve or artery traversed each other more than twice forming a twist. At the levels of lines IIV, the nerve was relatively close to the artery (separation of approximately 10 mm). All types of arteries were observed in all specimens around the superior angle of the scapula at the level of line II, whereas no artery was found below line IV. In US images of the patients, TCA was commonly observed at the level of line II (93.3%), followed by line III (90%), line I (86.7%), and line IV (66.7%).
Conclusions: The results of this study are expected to expand the current knowledge of the relation between the AN and TCA courses in the scapular region, and provide helpful information for selective diagnostic nerve block in this region.
Materials and Methods: This study included 21 and 30 shoulders of 14 embalmed Korean adult cadavers and 15 patients, respectively, for dissection and ultrasound (US) examination.
Results: The courses of the TCA and AN in the scapular region were classified into four types based on their positional relationships. Type A indicated the nerve that was medial to the artery and ran parallel without changing its location in the whole course (38% of all specimens). In type B (38%), the nerve was lateral to the artery and ran parallel without changing its location in the whole course. In type C (19%), the nerve or artery traversed each other only once during the whole course. In type D (5%), the nerve or artery traversed each other more than twice forming a twist. At the levels of lines IIV, the nerve was relatively close to the artery (separation of approximately 10 mm). All types of arteries were observed in all specimens around the superior angle of the scapula at the level of line II, whereas no artery was found below line IV. In US images of the patients, TCA was commonly observed at the level of line II (93.3%), followed by line III (90%), line I (86.7%), and line IV (66.7%).
Conclusions: The results of this study are expected to expand the current knowledge of the relation between the AN and TCA courses in the scapular region, and provide helpful information for selective diagnostic nerve block in this region.
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