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Exploring the mysteries of the brachial plexus: How does it help us feel and move?
The brachial plexus is an important neural network composed of the cervical nerve roots C5, C6, C7, C8 and the thoracic nerve root T1, which is responsible for controlling the movement and sensation of the upper limbs. This complex neural structure is not only vital to the functioning of the arm, but is also critical to neuroanesthesia, providing patients with anesthesia during upper limb surgery via brachial plexus blocks.
This technology can not only replace general anesthesia, but also avoid the risks brought by general anesthesia, such as hypotension, reduced cardiac output and respiratory depression. Of course, this process is not without risk, and it is important to understand how it works and provide a proper assessment.A local anesthetic is injected near the brachial plexus to temporarily block sensation and movement in the upper limb.
Brachial Plexus Anatomy
The brachial plexus is made up of multiple nerve roots in the neck that converge into different nerve branches that control movement and sensation in the arm. The technique of brachial plexus block depends mainly on the different injection sites, such as alternating bevel injections in the neck, supraclavicular nerve blocks above the clavicle, infraclavicular nerve blocks below the clavicle, and axillary nerve blocks in the armpit. stagnation. The core principle of these techniques lies in a sheath that surrounds the neurovascular bundle and extends from the deep cervical fascia to the axilla.
Techniques of Brachial Plexus Block
Brachial plexus blocks are usually performed by an anesthesiologist. When injecting local anesthetic, the needle tip needs to be close to the nerve for best effect. Common methods include puncturing a blood vessel, triggering a numbness sensation, or using a peripheral nerve stimulator or ultrasound scanner to locate the nerve.
Through these methods, doctors can more accurately determine the injection site of anesthetics in order to achieve the best anesthetic effect.If the needle tip touches a nerve, the patient may feel a sudden, tingling sensation, often described as a "pins and needles" or like an electric shock.
Various blocking techniques
Reciprocal angular nerve block
The reciprocal scalene nerve block is an injection of local anesthetic into the spinal nerve root between the anterior and middle apex muscles and is commonly used in surgeries of the clavicle, shoulder, and arm. This block technique has the advantage of rapid anesthesia, but it is not effective in anesthetizing the ulnar nerve, so it is not suitable for wrist and hand surgery.
Supraclavicular nerve block
Supraclavicular nerve blocks are a rapid method of providing upper extremity anesthesia and are particularly useful for procedures involving the lower humerus and hand. This technique helps to quickly and effectively anesthetize the upper extremity by injecting just outside the clavicle.
Subclavian nerve block
According to the latest research, when subclavian nerve blocks are performed using a peripheral nerve stimulator for nerve localization, the dual stimulation technique is more effective than the single stimulation technique, and the pain-related procedure time is shorter.
Axillary nerve block
Axillary nerve blocks are primarily used during surgery on the elbow, forearm, wrist, and hand. Axillary nerve block is considered one of the four safest block methods. Although this technique has the advantage of not causing paralysis of the phrenic nerve, caution must be exercised regarding the potential for aortic puncture and other complications.
Complications and risks
Although brachial plexus blocks have their advantages, they also have corresponding risks. Because the procedure involves the integrity of the skin, infection or bleeding may occur. The risk of bleeding-related complications is higher in patients taking anticoagulants than in the general population. In addition, local anesthetic toxicity may cause serious central nervous system problems, including seizures and cardiovascular complications.
This can reduce potential risks caused by the anesthesia process and ensure the safety of patients. ConclusionIt is crucial to monitor the patient's condition and deal with possible complications in a timely manner.
The mysteries of the brachial plexus and anesthetic techniques allow us to maintain patient comfort during upper extremity surgery and also demonstrate the progress of medicine in pain management. Faced with such a sophisticated neural network, we can't help but ask, what kind of innovation and change will brachial plexus-related medical technology bring in the future?
