背景及目的:超音波指引在週邊神經阻斷術與區域麻醉的普遍性愈來愈高。目前並沒有超音波指引下執行區域麻醉的動物模式,本研究目的是建立一個可行的活豬動物模式以便執行超音波指引下脊髓麻醉。 研究設計:實驗動物為六隻國產豬雙,於氣管插管全身麻醉下進行實驗。超音波儀器採用低頻彎曲探頭,取得腹部脊椎超音波影像。脊髓麻醉以22號脊髓穿刺針,於超音波指引下執行,穿刺平面與探頭平行。記錄是否有硬膜穿刺爆聲、超音波硬膜穿刺影像以及腦脊髓液之流出。 實驗結果:典型腰部脊椎超音波影像,藉由正中旁的矢狀切面取得。完成脊髓麻醉時,可觀察到大於百分之九十的穿刺有硬膜穿刺爆聲與超音波硬膜穿刺影像,與腦脊髓液之流出。 研究結論:本報告顯示活豬動物模式可以實際運用於學習超音波指引下脊髓麻醉。
Background: Ultrasound guidance has gained more popularity in both peripheral nerve and neuraxial block. A feasible live animal model for neuraxial block using ultrasound guidance has not been reported. The purpose of this study was to establish a feasible live swine model for learning ultrasound-guided spinal anesthesia. Materials and methods: Six Duroc-Landrace piglets were anesthetized and intubated. A Micromax ultrasound system with a low frequency curved array transducer was employed to obtain the spinal sonoanatomy in lumbar region. Spinal anesthesia was performed with a 22-guage spinal needle with in plane technique. Anesthetic records included pop sign of dural puncture, ultrasound image and finally cerebrospinal fluid flow. Results: Typical spinal sonoanatomy was obtained via paramedian sagittal oblique scan, The success of spinal anesthesia can be confirmed by pop sign of dural puncture, ultrasound image and/or finally cerebrospinal fluid flow, Conclusion: This report demonstrates a reliable and practical animal model for learning ultrasound-guided spinal anesthesia.