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Comparison of injectate spread and nerve involvement between retrolaminar and erector spinae plane blocks in the thoracic region: a cadaveric study

Authors
 H.-M. Yang  ;  Y. J. Choi  ;  H.-J. Kwon  ;  J. O  ;  T. H. Cho  ;  S. H. Kim 
Citation
 Anaesthesia, Vol.73(10) : 1244-1250, 2018 
Journal Title
 Anaesthesia 
ISSN
 0003-2409 
Issue Date
2018
Keywords
anaesthesia ; cadaver ; paravertebral ; regional ; ultrasonography
Abstract
Although different injection locations for retrolaminar and erector spinae plane blocks have been described, the two procedures have a similar anatomical basis. In this cadaveric study we compared anatomical spread of dye in the thoracic region following these two procedures. Following randomisation, 10 retrolaminar blocks and 10 erector spinae plane blocks were performed on the left or right sides of 10 unembalmed cadavers. For each block, 20 ml of dye solution was injected at the T5 level. The back regions were dissected and the involvement of the thoracic spinal nerve was also investigated. Twenty blocks were successfully completed. A consistent vertical spread, with deep staining between the posterior surface of the vertebral laminae and the overlaying transversospinalis muscle was observed in all retrolaminar blocks. Moreover, most retrolaminar blocks were predominantly associated with fascial spreading in the intrinsic back muscles. With an erector spinae plane block, dye spread in a more lateral pattern than with retrolaminar block, and fascial spreading in the back muscles was also observed. The number of stained thoracic spinal nerves was greater with erector spinae plane blocks than with retrolaminar blocks; median 2.0 and 3.5, respectively. Regardless of technique, the main route of dye spread was through the superior costotransverse ligament to the ipsilateral paravertebral space. Although erector spinae plane blocks were associated with a slightly larger number of stained thoracic spinal nerves than retrolaminar blocks, both techniques were consistently associated with posterior spread of dye and with limited spread to the paravertebral space.
Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1111/anae.14408
DOI
10.1111/anae.14408
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Anatomy (해부학교실)
1. Journal Papers (연구논문) > 2. College of Dentistry (치과대학) > Dept. of Oral Biology (구강생물학교실)
Yonsei Authors
김신형(Kim, Shin Hyung) ORCID logo https://orcid.org/0000-0003-4058-7697
양헌무(Yang, Hun Mu) ORCID logo https://orcid.org/0000-0003-1954-0114
오제훈(O, Jehoon) ORCID logo https://orcid.org/0000-0003-4351-3183
조태현(Cho, Tae-Hyeon) ORCID logo https://orcid.org/0000-0001-7230-620X
최유진(Choi, You Jin) ORCID logo https://orcid.org/0000-0003-3701-2200
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163667
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