Блокада плечевого сплетения подмышечным доступом. Обзор литературы

Abstract

The main tasks of an anesthesiologist during the anesthesiological support of surgical interventions are the maximum possible protection of the patient from pain with minimal effect on homeostasis, creating comfortable conditions for the work of operating surgeons. These requirements fully comply with regional paintering methods, especially during operations on the upper limb, when the anesthesiologist has a choice: to perform general anesthesia or blockade of the shoulder plexus. The regional blockade will fully ensure adequate analgesia, hyporeflexia and relaxation in the operation zone. To increase the efficiency and safety of regional blockade, ultrasonic navigation and neuromuscular stimulation are used. One of the safest and easy-to-perform is axillar access. Objective. Summarize and present modern information about the regional blockade of the shoulder plexus from axillary access. Material and methods. During the writing of the article on regional methods of upper limb anesthesia, in particular on axillary access, a literature from open electronic scientific databases of Pubmed, the US National Electronic Medical Library and Databases of the Russian Scientific Electronic Library Elibary was analyzed. Results. An analysis of domestic and foreign literature dedicated to the blockade of the shoulder plexus with axillary access was carried out. The article discusses options for the location of the nerve trunks of the shoulder plexus in the axillary region, the technique of performing the axillar blockade, indications and possible complications. Conclusions. The priority when choosing access when blocking the shoulder plexus is to ensure the safety and efficiency of anesthesia, especially in high-risk patients. Axillar access using sonoscopy and neuromuscular stimulation fully complies with these requirements.