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下肢神经阻滞：技术

Authors
Christina L Jeng, MD
Meg A Rosenblatt, MD
Section Editor
Lisa Warren, MD
Deputy Editor
Marianna Crowley, MD
Translators
李伟彦, 主任医师，教授

引言

下肢外周神经阻滞在多种下肢手术中被用于麻醉和/或术后镇痛。

本专题将讨论下肢的神经支配、下肢神经阻滞的技术和药物，以及这些阻滞的特定并发症。在适当处将讨论神经周围置管以行连续神经阻滞。各种外周神经阻滞相关技术的适应证、禁忌证和比较，设备及各种神经阻滞常见的并发症将会单独讨论。 (参见“外周神经阻滞概述”)

神经支配：下肢

腰丛由前3支腰神经(L1、L2、L3)的前支和第4腰神经(L4)一部分的前支组成。第12胸神经(T12)的一个分支常汇入L1神经根(图 1)。

腰丛位于腰大肌深面1/3处，腰椎横突前方。腰丛发出分支支配下肢肌肉和皮肤，包括髂腹下神经、髂腹股沟神经、生殖股神经、股神经、股外侧皮神经和闭孔神经(图 2)。

股神经(L2-L4)穿过腰大肌，从腰大肌与髂肌之间的下边界穿出，从腹股沟韧带下方穿过，走行于股总动脉外侧。股神经发出运动支支配大腿伸肌群，还发出感觉支支配大腿前侧、股骨、膝关节及腿内侧的皮肤(图 3和图 4)。隐神经是股神经的终末感觉支。

                                                  

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Literature review current through: 2017-06 . | This topic last updated: 2017-04-11.
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