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<title>神経ブロックに必要な画像解剖 | 株式会社文光堂</title>


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<meta name="description" content="神経ブロックは，確実性の向上，合併症の予防のため，ランドマークを基にした従来の神経ブロックから画像ガイド下神経ブロックへと移行しつつある．本書では，ターゲットの神経と周辺組織の立体解剖を把握し，それぞれの描出画像を理解できる知識・技術を解説する．その上で，各部位に対するX線透視・超音波・CTガイド下神経ブロックを同じ項目で並列的に解説した．各手技については，フローチャートで表すことで，神経ブロック">

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	<section class="book">

		<h1 class="catchCopy">より確実・安全に神経ブロックを行うための画像解剖を徹底解説！</h1>
		

		<h2 class="series">痛みのScience & Practice&nbsp;&nbsp;6</h2>
		
		<h1 class="title">神経ブロックに必要な画像解剖<span class="version"></span></h1>
		

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					編集：表　圭一（禎心会病院）
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					監修：表　圭一（禎心会病院）
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					<span class="transparent">監修</span>　山本達郎（熊本大学）
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					<span class="transparent">監修</span>　井関雅子（順天堂大学）
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					<span class="transparent">監修</span>　川真田樹人（信州大学）
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">神経ブロックは，確実性の向上，合併症の予防のため，ランドマークを基にした従来の神経ブロックから画像ガイド下神経ブロックへと移行しつつある．本書では，ターゲットの神経と周辺組織の立体解剖を把握し，それぞれの描出画像を理解できる知識・技術を解説する．その上で，各部位に対するX線透視・超音波・CTガイド下神経ブロックを同じ項目で並列的に解説した．各手技については，フローチャートで表すことで，神経ブロックを行う際に画像と照らし合わせながら理解できる構成となっている．<br>☆カラー写真4点，モノクロ写真5点，イラスト・線画100点</section><section class="preface">「神経ブロックに必要な画像解剖」序文<br><br>　ペインクリニックや手術麻酔の診療において，種々の神経ブロックが多用され，その有用性が確固としたものであることは明らかです．その確実性の向上，合併症の防止のために，ランドマークを基にした従来の神経ブロックから画像ガイド下神経ブロックへと移行してきました．画像ガイド下神経ブロックは，X線透視ガイド下に代表されますが，最近では，超音波ガイド下，さらには，CTガイド下に神経ブロックが行われてきています．<br>　これらの画像ガイド下神経ブロックを解説した成書はいくつか見受けられますが，それらは，画像パターンからブロック手法を解説したものがほとんどであり，実際の立体的解剖を念頭において画像を理解させ，ブロック針の刺入方法などを解説したものは非常に少ないと思われます．今回，ターゲットとなる神経およびその周辺組織の解剖を把握した上で，それぞれの描出画像を理解することで，適切な神経ブロックを行い，その確実性・安全性を高めることに役立てる解説書を企画しました．<br>　各々の画像下神経ブロックには，X線透視ガイド下や超音波ガイド下でのリアルタイムでブロック針刺入ができることや，超音波ガイド下やCTガイド下での内臓器とブロック針の位置関係の把握ができる，などの長所や，一方で放射線被曝といった短所があり，これらの画像の特徴を把握した上で，また，神経ブロックの種類に応じて，より正確で安全な画像を選択することも重要であると思います．<br>　本書は，（1）周辺解剖を立体的に理解でき，X線透視ガイド下，超音波ガイド下，CTガイド下神経ブロックを同じ章内で理解することができること，（2）神経ブロック手技については，フローチャートにて表すことで，実際に神経ブロックを行う際に画像と照らし合わせながら理解するのに大いに役立てていただこうとするのが趣旨です．<br>　本書が神経ブロックの実際の手引書となり，痛み治療の発展に貢献できれば幸いです．<br><br>2014年7月<br>禎心会病院ペインクリニックセンター　表　圭一</section><section class="indexes">総説<br>　画像ガイド下神経ブロックに必要な解剖の理解<br>　　T：X線透視ガイド下神経ブロック時の放射線被曝と安全性（1）<br>　　T：X線透視ガイド下神経ブロック時の放射線被曝と安全性（2）<br>　　T：CTガイド下神経ブロックに使用するCT装置の変遷<br>解説<br>　I．頭部<br>　　1 三叉神経節ブロック<br>　　　・X 線透視ガイド下三叉神経節ブロック　高周波熱凝固法<br>　　　・X 線透視ガイド下三叉神経節ブロック　エタノールブロック法<br>　　　・CTガイド下三叉神経節ブロック<br>　2 上顎神経ブロック<br>　　　・X線透視ガイド下上顎神経ブロック<br>　3 下顎神経ブロック<br>　　　・X線透視ガイド下下顎神経ブロック<br>　4 耳介側頭神経ブロック<br>　　　・X線透視ガイド下耳介側頭神経ブロック<br>　　　・CTガイド下下顎神経ブロック，CTガイド下耳介側頭神経ブロック<br>　5 眼窩上神経ブロック，眼窩下神経ブロック，オトガイ神経ブロック<br>　　　・X線透視ガイド下眼窩上神経ブロック<br>　　　・X線透視ガイド下眼窩下神経ブロック<br>　　　・X 線透視ガイド下オトガイ神経ブロック<br>　　　・超音波ガイド下眼窩上神経ブロック<br>　　　・超音波ガイド下眼窩下神経ブロック<br>　　　・超音波ガイド下オトガイ神経ブロック<br>II．頚部<br>　1 頚部硬膜外ブロック<br>　　・X線透視ガイド下頚部硬膜外ブロック<br>　　・超音波ガイド下頚部硬膜外ブロック　椎弓間アプローチ<br>　　・超音波ガイド下頚部硬膜外ブロック　経椎間孔アプローチ<br>　2 頚部神経根ブロック<br>　　・X線透視ガイド下頚部神経根ブロック（C2）<br>　　・X線透視ガイド下頚部神経根ブロック（C3〜C8）<br>　　・超音波ガイド下頚部神経根ブロック<br>　3 頚椎椎間関節ブロック，脊髄後枝内側枝神経ブロック<br>　　・X線透視ガイド下頚椎椎間関節ブロック<br>　　・X線透視ガイド下脊髄後枝内側枝神経ブロック<br>　　・超音波ガイド下頚椎椎間関節ブロック<br>　　・超音波ガイド下脊髄後枝内側枝神経ブロック<br>　4 腕神経叢ブロック<br>　　・X線透視ガイド下腕神経叢ブロック<br>　　・超音波ガイド下腕神経叢ブロック　斜角筋間アプローチ<br>　　・超音波ガイド下腕神経叢ブロック　鎖骨上アプローチ<br>　　・超音波ガイド下腕神経叢ブロック　鎖骨下近位アプローチ<br>　　・超音波ガイド下腕神経叢ブロック　腋窩アプローチ<br>　5 浅・深頚神経叢ブロック<br>　　・X線透視ガイド下深頚神経叢ブロック<br>　　・超音波ガイド下頚神経叢ブロック<br>　6 大後頭神経ブロック<br>　　・超音波ガイド下大後頭神経ブロック<br>　　　O：パルス高周波<br>　　　O：抗血栓薬と神経ブロック<br>III．胸部<br>　1 胸部硬膜外ブロック<br>　　・X線透視ガイド下胸部硬膜外ブロック<br>　　・超音波ガイド下胸部硬膜外ブロック<br>　2 胸部神経根ブロック<br>　　・X線透視ガイド下胸部神経根ブロック<br>　　・CTガイド下胸部神経根ブロック<br>　3 胸椎椎間関節ブロック，後枝内側枝高周波熱凝固法<br>　　・X線透視ガイド下胸椎椎間関節ブロック，X線透視ガイド下胸部後枝内側枝高周波熱凝固法<br>　4 胸部傍脊椎神経ブロック<br>　　・X線透視ガイド下胸部傍脊椎神経ブロック<br>　　・超音波ガイド下胸部傍脊椎神経ブロック<br>　5 肋間神経ブロック<br>　　・X線透視ガイド下肋間神経ブロック<br>　　・超音波ガイド下肋間神経ブロック<br>　　・CTガイド下胸部傍脊椎神経ブロック，CTガイド下肋間神経ブロック<br>IV．腰部<br>　1 腰部硬膜外ブロック<br>　　・X線透視ガイド下腰部硬膜外ブロック<br>　　・超音波ガイド下腰部硬膜外ブロック<br>　2 腰部神経根ブロック<br>　　・X線透視ガイド下腰部神経根ブロック腹臥位法<br>　　・X線透視ガイド下腰部神経根ブロック斜位法<br>　　・超音波ガイド下腰部神経根ブロック<br>　　・CTガイド下腰部神経根ブロック　非リアルタイム法<br>　3 腰椎椎間関節ブロック，脊髄神経後枝内側枝ブロック<br>　　・X線透視ガイド下腰椎椎間関節ブロック<br>　　・X線透視ガイド下脊髄神経後枝内側枝ブロック<br>　　・超音波ガイド下腰椎椎間関節ブロック<br>　　・超音波ガイド下脊髄神経後枝内側枝ブロック<br>　　・CTガイド下腰部脊髄神経後枝内側枝ブロック，CTガイド下腰椎椎間関節ブロック<br>　4 腰神経叢ブロック（大腰筋筋溝ブロック）<br>　　・X線透視ガイド下腰神経叢ブロック<br>　　・超音波ガイド下腰神経叢ブロック<br>Ⅴ．仙骨部<br>　1 仙骨硬膜外ブロック<br>　　・X線透視ガイド下仙骨硬膜外ブロック<br>　　・超音波ガイド下仙骨硬膜外ブロック<br>　2 仙骨神経根ブロック<br>　　・X線透視ガイド下仙骨神経根ブロック<br>　　・超音波ガイド下仙骨神経根ブロック<br>　3 仙腸関節ブロック，仙腸関節枝ブロック<br>　　・X線透視ガイド下仙腸関節ブロック，X 線透視ガイド下仙腸関節枝ブロック<br>　　・超音波ガイド下仙腸関節ブロック，超音波ガイド下仙腸関節枝ブロック<br>　　・CTガイド下仙腸関節ブロック<br>　　・CTガイド下仙腸関節枝ブロック<br>　4 坐骨神経ブロック<br>　　・X線透視ガイド下坐骨神経ブロック<br>　　・超音波ガイド下坐骨神経ブロック　傍仙骨アプローチ，膝窩部アプローチ<br>　　・超音波ガイド下坐骨神経ブロック　末梢枝ブロック<br>　　　T：脊髄刺激療法の現況<br>　　　T：椎間板ヘルニアに対する経皮的髄核摘出術<br>　　　T：MRガイド下腰椎椎間板摘出術<br>　　　T：Raczカテーテル<sup>®</sup><br>VI．四肢末梢<br>　1 橈骨神経ブロック，正中神経ブロック，尺骨神経ブロック<br>　　・超音波ガイド下橈骨神経ブロック<br>　　・超音波ガイド下正中神経ブロック<br>　　・超音波ガイド下尺骨神経ブロック<br>　2 大腿神経ブロック<br>　　・超音波ガイド下大腿神経ブロック<br>　3 伏在神経ブロック<br>　　・超音波ガイド下伏在神経ブロック<br>VII．交感神経系<br>　1 星状神経節ブロック<br>　　・X線透視ガイド下星状神経節ブロック　前方到達法<br>　　・X線透視ガイド下星状神経節ブロック　後方到達法<br>　　・超音波ガイド下星状神経節ブロック<br>　2 胸部交感神経節ブロック<br>　　・X線透視ガイド下胸部交感神経節ブロック<br>　　・CTガイド下胸部交感神経節ブロック<br>　3 腰部交感神経節ブロック<br>　　・X線透視ガイド下腰部交感神経節ブロック<br>　　・CTガイド下腰部交感神経節ブロック<br>　4 腹腔神経叢ブロック<br>　　・X線透視ガイド下腹腔神経叢ブロック<br>　　・CT ガイド下内臓神経ブロック，CT ガイド下腹腔神経叢ブロック<br>　5 下腸間膜動脈神経叢ブロック<br>　　・X線透視ガイド下下腸間膜動脈神経叢ブロック<br>　　・CTガイド下経椎間板的下腸間膜神経叢ブロック<br>　6 上・下腹神経叢ブロック<br>　　・X線透視ガイド下上・下腹神経叢ブロック<br>　　・CTガイド下上・下腹神経叢ブロック<br>　7 不対神経節ブロック<br>　　・X線透視ガイド下不対神経節ブロック<br>　　・CTガイド下不対神経節ブロック<br>VIII．椎間板内<br>　1 腰部椎間板ブロック，腰部椎間板加圧注入療法<br>　　・X線透視ガイド下腰部椎間板ブロック，X線透視ガイド下椎間板加圧注入療法<br>　　・CTガイド下椎間板ブロック<br>　　T：椎間板内高周波熱凝固法（IDET）<br>　　T：超音波内視鏡（EUS）ガイド下腹腔神経叢ブロック<br>　　O：椎間板性腰痛とは<br>　　O：椎間板性腰痛の診断と治療<br>　　O：脊髄刺激療法の鎮痛機序<br>索引<br><br>　　　* T ＝ Topics<br>　　　* O ＝ One Point Advice</section></article>
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