Ultrasound guidance in regional anesthesia: state of the art review through challenging clinical scenarios
Brian D Sites, John G Antonakakis
Departments of Anesthesiology and Orthopedic Surgery, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA; Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA, USA
Local and Regional Anesthesia 2009:2 1-14 DOI 10.2147/LRA.S3444
Abstract
Ultrasound guided regional anesthesia (UGRA) for peripheral nerve blockade is becoming increasingly popular. The advantage of ultrasound technology is that it affords the anesthesiologist the real time ability to visualize neural structures, needle advancement, and local anesthetic spread. Recent data suggest that UGRA generates improved success rates and reductions in performance times in comparison to traditional approaches. Further, the use of ultrasound technology in peripheral nerve blocks has provided insight into needle-nerve interactions, revealing distinct limitations of nerve stimulator techniques. Given that UGRA requires a unique set of skills, formal standards and guidelines are currently being developed by leadership societies in order to foster education and training. This review article, in a case vignette format, highlights important techniques, concepts, and limitations regarding the use of ultrasound to facilitate regional anesthesia. Clinically relevant aspects of ultrasound physics are also discussed.
Keywords: ultrasound, regional anesthesia.
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