Skip to main content
SpringerLink
Log in

Dolore cronico: il ruolo dell’anestesia loco-regionale eco-guidata

Chronic pain: the role of ultrasound-guided loco-regional anesthesia

  • Published:
Archivio di Ortopedia e Reumatologia

Abstract

The use of ultrasound (US), despite some limitations, has been demonstrated as a valuable imaging technique for loco-regional anesthesia (LRA). It can be used also for chronic pain treatment, both as a therapeutic and diagnostic tool, particularly to perform diagnostic selective blocks. In our paper we discuss US-guided LRA techniques to be used for chronic pain treatment, both nociceptive and neuropathic, as an assistance to nerve lesion techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Bibliografia

  1. Narouze SN (2010) Ultrasoundguided interventional procedures in pain management: Evidence-based medicine. Reg Anesth Pain Med 35[2 Suppl.]:55–58

    Article  Google Scholar 

  2. Peng PW, Tumber PS (2008) Ultrasound-guided interventional procedures for patients with chronic pelvic pain — a description of techniques and review of literature. Pain Physician 11:215–224

    PubMed  Google Scholar 

  3. Eichenberger U, Greher M, Kirchmair L et al (2006) Ultrasound-guided blocks of the ilioinguinal and iliohypogastric nerve: accuracy of a selective new technique confirmed by anatomical dissection. Br J Anaesth 97:238–243

    Article  PubMed  CAS  Google Scholar 

  4. Marhofer P, Greher M, Kapral S (2005) Ultrasound guidance in regional anaesthesia. Br J Anaesth 94:7–17

    Article  PubMed  CAS  Google Scholar 

  5. Saberski L, Fitzgerald J, Ahmad M (1998) Cryoneurolysis and radiofrequency lesioning. In: Raj PP (Ed.) Practical management of pain, 3rd edn. Lippincott-Raven, Philadelphia:1007–1061

    Google Scholar 

  6. Cohen SP, Van Zundert J (2010) Pulsed radiofrequency: rebel without cause. Reg Anesth Pain Med 35:8–10

    Article  PubMed  Google Scholar 

  7. Hagiwara S, Iwasaka H, Takeshima N, Noguchi T (2009) Mechanisms of analgesic action of pulsed radiofrequency on adjuvant-induced pain in the rat: roles of descending adrenergic and serotonergic systems. Eur J Pain 13:249–252

    Article  PubMed  CAS  Google Scholar 

  8. Aksu R, Uur F, Bicer C et al (2010) The efficiency of pulsed radiofrequency application on L5 and L6 dorsal roots in rabbits developing neuropathic pain. Reg Anesth Pain Med 35:11–15

    Article  PubMed  Google Scholar 

  9. Van Zundert J, Patijn J, Kessels A et al (2007) Pulsed radiofrequency adjacent to the cervical dorsal root ganglion in chronic cervical radicular pain: a double blind sham controlled randomized clinical trial. Pain 127:173–182

    Article  PubMed  Google Scholar 

  10. Schneider-Kolsky ME, Pike J, Connell DA (2004) CT-guided suprascapular nerve blocks: a pilot study. Skeletal Radiol 33:277–282

    Article  PubMed  CAS  Google Scholar 

  11. Harmon D, Hearty C (2007) Ultrasound-guided suprascapular nerve block technique. Pain Physician 10:743–746

    PubMed  Google Scholar 

  12. Peng PW, Wiley MJ, Liang J, Bellingham GA (2010) Ultrasound-guided suprascapular nerve block: a correlation with fluoroscopic and cadaveric findings. Can J Anaesth 57:143–148

    Article  PubMed  Google Scholar 

  13. Siegenthaler A, Moriggl B, Mlekusch S et al (2012) Ultrasound-guided suprascapular nerve block, description of a novel supraclavicular approach. Reg Anesth Pain Med 37:325–328

    PubMed  Google Scholar 

  14. Dahan TH, Fortin L, Pelletier M et al (2000) Double blind randomized clinical trial examining the efficacy of bupivacaine suprascapular nerve blocks in frozen shoulder. J Rheumatol 27:1464–1469

    PubMed  CAS  Google Scholar 

  15. Emery P, Bowman S, Wedderburn L, Grahame R (1989) Suprascapular nerve block for chronic shoulder pain in rheumatoid arthritis. BMJ 299:1079–1080

    Article  PubMed  CAS  Google Scholar 

  16. Kane TP, Rogers P, Hazelgrove J et al (2008) Pulsed radiofrequency applied to the suprascapular nerve in painful cuff tear arthropathy. J Shoulder Elbow Surg 17:436–440

    Article  PubMed  Google Scholar 

  17. Liliang PC, Lu K, Liang CL et al (2009) Pulsed radiofrequency lesioning of the suprascapular nerve for chronic shoulder pain: a preliminary report. Pain Med 10:70–75

    Article  PubMed  Google Scholar 

  18. Barrett J, Harmon D, Loughnane F et al (2004) Peripheral nerve blocks and peri-operative pain relief, 1st edn. W.B. Saunders Company, Philadelphia

    Google Scholar 

  19. Biboulet P, Morau D, Aubas P et al (2004) Postoperative analgesia after total-hip arthroplasty: Comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med 29:102–109

    PubMed  CAS  Google Scholar 

  20. Capdevila X, Biboulet P, Morau D et al (2008) How and why to use ultrasound for regional blockade. Acta Anaesthesiol Belg 59:147–154

    PubMed  CAS  Google Scholar 

  21. O’Donnell B, Mannion S (2006) Ultrasound-guided femoral nerve block, the safest way to proceed? Reg Anesth Pain Med 31:387–388

    PubMed  Google Scholar 

  22. Hebbard P, Ivanusic J, Sha S (2011) Ultrasound-guided supra-inguinal fascia iliaca block: a cadaveric evaluation of a novel approach. Anaesthesia 66:300–305

    Article  PubMed  CAS  Google Scholar 

  23. Rivera F, Mariconda C, Annaratone G (2012) Percutaneous radiofrequency denervation in patients with contraindications for total hip arthroplasty. Orthopedics 35:302–305

    Google Scholar 

  24. Kawaguchi M, Hashizume K, Iwata T, Furuya H (2001) Percutaneous radiofrequency lesioning of sensory branches of the obturator and femoral nerves for the treatment of hip joint pain. Reg Anesth Pain Med 26:576–581

    PubMed  CAS  Google Scholar 

  25. Wu H, Groner J (2007) Pulsed radiofrequency treatment of articular branches of the obturator and femoral nerves for management of hip joint pain. Pain Pract 7:341–344

    Article  PubMed  Google Scholar 

  26. Ng I, Vaghadia H, Choi PT, Helmy N (2008) Ultrasound imaging accurately identifies the lateral femoral cutaneous nerve. Anesth Analg 107:1070–1074

    Article  PubMed  Google Scholar 

  27. Bodner G, Bernathova M, Galiano K et al (2009) Ultrasound of the lateral femoral cutaneous nerve: normal findings in a cadaver and in volunteers. Reg Anesth Pain Med 34:265–268

    Article  PubMed  Google Scholar 

  28. Tagliafico A, Serafini G, Lacelli F et al (2011) Ultrasound-guided treatment of meralgia paresthetica (lateral femoral cutaneous neuropathy): technical description and results of treatment in 20 consecutive patients. J Ultrasound Med 30:1341–1346

    PubMed  Google Scholar 

  29. Fowler IM, Tucker AA, Mendez RJ (2011) Treatment of meralgia paresthetica with ultrasound guided pulsed radiofrequency ablation of lateral femoral cutaneous nerve. Pain Pract 12:394–398

    Article  PubMed  Google Scholar 

  30. Gray AT, Collins AB (2003) Ultrasound-guided saphenous nerve block. Reg Anesth Pain Med 28:148

    PubMed  Google Scholar 

  31. Tsai PB, Karnwal A, Kakazu C et al (2010) Efficacy of an ultrasound-guided subsartorial approach to saphenous nerve block: a case series. Can J Anaesth 57:683–688

    Article  PubMed  Google Scholar 

  32. Krombach J, Gray AT (2007) Sonography for saphenous nerve block near the adductor canal. Reg Anesth Pain Med 32:369–370

    PubMed  Google Scholar 

  33. Manickam B, Perlas A, Duggan E et al (2009) Feasibility and efficacy of ultrasound-guided block of the saphenous nerve in the adductor canal. Reg Anesth Pain Med 34:578–580

    Article  PubMed  Google Scholar 

  34. Akbas M, Luleci N, Dere K et al (2011) Efficacy of pulsed radiofrequency treatment on the saphenous nerve in patients with chronic knee pain. J Back Musculoskelet Rehabil 24:77–82

    PubMed  Google Scholar 

  35. Leliveld MS, Verhofstad MH (2012) Injury to the infrapatellar branch of the saphenous nerve, a possible cause for anterior knee pain after tibial nailing? Injury 43:779–783

    Article  PubMed  CAS  Google Scholar 

  36. Lundblad M, Kapral S, Marhofer P, Lönnqvist PA (2006) Ultrasound-guided infrapatellar nerve block in human volunteers: description of a novel technique. Br J Anaesth 97:710–714

    Article  PubMed  CAS  Google Scholar 

  37. Harvey G, Bell S (1999) Obturator neuropathy. An anatomic perspective. Clin Orthop 363:203–211

    PubMed  Google Scholar 

  38. Heywang-Köbrunner SH, Amaya B, Okoniewski M et al (2001) CT-guided obturator nerve block for diagnosis and treatment of painful conditions of the hip. Eur Radiol 11:1047–1053

    Article  PubMed  Google Scholar 

  39. Bouaziz H, Vial F, Jochum D et al (2002) An evaluation of the cutaneous distribution after obturator nerve block. Anesth Analg 94:445–449

    PubMed  Google Scholar 

  40. Enneking FK, Chan V, Greger J et al (2005) Lower-extremity peripheral nerve blockade: essentials of our current understanding. Reg Anesth Pain Med 30:4–35

    PubMed  Google Scholar 

  41. Soong J, Schafhalter-Zoppoth I, Gray AT (2007) Sonographic imaging of the obturator nerve for regional block. Reg Anesth Pain Med 32:146–151

    PubMed  Google Scholar 

  42. Helayel PE, da Conceição DB, Pavei P et al (2007) Ultrasoundguided obturator nerve block: a preliminary report of a case series. Reg Anesth Pain Med 32:221–226

    PubMed  Google Scholar 

  43. Akkaya T, Ozturk E, Comert A et al (2009) Ultrasound-guided obturator nerve block: a sonoanatomic study of a new methodologic approach. Anesth Analg 108:1037–1041

    Article  PubMed  Google Scholar 

  44. Anagnostopoulou S, Kostopanagiotou G, Paraskeuopoulos T et al (2008) Obturator nerve block: from anatomy to ultrasound guidance. Anesth Analg 106:350

    Article  PubMed  Google Scholar 

  45. Saranteas T, Anagnostopoulou S, Chantzi C (2007) Obturator nerve anatomy and ultrasound imaging. Reg Anesth Pain Med 32:539–540

    PubMed  Google Scholar 

  46. Willschke H, Marhofer P, Bösenberg A et al (2005) Ultrasonography for ilioinguinal/iliohypogastric nerve blocks in children. Br J Anaesth 95:226–230

    Article  PubMed  CAS  Google Scholar 

  47. Willschke H, Bösenberg A, Marhofer P et al (2006) Ultrasonographic guided ilioinguinal/iliohypogastric nerve block in pediatric anesthesia: what is the optimal volume? Anesth Analg 102:1680–1684

    Article  PubMed  CAS  Google Scholar 

  48. Werner MU, Bischoff JM, Rathmell JP, Kehlet H (2012) Pulsed radiofrequency in the treatment of persistent pain after inguinal herniotomy: a systematic review. Reg Anesth Pain Med 37:340–343

    PubMed  Google Scholar 

  49. Campos NA, Chiles JH, Plunkett AR (2009) Ultrasound-guided cryoablation of genitofemoral nerve for chronic inguinal pain. Pain Physician 12:997–1000

    PubMed  Google Scholar 

  50. Bruhn J, Van Geffen GJ, Gielen MJ, Scheffer GJ (2008) Visualization of the course of the sciatic nerve in adult volunteers by ultrasonography. Acta Anaesthesiol Scand 52:1298–1302

    Article  PubMed  CAS  Google Scholar 

  51. Karmakar MK, Kwok WH, Ho AM et al (2007) Ultrasoundguided sciatic nerve block: description of a new approach at the subgluteal space. Br J Anaesth 98:390–395

    Article  PubMed  CAS  Google Scholar 

  52. Schwemmer U, Markus CK, Greim CA et al (2005) Sonographic imaging of the sciatic nerve division in the popliteal fossa. Ultraschall Med 26:496–500

    Article  PubMed  CAS  Google Scholar 

  53. Prasad A, Perlas A, Ramlogan R et al (2010) Ultrasound-guided popliteal block distal to sciatic nerve bifurcation shortens onset time: a prospective randomized double-blind study. Reg Anesth Pain Med 35:267–271

    Article  PubMed  Google Scholar 

  54. Wilkes D, Ganceres N, Solanki D, Hayes M (2008) Pulsed radiofrequency treatment of lower extremity phantom limb pain. Clin J Pain 24:736–739

    Article  PubMed  Google Scholar 

  55. Restrepo-Garces CE, Marinov A, McHardy P et al (2011) Pulsed radiofrequency under ultrasound guidance for persistent stump-neuroma pain. Pain Pract 11:98–102

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento Scienze Mediche, Chirurgiche, Diagnostiche e Pediatriche, Università di Pavia, Pavia, Italy

    D. Bugada & M. Allegri

  2. Servizio di Terapia del Dolore, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    C. E. Minella & M. Allegri

Authors
  1. D. Bugada
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. E. Minella
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Allegri
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Bugada, D., Minella, C.E. & Allegri, M. Dolore cronico: il ruolo dell’anestesia loco-regionale eco-guidata. Arch Ortop Reumatol 123, 19–22 (2012). https://doi.org/10.1007/s10261-012-0022-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10261-012-0022-1

Search

Navigation