Abstract
An accurate nerve block can save time and resources. If local anesthetic is placed accurately in proximity to the target nerve, there is less need for heavy sedation. Furthermore, smaller quantities of local anesthetics are required, and the risks of systemic toxicity are reduced. Ultrasound guidance enables greater precision in nerve localization, less anesthetic volume, and less time to achieve surgical anesthesia. We have recently gained considerable experience in performing ultrasound-guided supraclavicular blocks to provide surgical anesthesia with rapid block onset time, and the patient is usually ready for surgery within 10 min of the injection. The essential skills required to achieve such “accuracy” using ultrasound are image acquisition, control of needle trajectory, and correct local anesthetic application. This chapter will cover some observations made while performing and training others in ultrasound-guided peripheral anesthesia.
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References
Tsui BC, Twomey C, Finucane BT. Visualization of the brachial plexus in the supraclavicular region using a curved ultrasound probe with a sterile transparent dressing. Reg Anesth Pain Med. 2006;31:182–4.
Tsui BC, Finucane BT. The importance of ultrasound landmarks: a “traceback” approach using the popliteal blood vessels for identification of the sciatic nerve. Reg Anesth Pain Med. 2006;31:481–2.
Tsui BC. Facilitating needle alignment in-plane to an ultrasound beam using a portable laser unit. Reg Anesth Pain Med. 2007;32(1):84–8.
Tsui BC, Dillane D. Needle puncture site and a “walkdown” approach for short-axis alignment during ultrasound-guided blocks. Reg Anesth Pain Med. 2006;31(6):586–7.
Tsui B. A trigonometric method to confirm needle tip position during out-of-plane ultrasound-guided regional blockade. Can J Anesth. 2012;59:501–2.
Suggested Reading
Chan VW. The use of ultrasound for peripheral nerve block. In: Boezaart AP, editor. Anesthesia and orthopaedic surgery. New York: McGraw-Hill; 2006. p. 283–90.
Grau T. Ultrasound in the current practice of regional anesthesia. Best Pract Res Clin Anaesth. 2005;19:175–200.
Gray AT. Ultrasound-guided regional anesthesia. Current state of the art. Anesthesiology. 2006;104:368–73.
Karmakar MK, Kwok WH. Ultrasound-guided regional anesthesia. In: Cote CJ, Lerman J, Todres ID, editors. A practice of anesthesia for infants and children. 4th ed. Philadelphia: WB Saunders; 2009. p. 911–8.
Marhofer P, Greher M, Kapral S. Ultrasound guidance in regional anesthesia. Br J Anaesth. 2005;94:7–17.
Schafhalter-Zoppoth I, McColluch CE, Gray AT. Ultrasound visibility of needles used for regional nerve block: an in vitro study. Reg Anesth Pain Med. 2004;29:480–8.
Tsui BC, Dillane D. Practical and clinical aspects of ultrasound and nerve stimulation-guided peripheral nerve blocks. In: Tsui BC, editor. Atlas of ultrasound and nerve stimulation-guided regional anesthesia. New York: Springer; 2007. p. 35–48.
Tsui BC, Finucane BT. Practical recommendations for improving needle-tip visibility under ultrasound guidance? Reg Anesth Pain Med. 2005;30:596–7.
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Noga, M.L., Ip, V.H.Y., Tsui, B.C.H. (2016). Clinical and Practical Aspects of Ultrasound Use. In: Tsui, B., Suresh, S. (eds) Pediatric Atlas of Ultrasound- and Nerve Stimulation-Guided Regional Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-0-387-79964-3_4
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DOI: https://doi.org/10.1007/978-0-387-79964-3_4
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