Der Schmerz

, Volume 27, Issue 3, pp 325–339 | Cite as

Ultraschall in der interventionellen Schmerztherapie

CME Zertifizierte Fortbildung
First Online:

Zusammenfassung

Auch in anatomisch komplexen Bereichen werden Nervenblockaden heute noch „blind“ durchgeführt. Meist verlässt man sich dabei auf tastbare Oberflächenmerkmale. Längst hat aber der Ultraschall Einzug in fast alle medizinischen Berufe gehalten. Diesem Trend schließt sich auch der interventionell tätige Schmerztherapeut immer häufiger an. Der Ultraschall ermöglicht eine genaue Lokalisierung von Zielstrukturen, die Verfolgung des Nadelverlaufs während einer Punktion und die Visualisierung der Ausbreitung des Lokalanästhetikums. Ein Vorteil gegenüber anderen radiologischen Techniken ist die Strahlensicherheit. Zwei Hauptvoraussetzungen für den erfolgreichen Einsatz dieser interventionellen Techniken sind sicherlich die profunde Kenntnis der anatomischen Strukturen und der Korrelate im Ultraschallschnittbild sowie die sichere Hand-Augen-Koordination während der Durchführung. Bei aller Euphorie sollte die Ultraschalltechnik in der Schmerztherapie nur bei ausreichender Indikation eingesetzt werden.

Schlüsselwörter

Nervenblockade Periphere Nerven Interventionelle Sonographie Punktion Lokalanästhetika 

Ultrasound in interventional pain therapy

Abstract

Peripheral nerve blocks are currently performed relatively blind even in the most complex anatomical structures and physicians mostly rely on palpable anatomical landmarks on the surface. Ultrasound has become an indispensable part of the modern medical world and has long since found its way into almost all medical professions. More and more this trend also reaches interventional pain physicians as it is possible to accurately target structures, to track the needle course during the intervention and to visualize the spread of the local anesthetic. Another advantage compared to other radiological techniques is the profound radiation safety for patients as well as for personnel performing the intervention. A deep understanding of anatomy and its correlate in ultrasound images is one of the most important requirements for the successful use of these interventional techniques. Moreover, the safe performance of the procedure depends on the simultaneous hand-eye coordination. Nevertheless, despite the euphoria ultrasound technology should only be used in pain management with sufficient indications.

Keywords

Nerve block Peripheral nerves Ultrasonography, interventional Puncture Anaesthetics, local 
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Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Klinik für Anästhesiologie und Operative IntensivmedizinUniklinikum KölnKölnDeutschland

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