The role of peripheral nerves in point-of-care ultrasound is mostly limited to their utility in providing quality regional anesthesia. Superior analgesia can be achieved in multiple painful pathologies by injecting local anesthetic around the nerve distribution producing pain. For instance, pain from a femur fracture can be well managed by injection of local anesthetic around the femoral nerve. A meta-analysis of patients with hip and femoral neck fractures found that, overall, regional anesthesia outperformed analgesia from opiates, acetaminophen, and non-steroidal anti-inflammatories . When administering regional anesthesia, ultrasound guidance is used to track the injection needle and avoid surrounding vasculature as it advances toward the desired nerve. Similarly, regional anesthesia by ultrasound guided injection can be used to allow for otherwise painful, invasive procedures to be performed, such as fracture reduction or laceration repair.
KeywordsNerve Anesthesia Radial nerve Median nerve Ulnar nerve Tibial nerve Peroneal nerve Femoral nerve
The branching of the radial nerve into its deep and superficial divisions scanning from proximal to distal. Video courtesy of David Spinner (AVI 18332 kb)
The path of the median nerve from mid-forearm to the wrist. Video courtesy of David Spinner (AVI 21780 kb)
The ulnar nerve traversing the forearm from proximal to distal. Video courtesy of David Spinner (AVI 21781 kb)