Skip to main content

Principles of Ultrasound Techniques

  • Chapter
  • First Online:
Essentials of Pain Management

Abstract

Surgery of the upper and lower extremity presents anesthesiologists with an alternative to general anesthesia (GA), that being regional anesthesia (RA). RA is most often performed for postoperative analgesia, but RA may also be utilized as the primary technique for intraoperative anesthesia under certain circumstances and with certain patients. For years, neuraxial techniques (spinal or epidural) have been used as the sole regional anesthetic of choice for the lower limb. The advent of low molecular weight heparins (i.e., enoxaparin, fondaparinux) and the potential risk for the development of neuraxial hematomas have limited neuraxial technique use and have led to a much higher use of peripheral nerve blocks (PNBs) in everyday practice. Since the mid-2000s, great improvements have been made in equipment used to perform PNB, including stimulating peripheral nerve catheters and the use of ultrasound to guide in the placement of RA and to assist in the identity of nerves and nerve plexus (Marhofer et al. 2007).

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003;97:534–40.

    Article  PubMed  Google Scholar 

  • Ballantyne JC, Carr DB, et al. The comparative effects of postoperative analgesic therapies on pulmonary outcome: cumulative meta-analyses of randomized, controlled trials. Anesth Analg 1998;86:598–612.

    Article  PubMed  CAS  Google Scholar 

  • Beattie WS, Badner NH, Choi P. Epidural analgesia reduces postoperative myocardial infarction: a meta-analysis. Anesth Analg. 2001;93:853–8.

    Article  PubMed  CAS  Google Scholar 

  • Bigeleisen P, Wilson M. A comparison of two techniques for ultrasound guided infraclavicular block. Br J Anaesth. 2006;96:502–7.

    Article  PubMed  CAS  Google Scholar 

  • Cash CJC, Sardesai AM, et al. Spatial mapping of the Brachial plexus using three-dimensional ultrasound. Br J Radiol. 2005;78:1086–94.

    Article  PubMed  CAS  Google Scholar 

  • Franco CD, Vieira ZE. 1,001 subclavian perivascular brachial plexus blocks: success with a nerve stimulator. Reg Anesth Pain Med. 2000 Jan–Feb;25(1):41–6.

    PubMed  CAS  Google Scholar 

  • Horlocker TT, Wedel DJ, et al. Regional anesthesia in the anticoagulated patient: defining the risks (the second ASRA Consensus Conference on Neuraxial Anesthesia and Anticoagulation). Reg Anesth Pain Med. 2003;28:172–97.

    PubMed  Google Scholar 

  • Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 2003;362:1921–8.

    Article  PubMed  Google Scholar 

  • Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet 2006;367:1618–25.

    Article  PubMed  Google Scholar 

  • Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg. 2002;183:630–41.

    Article  PubMed  Google Scholar 

  • Marhofer P, Chan VW, Marhofer P, Chan VWS. Ultrasound-guided regional anesthesia: current concepts and future trends. Anesth Analg. 2007;104:1265–9.

    Article  PubMed  Google Scholar 

  • Martin G, Lineberger CK, MacLeod DB, El-Moalem HE, Breslin DS, Hardman D, D’Ercole F. A new teaching model for resident training in regional anesthesia. Anesth Analg. 2002;95:1423–7.

    Article  PubMed  Google Scholar 

  • Reuben SS, Buvanendran A. Preventing the development of chronic pain after orthopaedic surgery with preventive multimodal analgesic techniques. J Bone Joint Surg. 2007;89: 1343–58.

    Article  PubMed  Google Scholar 

  • Rodgers A, Walker N, Schug S, McKee A, Kehlet H, van Zundert A, Sage D, Futter M, Saville G, Clark T, MacMahon S. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ 2000;321:1493.

    Article  PubMed  CAS  Google Scholar 

  • Schafhalter-Zoppoth I, Younger SJ, et al. The “seesaw” sign: improved sonographic identification of the sciatic nerve. Anesthesiology 2004;101:808–9.

    Article  PubMed  Google Scholar 

  • Silvestri E, Martinoli C, et al. Echotexture of peripheral nerves: correlation between US and histologic findings and criteria to differentiate tendons. Radiology 1995;197:291–6.

    PubMed  CAS  Google Scholar 

  • Sites, BD, Brull, R. Ultrasound guidance in peripheral regional anesthesia: philosophy, evidence-based medicine and techniques. Curr Opin Anaesthesiol. 2006;19:630–9.

    Article  PubMed  Google Scholar 

  • Urwin SC, Parker MJ, Griffiths R. General versus regional anesthesia for hip fracture surgery: a meta-analysis of randomized trials. Br J Anaesth. 2000;84:450–5.

    PubMed  CAS  Google Scholar 

  • Weinberg G. Lipid infusion resuscitation for local anesthetic toxicity: proof of clinical efficacy. Anesthesiology 2006a;105:7–8.

    Article  PubMed  Google Scholar 

  • Weinberg G. Lipid rescue resuscitation from local anaesthetic cardiac toxicity. Toxicol Rev. 2006b;25:139–45.

    Article  PubMed  CAS  Google Scholar 

  • Winnie AP, Collins VJ. The subclavian perivascular technique of brachial plexus anesthesia. Anesthesiology 1964;25:353–63.

    Article  PubMed  CAS  Google Scholar 

  • Wu CL, Hurley RW, Anderson GF, Herbert R, Rowlingson AJ, Fleisher LA. Effect of postoperative epidural analgesia on morbidity and mortality following surgery in medicare patients. Reg Anesth Pain Med. 2004;29:525–33.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Halaszynski, T. (2011). Principles of Ultrasound Techniques. In: Vadivelu, N., Urman, R., Hines, R. (eds) Essentials of Pain Management. Springer, New York, NY. https://doi.org/10.1007/978-0-387-87579-8_21

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-87579-8_21

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-87578-1

  • Online ISBN: 978-0-387-87579-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics