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Essential Knobology for Ultrasound-Guided Regional Anesthesia and Interventional Pain Management

  • Alan J. R. Macfarlane
  • Cyrus C. H. Tse
  • Richard Brull
Chapter

Abstract

The safety and efficacy of ultrasound (US)-guided nerve blockade relies heavily upon a comprehensive understanding of machine “knobology.”, Despite differences in appearance and layout, all US machines share the same basic operative functions that users must appreciate in order to optimize the image. While modern US machines offer an abundance of features, the basic functions that all operators should be familiar with are frequency and probe selection, depth, gain, time gain compensation (TGC), focus, preprogrammed presets, color Doppler, power Doppler, compound imaging, tissue harmonic imaging (THI) (on some models), and image freeze and acquisition. Once the physical principles of US are understood, it becomes clear that creating the “best” image is often a series of trade-offs between improving one function at the expense of another. Each of the aforementioned functions is presented in turn below, following the sequence we use when performing any US-guided intervention.

Keywords

Temporal Resolution Lateral Resolution Fresnel Zone Focal Zone High Frequency Wave 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Sites BD, Brull R, Chan VW, et al. Artifacts and pitfall errors associated with ultrasound-guided regional anesthesia. Part II: a pictorial approach to understanding and avoidance. Reg Anesth Pain Med. 2007;32:419–433.PubMedGoogle Scholar
  2. 2.
    Sites BD, Brull R, Chan VW, et al. Artifacts and pitfall errors associated with ultrasound-guided regional anesthesia. Part I: understanding the basic principles of ultrasound physics and machine operations. Reg Anesth Pain Med. 2007;32:412–418.PubMedGoogle Scholar
  3. 3.
    Brull R, Macfaulane AJ, Tse cc. Practical knobology for ultrasound-guided regional anesthesia. Reg Anesth Pain Med. 2010:35(2 suppl): S68–73.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Alan J. R. Macfarlane
  • Cyrus C. H. Tse
  • Richard Brull
    • 1
  1. 1.Department of AnesthesiaUniversity of Toronto, Toronto Western HospitalTorontoCanada

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