Ultrasound Guided Regional Anesthesia

2016 ◽  
Keyword(s):  
Regional Anesthesia ◽  
Patient Positioning ◽  
Needle Insertion ◽  
Clinical Anatomy ◽  
Ultrasound Images ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Basic Principles ◽  
Quadratus Lumborum ◽  
Out Of Plane

This clinically based, comprehensive textbook provides a detailed description of the most useful nerve blocks in ultrasound guided regional anesthesia. Four sections cover Basic Principles (including an appendix, “What Block for What Surgery?), Upper Limb Blocks, Lower Limb Blocks, and Trunk and Spine Blocks. The initial chapter provides a review of ultrasound physics that allows the practitioner to understand how to optimize the ultrasound machine to produce the best ultrasound images possible. This foundation, along with the clinical tips and step-by-step techniques for in-plane and out-of-plane needle guidance, make this instructive text useful for practitioners at all levels. The first chapter also includes seven Keys to Ultrasound Success and concludes with a clinical summary of which blocks to perform for specific surgeries or trauma situations. The specific blocks covered in the remaining chapters range from the classic femoral, interscalene, popliteal sciatic, and axillary blocks to more novel blocks such as the adductor canal, selective suprascapular, quadratus lumborum, and PECS blocks. Each block description includes a review of clinical anatomy, indications, positioning, and a step-by-step approach to ultrasound imaging and needle insertion. Ultrasound images are provided in both an unedited, clean version and a companion version that is clearly labeled, allowing the reader to compare the images side by side. Throughout the book, comprehensive photographs of ultrasound images, cadaver dissections, and patient positioning are provided, with vibrant, colorful annotations that significantly add to the clarity of instruction provided.

Trunk and Spine Ultrasound Guided Regional Anesthesia

2016 ◽  
Author(s):  
Stuart A. Grant ◽  
David B Auyong
Keyword(s):  
Regional Anesthesia ◽  
Rectus Sheath ◽  
Transversus Abdominis ◽  
Clinical Anatomy ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Risks And Benefits ◽  
Quadratus Lumborum ◽  
Tools And Techniques

This chapter describes the clinical anatomy and outlines the tools and techniques needed to perform thoracic, abdominal and neuraxial ultrasound-guided procedures. The nerve blocks described here include the transversus abdominis plane (TAP), quadratus lumborum, ilioinguinal-iliohypogastric, rectus sheath, intercostal, PECS, serratus plane, paravertebral, and neuraxial spinal and epidural blocks. For each nerve block, the indications, risks, and benefits of the varying approaches are described in detail. The chapter includes step-by-step instructions with illustrations to allow the operator to perform clinically effective and safe ultrasound-guided thoracic, truncal, and neuraxial procedures. At the conclusion of each block description, a “Pearls” segment highlights important tips gleaned from our clinical experience. This chapter provides the practitioner with thorough instruction and knowledge allowing the optimal delivery of regional anesthesia for any thoracic or abdominal surgery.

Upper Limb Ultrasound Guided Regional Anesthesia

2016 ◽  
Author(s):  
Stuart A. Grant ◽  
David B Auyong
Keyword(s):  
Upper Extremity ◽  
Regional Anesthesia ◽  
Nerve Block ◽  
Upper Limb ◽  
Clinical Anatomy ◽  
Ultrasound Guided ◽  
Cervical Plexus ◽  
Nerve Blocks ◽  
Risks And Benefits ◽  
Tools And Techniques

This chapter describes the clinical anatomy and outlines the tools and techniques needed to perform upper extremity ultrasound-guided nerve blocks. The nerve blocks above the clavicle described here include the interscalene, dorsal scapular, suprascapular, cervical plexus, and supraclavicular blocks. Nerve blocks below the clavicle described here include the infraclavicular and axillary blocks and distal blocks at the wrist and elbow. For each nerve block, the indications, risks, and benefits of the varying approaches are described in detail. The chapter includes step-by-step instructions with illustrations, including cadaver dissections, to allow the operator to perform clinically effective and safe ultrasound-guided upper extremity regional anesthesia. At the conclusion of each block description, a “Pearls” segment highlights important tips gained from our clinical experience. This chapter provides the practitioner with thorough instruction and knowledge allowing optimal delivery of regional anesthesia for any upper extremity surgery or trauma.

Basic Principles of Ultrasound Guided Nerve Block

2016 ◽  
Author(s):  
Stuart A. Grant ◽  
David B Auyong
Keyword(s):  
Regional Anesthesia ◽  
Nerve Block ◽  
Point Of Care ◽  
Ultrasound Images ◽  
Needle Guidance ◽  
Ultrasound Guided ◽  
Out Of Plane ◽  
Care Systems ◽  
Clinical Description ◽  
Guidance Technique

This chapter provides a clinical description of ultrasound physics tailored to provide the practitioner a solid background for optimal imaging and needle guidance technique during regional anesthesia. Important ultrasound characteristics are covered, including optimization of ultrasound images, transducer selection, and features found on most point-of-care systems. In-plane and out-of-plane needle guidance techniques and a three-step process for visualizing in-plane needle insertions are presented. Next, common artifacts and errors including attenuation, dropout, and intraneural injection are covered, along with clinical solutions to overcome these inaccuracies. Preparation details are reviewed to make the regional anesthesia procedures as reproducible and safe as possible. Also included are a practical review of peripheral nerve block catheter placement principles, an appendix listing what blocks may be used for what surgeries, and seven Keys to Ultrasound Success that can make ultrasound guided regional anesthesia understandable and clinically feasible for all practitioners.

Lower Limb Ultrasound Guided Regional Anesthesia

2016 ◽  
Author(s):  
Stuart A. Grant ◽  
David B Auyong
Keyword(s):  
Lower Extremity ◽  
Regional Anesthesia ◽  
Lower Limb ◽  
Clinical Anatomy ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Adductor Canal ◽  
Risks And Benefits ◽  
Tools And Techniques ◽  
Regional Anesthetic

This chapter describes the clinical anatomy relevant to the lower extremities and outlines the tools and techniques used to perform lower extremity ultrasound-guided nerve blocks. The nerve blocks described here include the femoral, lateral femoral cutaneous, adductor canal (selective femoral), saphenous, obturator, lumbar plexus, sciatic (proximal, anterior, and popliteal approaches), (iPACK) and ankle blocks. For each nerve block, the indications, risks, and benefits of the varying approaches are described in detail. The chapter includes step-by-step instructions with illustrations, including cadaver dissections, to allow the operator to perform clinically effective and safe ultrasound-guided lower extremity regional anesthesia. At the conclusion of each block description, a “Pearls” segment highlights important tips gleaned from our clinical experience. This chapter provides the practitioner with thorough instruction and knowledge allowing optimal delivery of regional anesthetic for any lower extremity surgery or trauma.

scholarly journals Ultrasound Imaging for Regional Anesthesia in Infants, Children, and Adolescents

2010 ◽  
Vol 112 (2) ◽  
pp. 473-492 ◽  
Author(s):  
Ban C. H. Tsui ◽  
Santhanam Suresh ◽  
David S. Warner
Keyword(s):  
Peripheral Nerve ◽  
Children And Adolescents ◽  
Regional Anesthesia ◽  
Ultrasound Images ◽  
Ultrasound Probe ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Anatomy And Physiology ◽  
Randomized Controlled

The use of ultrasound guidance has provided an opportunity to perform many peripheral nerve blocks that would have been difficult to perform in children based on pure landmark techniques due to the potential for injection into contiguous sensitive vascular areas. This review article provides the readers with techniques on ultrasound-guided peripheral nerve blocks of the extremities and trunk with currently available literature to substantiate the available evidence for the use of these techniques. Ultrasound images of the blocks with corresponding line diagrams to demonstrate the placement of the ultrasound probe have been provided for all the relevant nerve blocks in children. The authors hope that this review will stimulate further research into ultrasound-guided regional anesthesia in infants, children, and adolescents and stimulate more randomized controlled trials to provide a greater understanding of the anatomy and physiology of regional anesthesia in pediatrics.

Ultrasound-Guided Model Predictive Control of Needle Steering in Biological Tissue

2016 ◽  
Vol 01 (01) ◽  
pp. 1640007 ◽  
Author(s):  
Mohsen Khadem ◽  
Carlos Rossa ◽  
Ron S. Sloboda ◽  
Nawaid Usmani ◽  
Mahdi Tavakoli
Keyword(s):  
Biological Tissue ◽  
Tracking System ◽  
Maximum Error ◽  
Needle Insertion ◽  
Steering System ◽  
Ultrasound Images ◽  
Ultrasound Guided ◽  
Needle Steering ◽  
Needle Deflection ◽  
Main Components

In needle-based medical procedures, beveled tip flexible needles are steered inside soft tissue to reach the desired target locations. In this paper, we have developed an autonomous image-guided needle steering system that enhances targeting accuracy in needle insertion while minimizing tissue trauma. The system has three main components. First is a novel mechanics-based needle steering model that predicts needle deflection and accepts needle tip rotation as an input for needle steering. The second is a needle tip tracking system that determines needle deflection from the ultrasound images. The needle steering model employs the estimated needle deflection at the present time to predict needle tip trajectory in the future steps. The third component is a nonlinear model predictive controller (NMPC) that steers the needle inside the tissue by rotating the needle beveled tip. The MPC controller calculates control decisions based on iterative optimization of the predictions of the needle steering model. To validate the proposed ultrasound-guided needle steering system, needle insertion experiments in biological tissue phantoms are performed in two cases–with and without obstacle. The results demonstrate that our needle steering strategy guides the needle to the desired targets with the maximum error of 2.85[Formula: see text]mm.

Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade

2010 ◽  
Author(s):  
James Hebl ◽  
Robert Lennon
Keyword(s):  
Regional Anesthesia ◽  
Mayo Clinic ◽  
Detailed Knowledge ◽  
Ultrasound Images ◽  
Ultrasound Guided ◽  
Acute Pain Management ◽  
Reliable Identification ◽  
Nerve Blockade ◽  
Applied Anatomy ◽  
Variant Anatomy

Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade is a practical guide for residents-in-training and clinicians to gain greater familiarity with regional anesthesia and acute pain management to the upper and lower extremity. It emphasizes the importance of a detailed knowledge of applied anatomy to safely and successfully performing regional anesthesia. It also provides and overview of the emerging field of ultrasound-guided regional anesthesia, which allows reliable identification of both normal and variant anatomy. Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade contains more than 200 beautifully illustrated anatomic images important to understanding and performing regional anesthesia. Corresponding ultrasound images are provided when applicable.

scholarly journals A Novel Plant Based Ultrasound Phantom

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Shiv Kumar Singh ◽  
Tuhin Mistry
Keyword(s):  
Regional Anaesthesia ◽  
Low Cost ◽  
Aloe Vera ◽  
Needle Insertion ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Aloe Barbadensis ◽  
Animal Products ◽  
Other Substances ◽  
Ultrasound Phantom

Introduction In most of the ultrasound guided regional anaesthesia workshops, anaesthesiologists usually concentrate on identification of nerves & plexus on human volunteers and practice needling techniques on phantom. Proper needle insertion technique and correct manipulation are two important skills for ultrasound-guided peripheral nerve blocks. These skills can be sharpened by practicing on ultrasound phantom. It also helps anaesthesiologists to develop, practice and maintain the skills needed for regional anaesthesia and vascular access procedures [1]. But the use of phantoms is often limited due to the cost of the blue phantom [2]. Many courses use meat-based products like turkey legs or porcine models but these may not be acceptable to everyone [3,4]. Vegetable based models using gelatine also may not be acceptable as it too is made from animal products. We describe novel use of Aloe Vera (AV)stem as phantom for US guided needling training. This natural AV gel-based phantom can be used for scanning, needling and refine other relevant skills. The AV phantom can be constructed from low cost, readily available natural source and is reusable. Various materials have been used to make ultrasound training phantoms. Commercially available phantoms are expensive and homemade nerve block models are cumbersome to prepare [5]. The Aloe Vera gel is obtained from Aloe Vera plant (Aloe barbadensis miller). It is a natural product which has been used for centuries in various field specially in dermatology. Aloe Vera leaves are triangular and fleshy with serrated edges. Each leaf contains an inner clear gel which is made of 99% water and other substances (glucomannans, amino acids, lipids, sterols and vitamins) [6]. Aloe Vera is odorless and semi-transparent unlike meat-based models. Preparing the Aloe Vera US Model The covering of the leaves is non-echogenic and hence the pulp from Aloe Vera leaves is separated and placed in layers and covered with a Transparent Dressing(Te

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