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.

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.

scholarly journals Daring discourse: are we ready to recommend neuraxial anesthesia and peripheral nerve blocks during the COVID-19 pandemic? A pro-con

2020 ◽  
Vol 45 (10) ◽  
pp. 831-834
Author(s):  
Michael N Singleton ◽  
Ellen M Soffin
Keyword(s):  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Patient Outcomes ◽  
Pain Therapy ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Risks And Benefits ◽  
American Society ◽  
Improve Patient ◽  
Regional Anesthetic

The recent joint statement from the American Society of Regional Anesthesia and Pain Medicine (ASRA) and the European Society of Regional Anesthesia and Pain Therapy (ESRA) recommends neuraxial and peripheral nerve blocks for patients with coronavirus disease 2019 (COVID-2019) illness. The benefits of regional anesthetic and analgesic techniques on patient outcomes and healthcare systems are evident. Regional techniques are now additionally promoted as a mechanism to reduce aerosolizing procedures. However, caring for patients with COVID-19 illness requires rapid redefinition of risks and benefits—both for patients and practitioners. These should be fully considered within the context of available evidence and expert opinion. In this Daring Discourse, we present two opposing perspectives on adopting the ASRA/ESRA recommendation. Areas of controversy in the literature and opportunities for research to address knowledge gaps are highlighted. We hope this will stimulate dialogue and research into the optimal techniques to improve patient outcomes and ensure practitioner safety during the pandemic.

scholarly journals Lower extremity regional anesthesia: essentials of our current understanding

2019 ◽  
Vol 44 (2) ◽  
pp. 143-180 ◽  
Author(s):  
De Q Tran ◽  
Francis V Salinas ◽  
Honorio T Benzon ◽  
Joseph M Neal
Keyword(s):  
Lower Extremity ◽  
Regional Anesthesia ◽  
Lower Limb ◽  
Ultrasound Guidance ◽  
Evidence Based ◽  
Nerve Blocks ◽  
Pharmacological Agents ◽  
Current Review ◽  
American Society ◽  
Selection Of

The advent of ultrasound guidance has led to a renewed interest in regional anesthesia of the lower limb. In keeping with the American Society of Regional Anesthesia and Pain Medicine’s ongoing commitment to provide intensive evidence-based education, this article presents a complete update of the 2005 comprehensive review on lower extremity peripheral nerve blocks. The current review article strives to (1) summarize the pertinent anatomy of the lumbar and sacral plexuses, (2) discuss the optimal approaches and techniques for lower limb regional anesthesia, (3) present evidence to guide the selection of pharmacological agents and adjuvants, (4) describe potential complications associated with lower extremity nerve blocks, and (5) identify informational gaps pertaining to outcomes, which warrant further investigation.

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.

Ultrasound Guided Nerve Blocks for Lower Extremity

2021 ◽  
pp. 149-160
Author(s):  
Christopher M. Harmon ◽  
Kelly S. Davidson ◽  
Erik Helander ◽  
Matthew R. Eng ◽  
Alan David Kaye
Keyword(s):  
Lower Extremity ◽  
Ultrasound Guided ◽  
Nerve Blocks
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