scholarly journals Application of ultrasound guidance in the oral and maxillofacial nerve block

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12543
Author(s):  
Zhiwei Cao ◽  
Kun Zhang ◽  
Liru Hu ◽  
Jian Pan
Keyword(s):  
Nerve Block ◽  
Anterior Approach ◽  
Ultrasound Guidance ◽  
Anatomical Landmarks ◽  
Nerve Blocks ◽  
Anatomical Structures ◽  
Maxillary Nerve ◽  
Current Article ◽  
Nerve Localization ◽  
Oral And Maxillofacial Regions

Introduction Nerve block technology is widely used in clinical practice for pain management. Conventional nerve localization methods, which only rely on palpation to identify anatomical landmarks, require experienced surgeons and can be risky. Visualization technologies like ultrasound guidance can help prevent complications by helping surgeons locate anatomical structures in the surgical area and by guiding the operation using different kinds of images. There are several important and complex anatomical structures in the oral and maxillofacial regions. The current article reviews the application of ultrasound guidance in oral and maxillofacial nerve blocks. Methods We searched the literature on the use of ultrasound guidance for the main nerve block techniques in the oral and maxillofacial regions using both PubMed and MEDLINE and summarized the findings. Results and Discussion A review of the literature showed that ultrasound guidance improves the safety and effectiveness of several kinds of puncture procedures, including nerve blocks. There are two approaches to blocking the mandibular nerve: intraoral and extraoral. This review found that the role of ultrasound guidance is more important in the extraoral approach. There are also two approaches to the blocking of the maxillary nerve and the trigeminal ganglion under ultrasound guidance: the superazygomatic approach and the infrazygomatic approach. The infrazygomatic approach can be further divided into the anterior approach and the posterior approach. It is generally believed that the anterior approach is safer and more effective. This review found that the effectiveness and safety of most oral and maxillofacial nerve block operations can be improved through the use of ultrasound guidance.

Fluoroscopically guided mandibular nerve block: a modified lateral approach

2020 ◽  
Vol 45 (12) ◽  
pp. 1023-1025
Author(s):  
Jeffrey Jon Mojica ◽  
Vinay Kudur ◽  
Rudy Garza III ◽  
Maxim S Eckmann
Keyword(s):  
Nerve Block ◽  
Anterior Approach ◽  
Similar Efficacy ◽  
Lateral Approach ◽  
Mandibular Nerve ◽  
Anatomic Reconstruction ◽  
Nerve Blocks ◽  
Pterygoid Plate ◽  
Procedural Complications ◽  
Needle Trajectory

Background and objectivesMandibular nerve blocks are indicated for atypical face pain and trigeminal neuralgia. We hypothesized that a modified lateral approach, which entailed a combination of lateral and anterior approach techniques to the mandibular nerve block would lead to similar efficacy and improved safety profile rather than the typical lateral or anterior techniques.MethodsThis alternative approach was derived from anatomical investigation using the Radiology Anatomy Atlas Viewer and reconstructed axial cadaveric slices. We used axial slices at the level of the lateral pterygoid plate, and at the level of the temporomandibular joint to devise a needle path appropriate for this block.ResultsThe modified lateral approach to the mandibular nerve block was verified theoretically through cadaveric reconstructed slices and has been successfully performed in our practice. Precise needle trajectory could avoid both periosteal contact and gross redirection, as well as other procedural complications.ConclusionThe modified lateral approach to a mandibular nerve block avoids the respective risks associated with either the lateral and anterior approach. Facial intervention techniques typically pose increased safety challenges, however through cadaveric anatomic reconstruction, we have developed a safer approach for mandibular nerve blockade.

scholarly journals Double axillary vein variation diagnosed with ultrasound guidance during infraclavicular nerve block intervention

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-227495
Author(s):  
Başak Altıparmak ◽  
Melike Korkmaz Toker ◽  
Ali İhsan Uysal ◽  
Semra Gümüş Demirbilek
Keyword(s):  
Nerve Block ◽  
Ultrasound Guidance ◽  
Peripheral Nerve Block ◽  
Anaesthetic Management ◽  
Detailed Knowledge ◽  
Axillary Vein ◽  
Nerve Blocks ◽  
Different Types ◽  
Axillary Anatomy ◽  
Peripheral Block

The use of ultrasound guidance increases the safety of peripheral block interventions by allowing anaesthesiologists to simultaneously see the position of block needle, the targeted nerves and surrounding vessels. In this report, we represented three patients diagnosed with double axillary vein variation with ultrasound guidance during infraclavicular nerve block intervention. The patients were scheduled for different types of upper limb surgeries. All patients received infraclavicular nerve block for anaesthetic management. A double axillary vein variation was diagnosed with ultrasound during block interventions. Hydro-location technique was used in all cases and the procedures were completed uneventfully. In the current literature, there is limited number of reports concerning double axillary vein variation. Detailed knowledge of the axillary anatomy is important to avoid complications such as intravascular injection during peripheral nerve block interventions. The use of ultrasound guidance and hydro-location technique should be considered for nerve blocks, especially in the axillary area.

Anatomical landmarks for maxillary nerve block in the pterygopalatine fossa: A radiological study

2017 ◽  
Vol 118 (2) ◽  
pp. 90-94 ◽  
Author(s):  
S. Carrier ◽  
B. Castagneyrol ◽  
L. Beylacq ◽  
K. Nouette-Gaulain ◽  
M. Montaudon ◽  
...  
Keyword(s):  
Nerve Block ◽  
Pterygopalatine Fossa ◽  
Anatomical Landmarks ◽  
Radiological Study ◽  
Maxillary Nerve ◽  
Maxillary Nerve Block

scholarly journals Ultrasound-guided deep nerve block may increase the rate of local anesthetics toxicity in HBV carriers: A Randomized clinical trial

2019 ◽  
Author(s):  
Xu-hao Zhang ◽  
Yu-jie Li ◽  
Wenquan He ◽  
Chunyong Yang ◽  
Jianteng Gu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Nerve Block ◽  
Nerve Stimulation ◽  
Local Anesthetics ◽  
Ultrasound Guidance ◽  
Female Gender ◽  
Hbv Infection ◽  
Nerve Stimulator ◽  
Nerve Blocks

Abstract Background: Ultrasound-guidance might decrease the incidence of local anesthetics systemic toxicity(LAST) for many peripheral nerve blocks compared to nerve stimulation. However, it remained uncertain whether ultrasound-guidance would be superior to the nerve stimulation for deep nerve block in the lower extremity. This study was designed to investigate that deep nerve block with ultrasound-guidance would result in a lower rate of LAST comparing to that with nerve stimulator-guidance. Methods: Three hundred patients who were for elective lower limb surgery and desiring lumbar plexus blocks(LPBs) and sciatic nerve blocks(SNBs) were enrolled in this study. Patients were randomly assigned to receive LPB and SNB with ultrasound-guidance (Group U), nerve stimulator-guidance (Group N) and dual-guidance (Group M). The primary outcome was the incidence of the LAST. The secondary outcomes were number of needle redirections, motor and sensory block onset and restoration times in the nerve distributions, and associated risk factors. Results: There were 18 patients with the LAST, including 12 in group U, 4 in group N and 2 in group M. For multiple comparisons among the tree groups, we found that the incidence of LAST in group U(12%) was significantly higher than that in group N(4%)(P=0.037) and group M(2%)(P=0.006). The OR of LAST with HBV infection and female gender was 3.352(95% CI,1.233-9.108, P=0.013 ) and 9.488(95% CI,2.142-42.093, P=0.0004), respectively. Conclusions: For patients undergoing LPBs and SNBs, use of ultrasound may increase the incidence of the LAST. HBV infection and female gender were risk factors for deep nerve block. Trial registration: This study was approved by the human research review committee at the southwest hospital of third military medical university. The protocol was registered prospectively with Chinese Clinical Trial Registry (ChiCTR-IOR-16008099) on March 15th，2016. Keywords: Ultrasound; nerve stimulation; nerve block; female; HBV; LAST

Refining the rat sciatic nerve block: a novel ultrasound-guided technique

2021 ◽  
pp. 002367722110346
Author(s):  
Scott Hughey ◽  
Donald Campbell ◽  
Kamala Rapp-Santos ◽  
Jacob Cole ◽  
Gregory Booth ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Ultrasound Guidance ◽  
Sciatic Nerve Block ◽  
Sprague Dawley ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Translational Studies ◽  
Translational Models ◽  
Nerve Staining

Murine translational models are an important tool to understand pain pathophysiology. One procedure used frequently in murine research is the sciatic nerve block. This study sought to demonstrate the use of ultrasound-guided sciatic nerve block in a cadaveric murine model. A total of 40 injections were performed in 20 Sprague–Dawley male 18-month-old rat cadavers. Necropsy was performed to identify staining of the sciatic nerve. Staining with methylene blue occurred in 40 of 40 ultrasound-guided injections. The extremely accurate nature of this block under ultrasound guidance is favorable for future translational studies in rats undergoing sciatic nerve blocks. This method may represent a significant improvement in current methods.

A New Anterior Approach to the Sciatic Nerve Block 

1999 ◽  
Vol 91 (6) ◽  
pp. 1655-1655 ◽  
Author(s):  
Jacques E. Chelly ◽  
Laurent Delaunay
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Anterior Approach ◽  
Peroneal Nerve ◽  
Tibial Nerve ◽  
Common Peroneal Nerve ◽  
Sensory Block ◽  
Pubic Symphysis ◽  
Sciatic Nerve Block ◽  
Nerve Blocks

Background Although several anterior approaches to sciatic nerve block have been described, they are used infrequently. The authors describe a new anterior approach that allows access to the sciatic nerve with the patient in the supine position. Method Sciatic nerve blocks were performed in 22 patients. A line was drawn between the inferior border of the anterosuperior iliac spine and the superior angle of the pubic symphysis tubercle. Next, a perpendicular line bisecting the initial line was drawn and extended 8 cm caudad. The needle was inserted perpendicularly to the skin, and the sciatic nerve was identified at a depth of 10.5 cm (9.5-13.5 cm; median and range) using a nerve stimulator and a 15-cm b-beveled insulated needle. After appropriate localization, either 30 ml mepivacaine, 1.5% (group 1 = knee arthroscopy; n = 16), or 15 ml mepivacaine, 1.5%, plus 15 ml ropivacaine, 0.75%, (group 2 = other procedures; n = 6) was injected. Results Appropriate landmarks were determined within 1.3 min (0.5-2.0 min). The sciatic nerve was identified in all patients within 2.5 min (1.2-5 min), starting from the beginning of the appropriate landmark determination to the stimulation of its common peroneal nerve component in 13 cases and its tibial nerve component in 9 cases. A complete sensory block in the distribution of both the common peroneal nerve component and the tibial nerve component was obtained within 15 min (5-30 min). A shorter onset was observed in patients who received mepivacaine alone compared with those who received a mixture of mepivacaine plus ropivacaine (10 min [5-25 min] vs. 20 min [10-30 min]; P < 0.05). Recovery time was 4.6 h (2.5-5.5 h) after mepivacaine administration. The addition of ropivacaine produced a block of a much longer duration 13.8 h (5.2-23.6 h); P < 0.05. No complications were observed. Conclusions This approach represents an easy and reliable anterior technique for performing sciatic nerve blocks.

scholarly journals Combined Ultrasound and Nerve Stimulator-Guided deep nerve block may decrease the rate of local anesthetics systemic toxicity especially in HBV carriers: A Randomized clinical trial

2019 ◽  
Author(s):  
Xu-hao Zhang ◽  
Yu-jie Li ◽  
Wenquan He ◽  
Chunyong Yang ◽  
Jianteng Gu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Nerve Block ◽  
Local Anesthetics ◽  
Ultrasound Guidance ◽  
Female Gender ◽  
Hbv Infection ◽  
Nerve Stimulator ◽  
Nerve Blocks ◽  
Associated Risk Factors

Abstract Background: Ultrasound-guidance might decrease the incidence of local anesthetics systemic toxicity(LAST) for many peripheral nerve blocks compared with nerve stimulator-guidance. However, it remained uncertain whether ultrasound-guidance would be superior to the nerve stimulator-guidance for deep nerve block in the lower extremity. This study was designed to investigate that whether ultrasound-guided deep nerve block would decrease the incidence of LAST comparing with those with nerve stimulator-guidance, and to find out associated risk factors for LAST. Methods: Three hundred patients for elective lower limb surgery and desiring lumbar plexus blocks(LPBs) and sciatic nerve blocks(SNBs) were enrolled in this study. Patients were randomly assigned to receive LPBs and SNBs with ultrasound-guidance (Group U), nerve stimulator-guidance (Group N) or dual-guidance (Group M). The primary outcome was the incidence of the LAST. The secondary outcomes were the number of needle redirection, motor and sensory block onset and restoration time in the nerve distributions, and associated risk factors. Results: There were 18 patients occurring with LAST, including 12 in group U, 4 in group N and 2 in group M. For multiple comparisons among the three groups, we found that the incidence of LAST in group U(12%) was significantly higher than that in group N(4%)(P=0.037) and group M(2%)(P=0.006). The OR of LAST with hepatitis B （HBV） infection and female gender were 3.352(95% CI,1.233-9.108, P=0.013 ) and 9.488(95% CI,2.142-42.093, P=0.0004), respectively. Conclusions: Ultrasound-guidance, HBV infection and female gender were risk factors for LAST in LPBs and SNBs. For patients with HBV infection or female gender undergoing LPBs and SNBs, we recommended that combined ultrasound and nerve stimulator-guidance should be used to improve the safety. Trial registration: This study was approved by the Ethical Committee from the first affiliated hospital of Army Medical University. The protocol was registered prospectively with Chinese Clinical Trial Registry (ChiCTR-IOR-16008099) on March 15th，2016. Key words: ultrasound; nerve stimulation; nerve block; female; HBV; LAST

scholarly journals Combined Ultrasound and Nerve Stimulator-Guided deep nerve block may decrease the rate of local anesthetics systemic toxicity: A Randomized clinical trial

2019 ◽  
Author(s):  
Xu-hao Zhang ◽  
Yu-jie Li ◽  
Wenquan He ◽  
Chunyong Yang ◽  
Jianteng Gu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Nerve Block ◽  
Local Anesthetics ◽  
Ultrasound Guidance ◽  
Systemic Toxicity ◽  
Hbv Infection ◽  
Nerve Stimulator ◽  
Nerve Blocks ◽  
Associated Risk Factors

Abstract Background: Ultrasound guidance might decrease the incidence of local anesthetics systemic toxicity (LAST) for many peripheral nerve blocks compared with nerve stimulator guidance. However, it remains uncertain whether ultrasound guidance is superior to nerve stimulator guidance for deep nerve block of the lower extremity. This study was designed to investigate whether deep nerve block with ultrasound guidance would decrease the incidence of LAST compared with that with nerve stimulator guidance and to identify associated risk factors of LAST. Methods: Three hundred patients undergoing elective lower limb surgery and desiring lumbar plexus blocks (LPBs) and sciatic nerve blocks (SNBs) were enrolled in this study. The patients were randomly assigned to receive LPBs and SNBs with ultrasound guidance (group U), nerve stimulator guidance (group N) or dual guidance (group M). The primary outcome was the incidence of LAST. The secondary outcomes were the number of needle redirections, motor and sensory block onset and nerve distribution restoration time, as well as associated risk factors. Results: There were 18 patients with LAST, including 12 in group U, 4 in group N and 2 in group M. By multiple comparisons among the three groups, we found that the incidence of LAST in group U (12%) was significantly higher than that in group N (4%) (P=0.037) and group M (2%) (P=0.006). The OR of LAST with hepatitis B (HBV) infection and the female sex was 3.352 (95% CI, 1.233-9.108, P=0.013) and 9.488 (95% CI, 2.142-42.093, P=0.0004), respectively. Conclusions: Ultrasound guidance, HBV infection and the female sex were risk factors of LAST with LPBs and SNBs. For patients infected with HBV or female patients receiving LPBs and SNBs, we recommended that combined ultrasound and nerve stimulator guidance should be used to improve the safety. Trial registration: This study was approved by the Ethical Committee of the First Affiliated Hospital of Army Medical University. The protocol was registered prospectively with the Chinese Clinical Trial Registry (ChiCTR-IOR-16008099) on March 15, 2016.

scholarly journals Compuflo®-Assisted Performance of a Maxillary Nerve Block in Horses: Evaluation of a Novel Technology as a Training Tool and Guide in Clinical Practice

2020 ◽  
Vol 4 (1) ◽  
pp. 1-7
Author(s):  
Klaus Hopster ◽  
Keyword(s):  
Clinical Practice ◽  
Nerve Block ◽  
Nerve Blocks ◽  
Training Tool ◽  
Maxillary Nerve ◽  
Novel Technology ◽  
Maxillary Nerve Block

The CompuFlo®-device provides value as training tool for veterinary professionals learning to execute maxillary nerve blocks. Further research is warranted to determine its true benefits in equine dentistry practice.

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