#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Ultrasound guidance in regional anaesthesia and interventional pain management


Authors: Michálek Pavel 1;  Mach Dušan 2;  Pokorný Lukáš 1;  Gabrhelík Tomáš 3
Authors‘ workplace: Department of Anaesthetics, Antrim Area Hospital, Antrim, United Kingdom 1;  Department of Anaesthesia, Royal Victoria Hospital, Belfast, United Kingdom 2;  Klinika anesteziologie a resuscitace, FN Olomouc, Česká republika 3
Published in: Anest. intenziv. Med., 21, 2010, č. 1, s. 7-13
Category: Anesthesiology - Review Article

Overview

The use of ultrasound guidance for regional anaesthesia and interventional pain management marked the start of a new era at the end of the last century. New portable ultrasound machines with high-frequency probes allow visualisation of even very small nerve structures. Ultrasound-guided blocks offer some potential advantages when compared with other techniques such as neurostimulation or anatomical landmarks: a precise, real-time location of the needle-nerve relationship, an evaluation of the local anaesthetic distribution and a decreased risk of inadvertent vascular puncture. In some blocks, ultrasound guidance has helped to decrease the amount of local anaesthetic, improve the quality of the block or speed up the onset of regional anaesthesia. Ultrasound guidance may be used not only for brachial plexus blockades and lower extremity regional techniques, but also with lower frequency probes for neuraxial blocks such as epidurals, subarachnoid blocks and paravertebral blocks. Other techniques in which ultrasound guidance may be of use include blocks of the fascial and muscular compartments – the rectus sheath block, transversus abdominis plane block and fascia iliaca block in the setting of postoperative pain management. Ultrasound guidance may also be helpful in some techniques used for chronic pain management. Catheters to the peripheral nerves as well as some sympathetic nerve blocks including stellate ganglion and coeliac plexus may be performed under ultrasound. Endosonography combines the principles of endoscopy and ultrasound and can be used for the transgastric block of the celiac plexus or blockade of the superior hypogastric plexus through the urinary bladder.

Keywords:
ultrasound guidance – plexus blocks – neuraxial blocks – pain treatment


Sources

1. Kapral, S., Krafft, P., Eibenberger, K., Fitzgerald, R., Gosch, M., Weinstabl, C. Ultrasound-guided supraclavicular approach for regional anesthesia of the brachial plexus. Anesth. Analg., 1994, 78, p. 507–513.

2. Liu, S. S., Ngeow, J. E., Yadeau, J. T. Ultrasound-guided regional anesthesia and analgesia. A qualitative systematic review. Reg. Anesth. Pain Med., 2009, 34, p. 47–59.

3. Marhofer, P., Chan, V. W. Ultrasound-guided regional anesthesia: current concepts and future trends. Anesth. Analg., 2007, 104, p. 1265–1269.

4. Marhofer, P. Ultrasound guidance for nerve blocks. Principles and practical implementation. Oxford University Press: New York, 2008, 146 p.

5. Sites, B. D., Brull, R., Chan, V. W., Spence, B. C., Gallagher, J., Beach, M. L., Sites, V. R., Hartman, G. S. 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, p. 412–418.

6. Soeding, P. E., Sha, S., Royse, C. E., Marks, P., Hoy, G., Royse, A. G. A randomized trial of ultrasound-guided brachial plexus anaesthesia in upper limb surgery. Anaesth. Intensive Care, 2005, 33, p. 719–725.

7. Perlas, A., Lobo, G., Lo, N., Brull, R., Chan, V. W., Karhanis, R. Ultrasound-guided supraclavicular block. Outcome of 510 consecutive cases. Reg. Anesth. Pain Med., 2009, 34, p. 171–176.

8. Williams, S. R., Chouinard, P., Arcand, G., Harris, P., Ruel, M., Boudreault, D., Girard, F. Ultrasound guidance speeds execution and improves the quality of supraclavicular block. Anesth. Analg., 2003, 97, p. 1518–1523.

9. Dingemans, E., Williams, S. R., Arcand, Chouinard, P., Harris, P., Ruel, M., Girard, F. Neurostimulation in ultrasound-guided infraclavicular block: a prospective randomized trial. Anesth. Analg., 2007, 104, p. 1275–1280.

10. Casati, A., Danelli, G., Baciarello, M., Corradi, M., Leone, S., DiCianni, S., Fanelli, G. A prospective, randomized comparison between ultrasound and nerve stimulation guidance for multiple injection axillary brachial plexus block. Anesthesiology, 2007, 106, p. 992–996.

11. Liu, F. C., Liou, J. T., Tsai, Y. F., Li, A. H., Day, Y. Y., Hui, Y. L., Lui, P. W. Efficacy of ultrasound-guided axillary brachial plexus block: a comparative study with nerve stimulator-guided method. Chang Gung Med. J., 2005, 28, p. 396–402.

12. Chan, V. W., Perlas, A., McCartney, C. J., Brull, R., Xu, D., Abbas, S. Ultrasound guidance improves success rate of axillary brachial plexus block. Can. J. Anaesth., 2007, 54, p. 176–182.

13. Sites, B. D., Beach, M. L., Spence, B. C., Wiley, C. W., Shiffrin, J., Hartman, G. S., Gallagher, J. D. Ultrasound guidance improves the success rate of a perivascular axillary plexus block. Acta Anaesthesiol. Scand., 2006, 50, p. 678–684.

14. Macaire, P., Singelyn, F., Narchi, P., Paqueron, X. Ultrasound or nerve stimulation-guided wrist blocks for carpal tunnel release: a randomized prospective comparative study. Reg. Anesth. Pain Med., 2008, 33, p. 363–368.

15. Nader, A., Malik, K. K., Kendall, M. C., Benzon, H., McCarthy, R. J. Relationship between ultrasound imaging and eliciting motor response during femoral nerve stimulation. J. Ultrasound Med., 2009, 28, p. 345–350.

16. Casati, A., Baciarello, M., DiCianni, S., Danelli, G., De Marco, G., Leone, S., Rossi, M., Fanelli, G. Effects of ultrasound guidance on the minimum effective anaesthetic volume required to block the femoral nerve. Br. J. Anaesth., 2007, 98, p. 823–827.

17. Domingo-Triado, V., Selfa, S., Martinez, F., Sanchez-Contreras, D., Roche, M., Tecles, J., Crespo, M. T., Palanca, J. M., Moro, B. Ultrasound guidance for lateral midfemoral sciatic nerve block: a prospective, comparative, randomized study. Anesth. Analg., 2007, 104, p. 1270–1274.

18. Sandeman, D. J., Griffiths, M. J., Lennox, A. F. Ultrasound guided deep cervical plexus block. Anaesth. Intensive Care, 2006, 34, p. 240–244.

19. Hakl, M., Michalek, P., Ševčík, P., Pavlíková, J., Stern, M. Regional anaesthesia for carotid endarterectomy: an audit over 10 years. Br. J. Anaesth., 2007, 99, p. 415–420.

20. Pandit, J. J., Satya-Krishna, R., Gration, P. Superficial or deep cervical plexus block for carotid endarterectomy: a systematic review of complications. Br. J. Anaesth., 2007, 99, p. 159–169.

21. Grau, T., Leipold, R. W., Conradi, R., Martin, E., Motsch, J. Efficacy of ultrasound imaging in obstetric epidural anesthesia. J. Clin. Anesth., 2002, 14, p. 169–175.

22. Grau, T., Leipold, R. W., Conradi, R., Martin, E. Ultrasound control for presumed difficult epidural puncture. Acta Anaesthesiol. Scand., 2001, 45, p. 766–771.

23. National Institute for Health and Excellence. Ultrasound-guided catheterisation of the epidural space. IPG249, 2008. Dostupné na WWW: www.nice.org.uk

24. Chen, C. P. C., Tang, S. F. T., Hsu, T., Tsai, W. C., Liu, H. P., Chen, M. J., Date, E., Lew, H. L. Ultrasound guidance in caudal epidural needle placement. Anesthesiology, 2004, 101, p. 181–184.

25. Luyet, C., Eichenberger, U., Greif, R., Vogt, A., Szucs Farkas, Z., Moriggl, B. Ultrasound-guided paravertebral puncture and placement of catheters in human cadavers: an imaging study. Br. J. Anaesth., 2009, 102, p. 534–539.

26. Hara, K., Sakura, S., Nomura, T., Saito, Y. Ultrasound guided thoracic paravertebral block in breast surgery. Anaesthesia, 2009, 64, p. 223–225.

27. McDonnell, J. G., O’Donnell, B. D., Farrell, T., Gough, N., Tuite, D., Power, C., Laffey, J. G. Transversus abdominis plane block: a cadaveric and radiological evaluation. Reg. Anesth. Pain Med., 2007, 32, p. 399–404.

28. Tran, T. M., Ivanusic, J. J., Hebbard, P., Barrington, M. J. Determination of spread of injectate after ultrasound-guided transversus abdominis plane block: a cadaveric study. Br. J. Anaesth., 2009, 102, p. 123–127.

29. Willschke, H., Bosenberg, A., Marhofer, P., Johnston, S., Kettner, S. C., Wanzel, O., Kapral, S. Ultrasonography-guided rectus sheath block in paediatric anaesthesia – a new approach to an old technique. Br. J. Anaesth., 2006, 97, p. 244–249.

30. Willschke, H., Marhofer, P., Bosenberg, A., Johnston, S., Wanzel, O., Cox, S. G., Sitzwohl, C., Kapral, S. Ultrasonography for ilioinguinal/iliohypogastric nerve blocks in children. Br. J. Anaesth., 2005, 95, p. 226–230.

31. Kapral, S., Krafft, P., Gosch, M., Fleischmann, D., Weinstabl, C. Ultrasound imaging for stellate ganglion block: direct visualisation of puncture site and local anesthetic spread. A pilot study. Reg. Anesth., 1995, 20, p. 323–328.

32. Eichenberger, U., Greher, M., Kapral, S., Marhofer, P., Wiest, R., Remonda, L., Bogduk, N., Curatolo, M. Sonographic visualization and ultrasound guided block of the third occipital nerve. Anesthesiology, 2006, 104, p. 303–308.

33. Shim, J. K., Moon, J. C., Yoon, K. B., Kim, W. O., Yoon, D. M. Ultrasound-guided lumbar median-branch block: a clinical study with fluoroscopy control. Reg. Anesth. Pain Med., 2006, 31, p. 451–454.

34. Michalek, P., Kautznerova, D. Combined use of ultrasonography and neurostimulation for therapeutic phrenic nerve block. Reg. Anesth. Pain Med., 2002, 27, p. 306–308.

35. Bhatnagar, S., Gupta, D., Mishra, S., Thulkar, S., Chauhan, H. Bedside ultrasound-guided celiac plexus neurolysis with bilateral paramedian needle entry technique can be an effective pain control technique in advanced upper abdominal cancer pain. J. Palliat. Med., 2008, 11, p. 1195–1199.

36. Giménez, A., Martínez-Noguera, A., Donoso, L., Catalá, E., Serra, R. Percutaneous neurolysis of the celiac plexus via the anterior approach with sonographic guidance. Am. J. Roentgenol., 1993, 161, p. 1061–1063.

37. Wiersema, M. J., Wong, G. Y., Croghan, G. A. Endoscopic technique with ultrasound imaging for neurolytic celiac plexus block. Reg. Anesth. Pain Med., 2001, 26, p. 159–163.

38. Michalek, P., Dutka, J. Computed tomography-guided anterior approach to the superior hypogastric plexus for non-cancer pelvic pain: a report of two cases. Clin. J. Pain, 2005, 21, p. 553–556.

39. Mishra, S., Bhatnagar, S., Gupta, D., Thulkar, S. Anterior ultrasound-guided superior hypogastric plexus neurolysis in pelvic cancer pain. Anaesth. Intensive Care, 2008, 36, p. 732–735.

40. Ayub, K. Endoscopic ultrasound-guided superior hypogastric plexus neurolysis: a new technique for the management of pelvic pain. Gastrointest. Endosc., 2002, 56, p. S143.

41. Urmey, W. F., Stanton, J. Inability to consistently elicit a motor response following sensory paresthesia during interscalene block administration. Anesthesiology, 2002, 96, p. 552–554.

42. Robards, C., Hadzic, A., Somasundaram, L., Iwata, T., Gadsden, J., Xu, D., Sala-Blanch, X. Intraneural injection with low-current stimulation during popliteal sciatic nerve block. Anesth. Analg., 2009, 109, p. 673–677.

43. Sinha, S. K., Abrams, J. H., Weller, R. S. Ultrasound-guided interscalene needle placement produces successful anesthesia regardless of motor stimulation above or below 0.5 mA. Anesth. Analg., 2007, 105, p. 848–852.

44. Bigeleisen, P. E. Nerve puncture and apparent intraneural injection during ultrasound-guided axillary block does not invariably result in neurologic injury. Anesthesiology, 2006, 105, p. 779–783.

45. Sites, B. D., Chan, V. W., Neal, J. M., Weller, R., Grau, T., Koscielniak-Nielsen, Z. J., Ivani, G. The American Society of Regional Anesthesia and Pain Medicine and the European Society of Regional Anesthesia and Pain Therapy Joint Committee recommendations for education and training in ultrasound-guided regional anesthesia. Reg. Anesth. Pain Med., 2009, 34, p. 40–46.

Labels
Anaesthesiology, Resuscitation and Inten Surgery Intensive Care Medicine Neurology Orthopaedics Nurse Traumatology Trauma surgery
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#