Minimum anesthetic volume in regional anesthesia by using ultrasound-guidance

Abstract

The ultrasound guidance in regional anesthesia ensures the visualization of needle placement and the spread of Local Anesthetics. Over the past few years there was a substantial interest in determining the Minimum Effective Anesthetic Volume necessary to accomplish surgical anesthesia. The precise and real-time visualization of Local Anesthetics spread under ultrasound guidance block may represent the best requisite for reducing Local Anesthetics dose and Local Anesthetics-related effects. We will report a series of studies that have demonstrated the efficacy of ultrasound guidance blocks to reduce Local Anesthetics and obtain surgical anesthesia as compared to block performed under blind or electrical nerve stimulation technique. Unfortunately, the results of studies are widely divergent and not seem to indicate a dose considered effective, for each block, in a definitive way; but it is true that, through the use of ultrasound guidance, it is possible to reduce the dose of anesthetic in the performance of anesthetic blocks.

Local anesthetic volume in ultrasound-guided interscalene block and opioid consumption during shoulder arthroscopic surgery

“…Additionally, since the dose was determined in an up-and-down method and the sample size is small, there is a limitation in defining the required dose of local anesthetics as sole anesthesia in ISB, especially, in a prospective study. [ 4 ]…”

“…[ 2 , 3 ] The use of the ultrasonographic technique in ISB makes it possible to visualize the spread pattern of local anesthetics in real-time; the block was reported to be successful with a lower local anesthetics dose than the conventional volume. [ 4 ] One study reported that the minimum effective anesthetic volume (MEAV) required for successful surgical anesthesia is 5 mL. [ 5 ]…”

Anestésicos e anestesia locais: revisão narrativa de literatura para a prática clínica

“…É significativa a observação de que este bloqueio está intimamente relacionado ao diâmetro do neurônio, uma vez que, quanto maior o diâmetro da fibra nervosa, maior a concentração da droga para atingir um bloqueio eficiente, portanto, fibras A demandam mais anestésicos locais do que fibras C para gerar o mesmo efeito, por exemplo. Vale saber que os anestésicos locais também bloqueiam canais de K e Cálcio (Ca), porém em menor importância quando comparados aos canais de Na, o que intensifica o bloqueio neural [9][10][11][12][13] .…”

The Retrospective Comparison of the Effects of Low and High Volume Practices in Ultrasonography Guided Axillary Brachial Plexus Block

“…9 Lokal anestetik ajan dağılımının USG rehberliğinde net görüntülenmesi lokal anestezi dozunu ve doz ilişkili yan etkileri azaltmak için bir gerekliliktir. 10 Yüksek volümde lokal anestetik ajan uygulanması toksik yan etkileri tetikleyebilmektedir. Lokal anestetik solüsyonların nörotoksik ve miyotoksik etkisi bilinmektedir.…”