Fifteen years of ultrasound guidance in regional anaesthesia: Part 1

Marhofer, Peter; Harrop‐Griffiths, William; Kettner, Stephan C.; Kirchmair, Lukas

doi:10.1093/bja/aeq069

Cited by 195 publications

(148 citation statements)

References 48 publications

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“…1,2 This may be due in part to the fact that the vast majority of anesthesiologists master the conventional surface landmark-based techniques for spinal anesthesia with success rates approaching 96%. 3 In addition, there is less familiarity and greater perceived difficulty of spinal sonoanatomy compared with sonoanatomy for other blocks.…”

Section: Résumé Objectif Le Sonixgpsmentioning

confidence: 99%

Single-operator real-time ultrasound-guided spinal injection using SonixGPS™: a case series

Brinkmann

Tang

Sawka

et al. 2013

Can J Anesth/J Can Anesth

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Purpose The SonixGPS TM is a novel needle tracking system that has recently been approved in Canada for ultrasound-guided needle interventions. It allows optimization of needle-beam alignment by providing a real-time display of current and predicted needle tip position. Currently, there is limited evidence on the effectiveness of this technique for performance of realtime spinal anesthesia. This case series reports performance of the SonixGPS system for real-time ultrasound-guided spinal anesthesia in elective patients scheduled for joint arthroplasty. Methods In this single-centre case series, 20 American Society of Anesthesiologists' class I-II patients scheduled for lower limb joint arthroplasty were recruited to undergo real-time ultrasound-guided spinal anesthesia with the SonixGPS after written informed consent. The primary outcome for this clinical cases series was the success rate of spinal anesthesia, and the main secondary outcome was time required to perform spinal anesthesia. Results Successful spinal anesthesia for joint arthroplasty was achieved in 18/20 patients, and 17 of these required only a single skin puncture. In 7/20 (35%) patients, dural puncture was achieved on the first needle pass, and in 11/20 (55%) patients, dural puncture was achieved with two or three needle redirections. Median (range) time taken to perform the block was 8 (5-14) min. The study procedure was aborted in two cases because our clinical protocol dictated using a standard approach if spinal anesthesia was unsuccessful after three ultrasound-guided insertion attempts. These two cases were classified as failures. No complications, including paresthesia, were observed during the procedure. All patients with successful spinal anesthesia found the technique acceptable and were willing to undergo a repeat procedure if deemed necessary. Conclusions This case series shows that real-time ultrasound-guided spinal anesthesia with the SonixGPS system is possible within an acceptable time frame. It proved effective with a low rate of failure and a low rate of complications. Our clinical experience suggests that a randomized trial is warranted to compare the SonixGPS with a standard block technique. Résumé Objectif Le SonixGPSTM est un système innovant de suivi de l'aiguille récemment approuvé au Canada pour les interventions échoguidées réalisées avec une aiguille. Cet appareil optimise l'alignement entre l'aiguille et le faisceau grâce à un affichage en temps réel du positionnement actuel et prévu de la pointe de l'aiguille. À l'heure actuelle, les données probantes concernant l'efficacité de cette technique pour réaliser une rachianesthésie en temps réel sont limitées. Cette série de cas porte sur la performance du système SonixGPS pour réaliser une rachianesthésie échoguidée en temps réel chez des patients devant subir une chirurgie non urgente d'arthroplastie.

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Section: Résumé Objectif Le Sonixgpsmentioning

confidence: 99%

Single-operator real-time ultrasound-guided spinal injection using SonixGPS™: a case series

Brinkmann

Tang

Sawka

et al. 2013

Can J Anesth/J Can Anesth

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“…Lower volume of local anesthetic is required to achieve an adequate block, the quality of the block is better, the procedure itself is associated with less discomfort, and the incidence of complications as described such as hemidiaphragmatic paralysis and LAST is lower. The result is a more efficient procedure and better patient satisfaction [1,3,8,[17][18][19].…”

Section: Case 1: Bilateral Supraclavicular Cathetersmentioning

confidence: 99%

Continuous Bilateral Brachial Plexus Blockade for Acute Pain Control in Patients with Bilateral Upper Extremity Traumatic Injuries: A Review of Five Cases

Sen¹

2017

Clin Med Rev Case Rep

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Study objective: Brachial plexus catheters are typically placed to provide regional anesthesia to the shoulder, arm, forearm, wrist and hand. However, there are risks associated with catheter placement including infection and local anesthetic toxicity. Study design:In this study we discuss five case scenarios where we felt bilateral brachial plexus blocks were appropriate and, if performed with caution, the benefits would outweigh the risks. Each of these patients suffered severe bilateral upper-extremity traumatic injuries, requiring multiple surgical procedures and debridement's while inpatient on the trauma service. These patients were chosen because of the need for pain control during their hospital stay, the appropriateness of these particular techniques, and a lack of absolute contraindications to these techniques. Conclusions:In carefully-selected patients, bilateral brachial plexus catheters can be used safely and effectively to control pain secondary to traumatic injuries to the upper extremities. These catheters are a potentially valuable tool as part of a multimodal pain control regimen, with the goal of achieving adequate pain management, while limiting opioid use.

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“…No signs of vascular puncture or inadvertent intravascular injection were detected during any of the procedures. The mean duration of the block was 14.1 h (range, [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Five patients (25%) did not need any analgesics in the 48 h until hospital discharge.…”

Section: Secondary Outcome Measurementsmentioning

confidence: 99%

Ultrasound guided spermatic cord block for scrotal surgery

Wipfli¹

2013

http://isrctn.org/>

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Editor's key points † Spermatic cord block for scrotal surgery can be an alternative to neuraxial and general anaesthesia and provides long-lasting postoperative analgesia; however, major limitations of the conventional anatomical landmark-based blind injection technique limit its use. † This study showed that a new ultrasound-guided technique for spermatic cord block is feasible and has a high success rate.Background. Performing spermatic cord block for scrotal surgery avoids the potential risks of neuraxial and general anaesthesia and provides long-lasting postoperative analgesia. A blindly performed block is often inefficient and bears its own potential risks (intravascular injection of local anaesthetics, haematoma formation and perforation of the deferent duct). The use of ultrasound may help to overcome these disadvantages. The aim of this study was to test the feasibility and monitor the success rate of a new ultrasoundguided spermatic cord block.

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Fifteen years of ultrasound guidance in regional anaesthesia: Part 1

Cited by 195 publications

References 48 publications

Single-operator real-time ultrasound-guided spinal injection using SonixGPS™: a case series

Single-operator real-time ultrasound-guided spinal injection using SonixGPS™: a case series

Continuous Bilateral Brachial Plexus Blockade for Acute Pain Control in Patients with Bilateral Upper Extremity Traumatic Injuries: A Review of Five Cases

Ultrasound guided spermatic cord block for scrotal surgery

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