Practical Knobology for Ultrasound-Guided Regional Anesthesia

Brull, Richard; Macfarlane, Alan; Tse, Cyrus

doi:10.1097/aap.0b013e3181d245f9

Cited by 27 publications

(9 citation statements)

References 3 publications

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“…A low‐frequency (2–5 MHz) curved‐array ultrasound probe is placed in a transverse midline orientation over the patient's lumbar spine and is manipulated in a cephalad‐caudad direction to identify at least two consecutive lumbar spinous processes between L2 and L5. The ultrasound machine settings of probe frequency, depth, gain, and focus should be appropriately adjusted to optimize image quality …”

Section: Technical Description Of the Ultrasound‐assisted Paraspinousmentioning

confidence: 99%

The ultrasound‐assisted paraspinous approach to lumbar neuraxial blockade: a simplified technique in patients with difficult anatomy

Chin

Perlas

Chan

2015

Acta Anaesthesiol Scand

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Pre-procedural ultrasound imaging of the spine to identify the interspinous and interlaminar space has been shown to facilitate subsequent performance of lumbar neuraxial blockade. However, adequate visualization of the vertebral canal can be challenging for less-experienced operators, and particularly in subjects with difficult anatomy. In this case report, we describe a simplified technique of ultrasound-assisted neuraxial blockade that addresses these limitations and may thus be a useful fallback option. A pre-procedural scan is performed in which the main ultrasonographic landmarks to be identified are the neuraxial midline and the spinous processes, rather than the posterior and anterior complexes of the vertebral canal. Another key difference is the use of a paraspinous (or paramedian) needle approach rather than a midline approach that is advantageous where the interspinous spaces are narrowed by disease or suboptimal patient positioning. The anatomical basis and technical performance of this novel ultrasound-assisted paraspinous approach are presented in detail.

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Section: Technical Description Of the Ultrasound‐assisted Paraspinousmentioning

confidence: 99%

The ultrasound‐assisted paraspinous approach to lumbar neuraxial blockade: a simplified technique in patients with difficult anatomy

Chin

Perlas

Chan

2015

Acta Anaesthesiol Scand

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“…1,2,3 Despite differences in appearance and layout, all US machines share the same basic operative functions that users must appreciate in order to optimize the image. While modern US machines offer an abundance of features, the basic functions that all operators should be familiar with are frequency and probe selection, depth, gain, time gain compensation (TGC), focus, preprogrammed presets, color Doppler, power Doppler, compound imaging, tissue harmonic imaging (THI) (on some models), and image freeze and acquisition.…”

Section: Introductionmentioning

confidence: 99%

Essential Knobology for Ultrasound-Guided Regional Anesthesia and Interventional Pain Management

Macfarlane

Tse

Brull

2010

Atlas of Ultrasound-Guided Procedures in Interventional Pain Management

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“…We will only briefly touch on topics dealing with physics, artifacts, or sonopathology, which are available elsewhere in the medical literature. [4–6] We hope to, in the future, publish an article that will provide an exhaustive review concerning the use of sonoanatomy of the neck above the clavicle.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound: Basic understanding and learning the language

Ihnatsenka¹,

Boezaart²

2010

Int J Shoulder Surg

175

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Ultrasound (US) use has rapidly entered the field of acute pain medicine and regional anesthesia and interventional pain medicine over the last decade, and it may even become the standard of practice. The advantages of US guidance over conventional techniques include the ability to both view the targeted structure and visualize, in real time, the distribution of the injected medication, and the capacity to control its distribution by readjusting the needle position, if needed. US guidance should plausibly improve the success rate of the procedures, their safety and speed. This article provides basic information on musculoskeletal US techniques, with an emphasis on the principles and practical aspects. We stress that for the best use of US, one should venture beyond the “pattern recognition” mode to the more advanced systematic approach and use US as a tool to visualize structures beyond the skin (sonoanatomy mode). We discuss the sonographic appearance of different tissues, introduce the reader to commonly used US-related terminology, cover basic machine “knobology” and fundamentals of US probe selection and manipulation. At the end, we discuss US-guided needle advancement. We only briefly touch on topics dealing with physics, artifacts, or sonopathology, which are available elsewhere in the medical literature.

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Practical Knobology for Ultrasound-Guided Regional Anesthesia

Abstract: This article provides an instructive review of the essential functions universal to modern ultrasound machines in use for regional anesthesia practice. An understanding of machine knobology is integral to performing safe and successful ultrasound-guided regional anesthesia.

Cited by 27 publications

References 3 publications

The ultrasound‐assisted paraspinous approach to lumbar neuraxial blockade: a simplified technique in patients with difficult anatomy

The ultrasound‐assisted paraspinous approach to lumbar neuraxial blockade: a simplified technique in patients with difficult anatomy

Essential Knobology for Ultrasound-Guided Regional Anesthesia and Interventional Pain Management

Ultrasound: Basic understanding and learning the language

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