Recent advancements in regional anaesthesia

Abstract

Patient safety, improved quality of care, and better patient satisfaction and functional outcomes are currently the topmost priorities in regional anaesthesia (RA) and all advancements in RA move in this direction. Ultrasonography-guided central neuraxial and peripheral nerve blocks, intracluster and intratruncal injections, fascial plane blocks, diaphragm-sparing blocks, use of continuous nerve block techniques, and continuous local anaesthetic wound infiltration catheters are now topics of popular clinical interest. The safety and efficacy of nerve blocks can be improved with the help of injection pressure monitoring and the incorporation of advanced technology in the ultrasound machine and needles. Novel procedure-specific and motor-sparing nerve blocks have come up. The anaesthesiologist of the current era, with a good understanding of the sonoanatomy of the target area and the microarchitecture of nerves, along with the backup of advanced technology, can be very successful in performing RA techniques. RA is rapidly evolving and revolutionising the practice of anaesthesia.

Lateral Decubitus Supraclavicular Brachial Plexus Block in Transverse Myelitis

“…Its anatomical advantage lies in blocking the brachial plexus at a site where its components are closely clustered, enabling a single injection point and a rapid onset of effect [ 8 ]. In comparison with the blind technique using anatomical landmarks, the ultrasound-guided technique of nerve block has minimal complications and increased success rates due to easy image acquisition relating to the superficial location of the brachial plexus and identifying the pleura thus minimizing complications [ 9 , 10 ].…”

Avances en Técnicas De Anestesia Regional: Beneficios Y Consideraciones.

“…Estos bloqueos han demostrado ser prometedores y se necesita más investigación para establecer su eficacia como única técnica anestésica (22,23). La anestesia espinal segmentaria implica el depósito de una dosis baja de anestésico local cerca de los nervios que irrigan el campo operatorio para limitar la anestesia solo a esa área, evitando efectos adversos sistémicos (20). La técnica es segura y puede proporcionar una analgesia posoperatoria superior en comparación con la anestesia general en ciertos grupos de pacientes.…”

“…En las últimas dos décadas, con la mejora de la ecografía, es posible identificar la vaina paraneural que rodea el plexo braquial, lo que ha llevado a técnicas más precisas (25). Se ha propuesto el enfoque intertroncal como una alternativa ventajosa a las inyecciones intragrupo, ya que evita lesiones nerviosas, aunque se necesitan más estudios clínicos para respaldarlo como estándar de atención (20).…”

A case of accidental intraperitoneal placement of the rectus sheath block catheter via an out-of-plane approach

“…The primary disadvantage is its narrow ultrasound beam width of ≤ 1 mm, which makes the visibility of the needle difficult [ 2 ]. Furthermore, the distance from the skin to the target tends to be longer using this approach, possibly resulting in reduced visibility in deeper areas [ 3 ]. In contrast, the out-of-plane approach has the advantage of good maneuverability of the needle compared to the in-plane approach [ 2 ].…”