Ultrasound guidance, a win-win approach to peripheral nerve blockade

Abstract

Ultrasound is clearly superior to other techniques with the aim of achieving maximum efficacy with minimum risk: a win-win approach.

Ultrasound‐guided perineural injection for nerve blockade: Does a single‐sided injection produce circumferential nerve coverage?

“…3,4 In addition, US guidance has been shown to decrease the amount of injectate needed for nerve block, 5,6 thus decreasing the risk for local anesthetic systemic toxicity. 7,8 Anesthesiologists may also use hydrodissection techniques via US guidance prior to infusion of perineural anesthetics in order to get circumferential coverage of the nerve, 9 although it is uncertain if this improves the quality or duration of nerve blockade. [9][10][11] Nonetheless, obtaining circumferential coverage during nerve blockade has been shown to improve the rate of sensory blockade, 12,13 and it is generally recommended.…”

The Efficacy of Additional Intravenous Patient-controlled Analgesia to the Interscalene Block in Arthroscopic Shoulder Surgery: A Prospective Randomized Controlled Study

“…Single ISB has a high success rate and lesser complications as compared with other modalities, especially when administered with ultrasound (US) guidance. 6) However, single ISB is often combined with continuous analgesic infusion 7) or with additional IV-PCA due to its short analgesic effect. 8) IV-PCA with opioids is a well-established technique for postoperative pain management after major surgeries.…”

Ultrasound-Guided Peripheral Nerve Injection Techniques

“…US is frequently used during nerve blocks because US guidance has been shown to improve the accuracy of nerve injections compared with nerve stimulation or blind injections [6,7]. The precise targeting afforded by US guidance decreases the amount of injectant needed to produce an effective nerve block [6,7], thus reducing the risk of local anesthesia-induced toxicity [8,9]. US guidance also allows the operator to avoid the critical vascular structures that often accompany nerves and may decrease the risk of intraneural injection [10].…”