Ultrasound guidance for peripheral nerve blockade

Walker, Kevin; McGrattan, Ken; Aas-Eng, Kristine; Smith, Andrew F

doi:10.1002/14651858.cd006459.pub2

Cited by 102 publications

(69 citation statements)

References 32 publications

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“…Another systematic review of 16 RCTs found that use of ultrasound for upper and lower extremity nerve blocks was associated with a better quality of block [11]. Although we did not assess for outcomes other than block success, other authors have noted that the use of ultrasound for nerve blocks is associated with significantly less time to perform blocks, faster onset and longer duration of analgesia, and decreased the risk of vascular puncture or hematoma formation during the block procedure [10][11][12].…”

Section: Discussionmentioning

confidence: 97%

“…Although the superior visualization and localization for injection of local anesthetic provided by ultrasound guidance theoretically would result in a reduction in complication rates (eg, neurologic injuries), this has not been definitively proven [6,7]. Previous reviews and metaanalyses indicate that ultrasound-guided regional anesthesia may offer many benefits including a higher block success rate, decreased time to onset of blocks, and possibly improved quality of sensory block [8][9][10][11][12]. However, these meta-analyses have not examined the analgesic efficacy of ultrasound guidance for specific peripheral nerve blocks.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Analgesic efficacy of ultrasound-guided regional anesthesia: a meta-analysis

Gelfand¹,

Ouanes²,

Lesley³

et al. 2011

Journal of Clinical Anesthesia

108

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Analgesic efficacy of ultrasound-guided regional anesthesia: a meta-analysis

Gelfand¹,

Ouanes²,

Lesley³

et al. 2011

Journal of Clinical Anesthesia

108

View full text Add to dashboard Cite

“…Complications from femoral nerve blockade are infrequent and are likely decreased with the utilization of point-of-care ultrasound needle guidance. 18,[21][22][23] Needle insertion using the in-plane technique may be superior to "out-of-plane" technique because it allows for improved visualization of the needle tip, avoiding inadvertent injection into the femoral nerve as well as allowing for localization of anesthetic around the target nerve. 2,21,24 Hematoma formation may result from vascular puncture or from bleeding if lymph nodes are penetrated.…”

Section: Pitfall and Complicationmentioning

confidence: 99%

Ultrasound-Guided Femoral Nerve Blocks

Baker

Gullett

2015

Pediatric Emergency Care

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Pediatric acute femur fractures are a relatively common major orthopedic injury seen in emergency departments. Providing adequate and safe analgesia is essential while patients await definitive management of these fractures. Opioid medications are typically used to treat fracture-associated pain but have well-known adverse effects including respiratory and central nervous system depression, pruritus, nausea, and allergic reactions. Dose titration of opioids in pediatric patients may be difficult and requires frequent nursing and physician reassessments. Regional anesthesia using ultrasound guidance has been proposed as a reliable and safe method to provide pain relief for this population and to decrease reliance on opioid medications. There is a growing body of literature on the utility and safety of ultrasound-guided femoral nerve blocks for pediatric patients in the acute care setting. This review article covers recent literature on point-of-care ultrasound-guided femoral nerve blocks for pediatric patients, with a discussion of the indications, sonographic anatomy, selection of anesthetics, nerve block technique, and complications. This review supplements the expert supervision and practice required to gain competency.

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“…Ultraschallgesteuerte Punktionstechniken, die in unserer Abteilung seit 2007 routinemäßig zum Einsatz kommen, scheinen die Sicherheit des Verfahrens dabei noch weiter zu erhöhen [17,18].…”

Section: Diskussionunclassified

Perioperatives Schmerzmanagement bei großen plastisch-rekonstruktiven Eingriffen in der Kinderurologie

Rubenwolf

Koller

Rübben

et al. 2011

Urologe

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Regional analgesia is firmly established in modern pediatric anesthetic practice and its popularity continues to grow. In our department continuous epidural anesthesia (CEA) is a frequently used technique of pain management following major reconstructive procedures of the lower urinary tract. The aim of this study was to investigate the efficacy, safety, and potential benefits of CEA over standard analgesics.We retrospectively reviewed the records of 21 infants who underwent single-stage bladder exstrophy repair in our department. In 15 children an epidural catheter was placed preoperatively for CEA; 6 patients treated without CEA served as controls. Total doses of narcotics and analgesics, length of intensive care unit (ICU) stay and ventilatory assistance, time to first bowel activity, anticholinergic requirements, and CEA-related side effects were documented and compared for both groups.Children given epidural anesthesia required six- to tenfold lower doses of morphine intra- and postoperatively compared to those without CEA; ventilatory support upon completion of surgery was remarkably shorter (59 versus 210 min) in the CEA group as well as ICU stay (1.1 versus 1.8 days). The total consumption of anticholinergics was twice as high as in patients without CEA. There were no relevant CEA-related complications.Being a retrospective audit of practice in our institution with a small number of patients, our results are in line with previously published data on CEA in pediatric patients. CEA has been shown to significantly reduce the need for anesthetics and morphine and allows early extubation with all subsequent advantages for a speedy recovery post surgery. Thus, the technique is to be recommended as a safe and efficacious method for pain management following major reconstructive surgery in pediatric urology. Importantly, this type of anesthesia should be performed only by experienced anesthesiologists in institutions where appropriate equipment, staff, and monitoring are available.

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Ultrasound guidance for peripheral nerve blockade

Cited by 102 publications

References 32 publications

Analgesic efficacy of ultrasound-guided regional anesthesia: a meta-analysis

Analgesic efficacy of ultrasound-guided regional anesthesia: a meta-analysis

Ultrasound-Guided Femoral Nerve Blocks

Perioperatives Schmerzmanagement bei großen plastisch-rekonstruktiven Eingriffen in der Kinderurologie

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