Ultrasound-Guided Forearm Nerve Blocks: A Novel Application for Pain Control in Adult Patients with Digit Injuries

Amini, Richard; Javedani, Parisa P.; Amini, Albert; Adhikari, Srikar

doi:10.1155/2016/2518596

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Regional anesthesia has been shown to reduce the utilization of systemic analgesics and their subsequent side effects [1, 2, 5]. Examples of commonly used UGRA in the emergency department include fascia iliaca compartment blocks in patients with hip and proximal femur fractures [1, 2, 5–8], interscalene brachial plexus blocks in patients with shoulder dislocations [9], serratus anterior plane blocks in patients with rib fractures [10], and forearm nerve blocks in patients with hand injuries [10–13]. Studies have shown that medical training on simulation models is an effective way to learn new procedures and ultrasound techniques [14–16].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided regional anesthesia simulation: use of meat glue in inexpensive and realistic nerve block models

et al. 2019

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Background Ultrasound-guided regional anesthesia (UGRA) is increasingly used by emergency physicians to provide safe and effective pain relief for patients. However, one of the factors limiting its widespread use is the lack of realistic models available for learners to train on. There are currently no inexpensive nerve block models available that are injectable and that closely mimic nerves, fascial planes, muscles, and other landmarks. Our aim is to create inexpensive, injectable nerve block models that can be used as effective medical training tools for UGRA. Methods By using a lean cut of pork such as pork loin, yarn soaked in ultrasound gel to simulate peripheral nerves, and drinking straws filled with gel to represent vascular structures, we created various nerve block models. Meat glue applied between sections of meat appears hyperechoic under ultrasound, thereby mimicking fascial planes and has the added benefit of helping to secure the components of the model together. Using these elements, we were able to create realistic peripheral nerve, fascia iliaca compartment, serratus anterior plane, and interscalene brachial plexus models. Results One of the necessary skills in performing UGRA involves placing the needle tip along a fascial plane and visualizing hydrodissection of this plane with the local anesthetic. When meat glue (transglutaminase) is applied between layers of meat such as pork loin, the meat binds together and creates a hyperechoic line that mimics a fascial plane. When meat glue is applied to two apposing fascial layers naturally occurring on the meat, the fascial plane can be injected, and fluid can be seen hydrodissecting in this space. We created several nerve block models using meat glue and other components to mimic normal landmarks. Conclusions We have developed inexpensive and easily reproducible models that create the realistic appearance of tissues, nerves, and fascial planes under ultrasound. They can also accurately simulate hydrodissection of fluid in fascial planes. We hope these nerve block models will allow for the education in UGRA to be more widespread and accessible to learners from all specialties. Electronic supplementary material The online version of this article (10.1186/s12909-019-1591-1) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Ultrasound-guided regional anesthesia simulation: use of meat glue in inexpensive and realistic nerve block models

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Studies measuring feasibility have found that these blocks can be done in less than 10 minutes, and without significant complications [ 12 , 17 ]. Recent emergency medicine literature has demonstrated the successful use of US-guided regional nerve blocks in the ED for finger reduction [ 18 ], upper extremity fractures, dislocations, abscess drainage [ 17 ], and hand blast injuries [ 9 ]. Widespread adoption of US-guided nerve blocks can add to a larger portfolio of multimodal analgesia and limit exposure to opioids.…”

Section: Discussionmentioning

confidence: 99%