Ultrasound standard for popliteal sciatic block: circular expansion of the paraneural sheath with the needle in-plane from lateral-to-medial in the ‘reverse Sim’s position’

Abstract

survival curve is shown in Figure 1. There were no device-related or procedure-related adverse events. Sixty-seven percent of patients survived more than three yr, and 25% more than five yr. In contrast, Conway 5 reported a three-yr survival rate of 17% among 106 abdominal aortic aneurysm patients (mean age, 78.4 yr) who were denied or refused intervention. Using this alternative anaesthetic technique, EVAR in nonagenarians is associated with a high success rate and low adverse event rate. Survival times after successful hospital discharge are encouraging. The 5-year survival rate of 25% is comparable with the 10% rate described in the only other study that followed nonagenarian patients this long, 6 and even to the five-yr survival rates reported for octogenarians, which ranged from 27.4 7 to 64%. 8 This represents the first analysis of EVAR outcomes for nonagenarians with outcomes specifically associated with this anaesthetic technique. True comparison of outcomes using various techniques of anaesthesia, particularly in the very elderly, awaits randomized controlled trials that monitor mortality, morbidity, and subsequent quality of life in a quantitative manner; however, this study suggests that age and the dangers of anaesthesia are not bars to use of EVAR in this age group.

Ultrasound standard of peripheral nerve block for shoulder arthroscopy: a single-penetration double-injection approach targeting the superior trunk and supraclavicular nerve in the lateral decubitus position

“…1) more ergonomically facilitates the transducer along the visual axis, meanwhile avoiding needle contamination by gravity-dependent gel flow as a general rule. 17 indicating the spread of injectate from the dotted green needle tip), the needle is then pulled back to place its tip (the solid green arrow) over the prevertebral fascia above scalenus medius (). Not only indicated for the superior trunk block, the opening pressure test 13 is also recommended for the usually invisible supraclavicular nerve.…”

The influence of patient position on ultrasound examination of the sciatic nerve in the popliteal fossa: A cross‐sectional study

“…Still others suggested to position patients in an oblique or lateral decubitus position allowing one to scan the posterior thigh without entirely proning the patient. 8 G€ urkan et al 9 compared various leg positions in the prone position and found the 'figure of four' position to offer the best visibility of the sciatic nerve. Kim et al 10 studied flexion and rotation of the hip on visibility and depth of the sciatic nerve when performing anterior sciatic nerve blockade.…”

“…The medial approach was described by Taha and Ahmed 6 and involves a small degree of knee flexion, with or without a slight ipsilateral pelvic tilt. Still others suggested to position patients in an oblique or lateral decubitus position allowing one to scan the posterior thigh without entirely proning the patient 8 . Gürkan et al 9 .…”

Transversus Abdominis Plane Block: An Updated Review of Anatomy and Techniques

“…After making the skin aseptic, we suggest performing the lateral/posterior approach first and then the subcostal approach, to keep the probe aseptic. In other words, the probe is placed in the gravity-dependent part as a general rule below the needle insertion site for single-shot peripheral nerve blocks [ 65 , 66 ]. Jelly introduction into the central part of the body should be avoided whenever possible, even if it is aseptic [ 67 ], and ultrasound gel itself near peripheral nerves may cause inflammation [ 68 ].…”