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Ultrasound guided regional anaesthesia

L A Sermeus, X Sala-Blanch, J G McDonnell, C A Lobo, B J Nicholls, G J van Geffen, O Choquet, G Iohom, B de Jose Maria Galve, C Hermans, M Lammens
This study evaluated the incidence of nerve puncture and intraneural injection based on the needle approach to the nerve (direct vs. tangential). Two expert operators in regional anaesthesia performed in-plane ultrasound-guided nerve blocks (n = 158) at different levels of the brachial plexus in cadavers, aiming either directly for the nerve (n = 77) or tangentially inferior to the nerve (n = 81). After reaching the outer limit of the nerve, the needle was intentionally advanced approximately 1 mm in both approaches, and 0...
April 2017: Anaesthesia
D S Guardabassi, S Lupi, R Agejas, J M Allub, G García-Fornari
OBJECTIVES: Transversus abdominis plane block is a regional anaesthesia technique that has proven to be effective for postoperative pain reduction in different abdominal surgical procedures. This study evaluated its efficacy on post laparoscopic hysterectomy pain intensity and analgesic consumption. MATERIALS AND METHODS: Randomized controlled trial which included 40 patients scheduled for laparoscopic hysterectomy, enrolled in 2 groups: transversus abdominis plane block+systemic analgesia (Group 1; n=20), versus systemic analgesia (Group 2; n=20)...
May 2017: Revista Española de Anestesiología y Reanimación
V Mojica, D Nieuwveld, A E Herrera, G Mestres, A M López, X Sala-Blanch
INTRODUCTION: Regional anaesthesia is commonly preferred for arteriovenous fistula (AVF) creation. Previous studies suggest a shorter block duration in patients with chronic renal failure, maybe because of the changes in regional blood flow. The aim of our study was to evaluate the duration of the axillary block with 1.5% mepivacaine in patients with chronic renal failure scheduled for AVF compared with healthy controls. METHODS: Patients scheduled for AVF creation for the first time (GIRC) were included...
April 2017: Revista Española de Anestesiología y Reanimación
Alparslan Turan, Rovnat Babazade, Hesham Elsharkawy, Wael Ali Sakr Esa, Kamal Maheshwari, Ehab Farag, Nicole M Zimmerman, Loran Mounir Soliman, Daniel I Sessler
BACKGROUND: Ultrasound-guided nerve blocks have become the standard when performing regional nerve blocks in anaesthesia. Infiniti Plus (CIVCO Medical Solutions, Kalona, Iowa, USA) is a needle guide that has been recently developed to help clinicians in performing ultrasound-guided nerve blocks. OBJECTIVES: We tested the hypothesis that femoral nerve catheter placement carried out with the Infiniti Plus needle guide will be quicker to perform than without the Infiniti Plus...
March 2017: European Journal of Anaesthesiology
A Chandra, R Eisma, P Felts, S Munirama, G A Corner, C E M Demore, G McLeod
Despite widespread use of ultrasound imaging to guide needle placement, the incidence of transient and permanent nerve damage as a complication of regional anaesthesia has not changed over the last decade. In view of the controversy surrounding intraneural injection there is a need to understand the structural changes caused by subepineural and subperineural needle penetration. Clinical ultrasound machines do not provide adequate anatomical resolution, and anaesthetists have difficulty judging the precise location of the needle tip relative to the epineurium...
November 29, 2016: Anaesthesia
Paweł Mądro, Alina Dąbrowska, Jarosław Jarecki, Piotr Garba
BACKGROUND: Carotid endarterectomy carries a significant risk of intraoperative brain ischaemia. Various methods for intraoperative cerebral function monitoring can be utilized, but the assessment of the patient's consciousness remains the easiest and most available method, requiring that the patient remain awake and under local/regional anaesthesia. The aim of this study was to compare infiltration anaesthesia with an ultrasound-guided superficial/combined cervical plexus block for patient safety and comfort...
2016: Anaesthesiology Intensive Therapy
Jan Jakobsson, Mark Z Johnson
Regional anaesthesia provides effective anaesthesia and analgesia in the perioperative setting. Central neuraxial blocks-that is, spinal and epidural blocks-are well established as an alternative or adjunct to general anaesthesia. Peripheral blocks may be used as part of multimodal anaesthesia/analgesia in perioperative practice, reducing the need for opioid analgesics and enhancing early recovery. Furthermore, regional anaesthesia has increased in popularity and may be done with improved ease and safety with the introduction of ultrasound-guided techniques...
2016: F1000Research
Arunangshu Chakraborty, Rakhi Khemka, Taniya Datta
The practice of regional anaesthesia is rapidly changing with the introduction of ultrasound into the working domain of the anaesthesiologist. New techniques are being pioneered. Among the recent techniques, notable are the truncal blocks, for example, the transversus abdominis plane block, rectus sheath block, hernia block and quadratus lumborum block in the abdomen and the pectoral nerves (Pecs) block 1 and 2, serratus anterior plane block and intercostal nerve block. This narrative review covers the brief anatomical discourse along with technical description of the ultrasound-guided truncal blocks...
October 2016: Indian Journal of Anaesthesia
Ki Jinn Chin, Javier E Cubillos, Husni Alakkad
BACKGROUND: Regional anaesthesia comprising axillary block of the brachial plexus is a common anaesthetic technique for distal upper limb surgery. This is an update of a review first published in 2006 and previously updated in 2011 and 2013. OBJECTIVES: To compare the relative effects (benefits and harms) of three injection techniques (single, double and multiple) of axillary block of the brachial plexus for distal upper extremity surgery. We considered these effects primarily in terms of anaesthetic effectiveness; the complication rate (neurological and vascular); and pain and discomfort caused by performance of the block...
September 2, 2016: Cochrane Database of Systematic Reviews
Arslane Alilet, Pascal Petit, Benedicte Devaux, Corinne Joly, Emmanuel Samain, Sebastien Pili-Floury, Guillaume Besch
INTRODUCTION: The value of ultrasound guidance for intermediate cervical blocks in patients undergoing carotid artery endarterectomy is poorly described. This study aimed at comparing the efficacy of ultrasound-guided intermediate cervical block to superficial cervical block for carotid artery endarterectomies. PATIENTS AND METHODS: We conducted a single-centre randomized-controlled study in a French University Hospital, from April 2011 to March 2012. The anaesthesia technique was randomly allocated to patients scheduled for carotid artery endarterectomy under regional anaesthesia (ropivacaine 4...
April 2017: Anaesthesia, Critical Care & Pain Medicine
Thomas F Bendtsen, Stephen Haskins, Jens Aage Kølsen Petersen, Jens Børglum
It has been suggested for many years that regional anaesthesia is advantageous in high-risk patients, either as the sole anaesthetic or in combination with general anaesthesia. Regional techniques are safe and even more so when guided by ultrasound. In the high-risk patient population, ultrasound-guided regional anaesthesia (UGRA) can help decrease risk of perioperative morbidity and improve short-term as well as long-term outcomes, particularly in the orthopaedic, vascular, oncologic and chronic pain patient populations...
June 2016: Best Practice & Research. Clinical Anaesthesiology
A K Gupta, J R Morton
No abstract text is available yet for this article.
August 2016: Anaesthesia
M A Corvetto, J Carmona, M I Vásquez, C Salgueiro, J Crostón, R Sosa, V Folle, F R Altermatt
OBJECTIVE: A survey was conducted in order to obtain a profile of the practice of regional anesthesia in South America, and determine the limitations of its use. METHODS: After institutional ethics committee approval, a link to an online questionnaire was sent by e-mail to anaesthesiologists in Argentina, Bolivia, Chile, Colombia, Panamá, Paraguay, Perú, and Uruguay. The questionnaire was processed anonymously. RESULTS: A total of 1,260 completed questionnaires were received...
January 2017: Revista Española de Anestesiología y Reanimación
N A Duce, L Gillett, J Descallar, M T Tran, S C M Siu, A Chuan
BACKGROUND: The knowledge on the type and influence of visuospatial ability on sonography performance relevant for ultrasound-guided regional anaesthesia remains incomplete. The aim of this study was to determine whether four different factors of visuospatial ability are important in determining proficiency and procedure time of novices performing brachial plexus sonography. These factors were spatial visualisation, flexibility of closure, spatial relations and speed of closure. METHODS: Thirty-three ultrasound novices were recruited in this prospective, observational trial...
September 2016: Acta Anaesthesiologica Scandinavica
Juan A Juanes, Pablo Alonso, Felipe Hernández, Pablo Ruisoto, Clemente Muriel
INTRODUCTION: Regions considered optimal for performing peripheral nerve blocking have been well documented. However identify and perform regional anesthesia in those regions from ultrasound images remains a challenge. AIM: This study aims to develop a virtual environment for the simulation of ultrasound exploration of the neck nerves and both the upper and lower limbs for regional anesthesia. METHOD: Cross-sectional images were obtained from Magnetic Resonance Imaging for puncture regions involved in ultrasound-guided nerve block...
July 2016: Journal of Medical Systems
S Munirama, R Eisma, M Columb, G A Corner, G A McLeod
BACKGROUND: We evaluated the physical properties and functional alignment of the soft-embalmed Thiel cadaver as follows: by assessing tissue visibility; by measuring its acoustic, mechanical and elastic properties; by evaluating its durability in response to repeated injection; and by aligning images with humans. METHODS: In four soft-embalmed Thiel cadavers, we conducted three independent studies. We assessed the following factors: (i) soft tissue visibility in a single cadaver for 28 weeks after embalming; (ii) the displacement of tissues in response to 1 and 5 ml interscalene and femoral nerve blocks in a single cadaver; and (iii) the stiffness of nerves and perineural tissue in two cadavers...
May 2016: British Journal of Anaesthesia
A Chuan, S Thillainathan, P L Graham, B Jolly, D M Wong, N Smith, M J Barrington
The Direct Observation of Procedural Skills (DOPS) form is used as a workplace-based assessment tool in the current Australian and New Zealand College of Anaesthetists curriculum. The objective of this study was to evaluate the reliability of DOPS when used to score trainees performing ultrasound-guided regional anaesthesia. Reliability of an assessment tool is defined as the reproducibility of scores given by different assessors viewing the same trainee. Forty-nine anaesthetists were recruited to score two scripted videos of trainees performing a popliteal sciatic nerve block and an axillary brachial plexus block...
March 2016: Anaesthesia and Intensive Care
Y Kuang, A Hilgers, M Sadiq, S Cochran, G Corner, Z Huang
Clear needle visualisation is recognised as an unmet need for ultrasound guided percutaneous needle procedures including regional anaesthesia and tissue biopsy. With inadequate needle visibility, these procedures may result in serious complications or a failed operation. This paper reports analysis of the modal behaviour of a previously proposed ultrasound-actuated needle configuration, which may overcome this problem by improving needle visibility in colour Doppler imaging. It uses a piezoelectric transducer to actuate longitudinal resonant modes in needles (outer diameter 0...
July 2016: Ultrasonics
S Heschl, B Hallmann, T Zilke, G Gemes, M Schoerghuber, M Auer-Grumbach, F Quehenberger, P Lirk, Q Hogan, M Rigaud
BACKGROUND: Peripheral nerve stimulation is commonly used for nerve localization in regional anaesthesia, but recommended stimulation currents of 0.3-0.5 mA do not reliably produce motor activity in the absence of intraneural needle placement. As this may be particularly true in patients with diabetic neuropathy, we examined the stimulation threshold in patients with and without diabetes. METHODS: Preoperative evaluation included a neurological exam and electroneurography...
April 2016: British Journal of Anaesthesia
A Chuan, Y C Lim, H Aneja, N A Duce, R Appleyard, K Forrest, C F Royse
The aim of this prospective, blinded, randomised controlled study was to compare novices' acquisition of the technical skills of ultrasound-guided regional anaesthesia using either a meat phantom model or fresh-frozen human cadavers. The primary outcome was the time taken to successfully perform an ultrasound-guided sciatic nerve block on a cadaver; secondary outcomes were the cumulative score of errors, and best image quality of the sciatic nerve achieved. After training, the median (IQR [range]) time taken to perform the block was 311(164-390 [68-600]) s in the meat model trained group and 210 (174-354 [85-600]) s in the fresh-frozen cadaver trained group (p = 0...
August 2016: Anaesthesia
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