Regional anesthesia meets ultrasound: a specialty in transition.
Despite its well-known benefits, regional anesthesia has not attained the stature, simplicity, and safety of general anesthesia. Many of the challenges and clinical failures of regional anesthetic techniques can be attributed to fact that neurovascular anatomy is highly variable. Furthermore, current nerve localization techniques provide little or no information regarding the anatomical spread local anesthesia. Recently, ultrasound technology has been utilized by anesthesiologists in an attempt to minimize many of the drawbacks of traditional nerve block techniques. This review article will update the reader on the current status of ultrasound-guided regional anesthesia, provide an evidence-based context, and supply key facts regarding ultrasound physics. In the process, we will also highlight several possible limitations of ultrasound techniques including learning curve issues, costs, and artifact generation.
Sites
B D
BD
Department of Anesthesiology, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. brian.sites@hitchcock.org
Spence
B C
BC
Gallagher
J
J
Beach
M L
ML
Antonakakis
J G
JG
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V R
VR
Hartman
G S
GS
D000765:Anesthesia, Conduction / Q000009:adverse effects / Q000379:methods; D000776:Anesthesiology / Q000191:economics / Q000193:education; D016477:Artifacts; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000191:economics / Q000379:methods