title: Real-time three-dimensional ultrasound-assisted axillary plexus block defines soft tissue planes.
abstract: Two-dimensional (2D) ultrasound is commonly used for regional block of the axillary brachial plexus. In this technical case report, we described a real-time three-dimensional (3D) ultrasound-guided axillary block. The difference between 2D and 3D ultrasound is similar to the difference between plain radiograph and computer tomography. Unlike 2D ultrasound that captures a planar image, 3D ultrasound technology acquires a 3D volume of information that enables multiple planes of view by manipulating the image without movement of the ultrasound probe. Observation of the brachial plexus in cross-section demonstrated distinct linear hyperechoic tissue structures (loose connective tissue) that initially inhibited the flow of the local anesthesia. After completion of the injection, we were able to visualize the influence of arterial pulsation on the spread of the local anesthesia. Possible advantages of this novel technology over current 2D methods are wider image volume and the capability to manipulate the planes of the image without moving the probe.
authors.affiliation: Department of Anesthesiology, Mayo Clinic College of Medicine, Department of Anesthesiology, Mayo Clinic, Jacksonville, Florida 32224, USA. clendenen.steven@mayo.edu
authors.forename: Steven R
authors.initials: SR
authors.lastname: Clendenen
authors.forename: Kevin
authors.initials: K
authors.lastname: Riutort
authors.forename: Beth L
authors.initials: BL
authors.lastname: Ladlie
authors.forename: Christopher
authors.initials: C
authors.lastname: Robards
authors.forename: Carlo D
authors.initials: CD
authors.lastname: Franco
authors.forename: Roy A
authors.initials: RA
authors.lastname: Greengrass
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D001365:Axilla / Q000000981:diagnostic imaging / Q000294:innervation*; D001917:Brachial Plexus / Q000000981:diagnostic imaging*; D003238:Connective Tissue / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007267:Injections; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local