Fifteen years of ultrasound guidance in regional anaesthesia: Part 2-recent developments in block techniques.
The use of ultrasound guidance for regional anaesthesia has gained enormous popularity in the last 10 yr. The first part of this review article provided information on safety, technical developments, economic aspects, education, advantages, needle guidance techniques, and future developments in ultrasound. The second part focuses on practical and technical details of individual ultrasound-guided nerve blocks in adults. We present a comprehensive review of the relevant literature of the last 5 yr with a commentary based on our own clinical experience in order to provide information relevant to patient management. Upper limb blocks, including interscalene, supra- and infraclavicular, and axillary approaches, are described and discussed. For the lower limb, psoas compartment, femoral, obturator, sciatic, and lateral cutaneous nerve blocks are described, as are some abdominal wall blocks. The potential role of ultrasound guidance for neuraxial block is addressed. The need for further large-scale studies of the role of ultrasound is emphasized.
Marhofer
P
P
Department of Anaesthesia, Intensive Care Medicine, and Pain Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, Austria. peter.marhofer@meduniwien.ac.at
Harrop-Griffiths
W
W
Willschke
H
H
Kirchmair
L
L
D000328:Adult; D000765:Anesthesia, Conduction / Q000379:methods*; D006801:Humans; D035002:Lower Extremity / Q000000981:diagnostic imaging / Q000294:innervation; D009407:Nerve Block / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods*; D034941:Upper Extremity / Q000000981:diagnostic imaging / Q000294:innervation