Ultrasound-Guided Regional Anesthesia :A Practical Approach to Peripheral Nerve Blocks and Perineural Catheters

Publication subTitle :A Practical Approach to Peripheral Nerve Blocks and Perineural Catheters

Author: Fernando L. Arbona; Babak Khabiri; John A. Norton  

Publisher: Cambridge University Press‎

Publication year: 2011

E-ISBN: 9780511784484

P-ISBN(Paperback): 9780521515788

Subject: R614 Anesthesiology

Keyword: 麻醉学

Language: ENG

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Ultrasound-Guided Regional Anesthesia

Description

Regional anesthesia is a fast-growing field, fuelled by the application of ultrasound technology over the last decade. This book is a technique-oriented guide, which introduces the use of ultrasound technology with practical instruction in the placement of peripheral nerve blocks and continuous perineural catheters. Each procedure is summarized for quick, easy reference, and supplemented by ultrasound images, color photos, and detailed illustrations. Helpful hints and instructions are provided to further optimize block success. Chapters are organized into four sections, focusing on introductory concepts, upper extremity peripheral nerve blocks, lower extremity peripheral nerve blocks and continuous perineural catheters. Written by instructors from a major academic medical center who work in a fast-paced ambulatory setting, this is a key text for residents, fellows and staff physicians who wish to incorporate the use of ultrasound into the scope of their anesthetic practice.

Chapter

Dexamethasone

Suggested reading

Chapter 2 Introduction to ultrasound

Introduction

Image generation

Ultrasound waves and tissue interaction

Reflection

Attenuation

Refraction

Resolution

Axial resolution

Lateral resolution

Ultrasound equipment

Introduction

Ultrasound transducers

Ultrasound machine controls

Depth

Frequency

Gain

Color-flow Doppler

Pulse-wave Doppler

Tissue appearance under ultrasound

Artifacts

Reverberation artifact

Mirror artifact

Bayonet artifact

Acoustic enhancement artifact

Absent blood flow

Acoustic shadowing

Suggested reading

Chapter 3 Application of ultrasound in regional anesthesia

Probe preparation

Physician and patient positioning

Scanning

Orientation marker

Transverse scan

Longitudinal scan

Transducer movement

Systematic scanning

Orienting structures

Needle insertion

In plane (IP)

Partial plane

Out of plane (OOP)

Local anesthetic injection

Hydrolocation

Nerve stimulation

Suggested reading

Section 2 Upper extremity peripheral nerve blocks

Chapter 4 Upper extremity anatomy forregional anesthesia

The brachial plexus

The cervical plexus

Suggested reading

Chapter 5 Interscalene brachial plexus block

Introduction and anatomy

Brachial plexus

Suprascapular nerve

Superficial cervical plexus

Ultrasound anatomy

Interscalene region

Orienting structure carotid artery

Supraclavicular region

Orienting structure subclavian artery

Contraindications

Side effects and complications

Horner syndrome

Phrenic nerve block

Recurrent laryngeal nerve block

Technique

Equipment

Scanning

Alternative scanning

Needle insertion

Local anesthetic injection

Author' s clinical practice

Suggested reading

Chapter 6 Supraclavicular brachial plexus block

Introduction and anatomy

Brachial plexus

Ultrasound anatomy

Orienting structure subclavian artery (Figure 6.1)

Contraindications

Side effects and complications

Horner syndrome

Phrenic nerve block

Pneumothorax

Equipment

Technique

Scanning

Needle insertion

Local anesthetic injection

Author' s clinical practice

Suggested reading

Chapter 7 Infraclavicular brachial plexus block

Introduction and specific anatomy

Brachial plexus

Intercostobrachial nerve

Ultrasound anatomy

Orienting structure axillary artery

Contraindications

Side effects and complications

Equipment

Technique

Technique summary

Scanning

Needle insertion

Local anesthetic injection and needle repositioning

Block of the intercostobrachial nerve

Authors clinical practice

Suggested reading

Chapter 8 Axillary peripheral nerve blocks

Introduction and specific anatomy

Brachial plexus

Intercostobrachial nerve

Side effects and complications

Ultrasound anatomy

Orienting structure axillary artery

Equipment

Technique summary

Scanning

Needle insertion

Local anesthetic injection and needle repositioning

Block of the musculocutaneous nerve

Block of the intercostobrachial nerve

Authors' clinical practice

Suggested reading

Chapter 9 Additional upper extremity peripheral nerve blocks

Superficial Cervical Plexus Block

Anatomy

Equipment

Technique

Complications

Authors´ clinical practice

Suprascapular nerve block

Anatomy

Equipment

Technique

Complications

Authors´ clinical practice

Intercostobrachial

Anatomy

Equipment

Technique

Complications

Authors´ clinical practice

Suggested reading

Section 3 Lower extremity peripheral nerve blocks

Chapter 10 Lower extremity anatomy for regional anesthesia

The lumbar plexus

The sacral plexus

Suggested reading

Chapter 11 Sciatic nerve block proximal approaches

Introduction and specific anatomy

The sciatic nerve and branches

Ultrasound anatomy

Subgluteal approach

Orienting structure (subgluteal approach) the greater trochanter (femur) and fascia

Anterior sciatic approach

Orienting structure (anterior sciatic approach) the lesser trochanter (femur)

Contraindications

Side effects and complications

Equipment

Technique summary

Subgluteal approach

Scanning

Needle insertion

Local anesthetic injection and needle repositioning

Anterior sciatic approach

Scanning

Needle insertion

Local anesthetic injection and needle repositioning

Authors' clinical practice

Suggested reading

Chapter 12 Sciatic nerve block lateral popliteal fossa/distal thigh approach

Introduction and specific anatomy

Sciatic nerve and branches

The saphenous nerve

Ultrasound anatomy

Orienting structure popliteal artery and biceps femoris muscle

Contraindications

Side effects and complications

Equipment

Technique

Technique summary

Scanning

Needle insertion

Local anesthetic injection and needle repositioning

Saphenous nerve blocks

Transsartorial (perifemoral) approach

Transsartorial (distal thigh) approach

Perivenous approach

Field block at the ankle

Authors clinical practice

Suggested reading

Chapter 13 Femoral peripheral nerve block

Introduction and specific anatomy

Femoral nerve

``3-in-1´´ block

Femoral vasculature

Ultrasound anatomy

Orienting structure femoral artery (Figure 13.7)

Contraindications

Side effects and complications

Equipment

Technique

Scanning

Needle insertion

Local anesthetic injection and needle repositioning

Authors clinical practice

Suggested reading

Chapter 14 Ultrasound-assisted ankle block

Introduction and specific anatomy

The tibial nerve (posterior tibial nerve)

The deep peroneal nerve

The superficial peroneal nerve

The sural nerve

The saphenous nerve

Ultrasound anatomy

Posterior tibial nerve

Orienting structure the posterior tibial artery (Figure 14.2)

Deep peroneal nerve

Orienting structure the anterior tibial/dorsalis pedis artery (Figure 14.4)

Contraindications

Side effects and complications

Equipment

Technique summary

The tibial nerve (posterior tibial nerve)

Scanning

Needle insertion

Local anesthetic injection and needle repositioning

The deep peroneal nerve

Scanning

Needle insertion

Local anesthetic injection and needle repositioning

The superficial peroneal nerve, sural nerve, and saphenous nerve

Authors clinical practice

Suggested reading

Section 4 Peripheral perineural catheters

Chapter 15 Introduction to continuous perineural catheters

Introduction

Benefits of continuous perineural catheters

Indications and selection criteria for perineural catheter placement

Infectious risk of perineural catheters

Catheter placement and securing

Equipment

Set-up for unassisted catheter placement

Infusion pump selection

Infusion and dosing regimen selection

Discharge instructions and follow-up care

Patient education

Patient follow-up

Catheter removal and pump disposal/return

Authors' clinical practice

Suggested reading

Chapter 16 Interscalene continuous perineural catheter

Introduction

Ultrasound anatomy review

Orienting structure carotid artery (Figure 16.1)

Equipment

Technique summary

Patient and equipment preparation

Scanning

Needle insertion

Local anesthetic injection and needle repositioning

Catheter insertion

Confirmation of catheter position

Securing and dressing the catheter site

Authors' clinical practice

Suggested reading

Chapter 17 Supraclavicular continuous perineural catheter

Introduction

Ultrasound anatomy review

Orienting structure subclavian artery (Figure 17.1)

Equipment

Technique summary

Patient and equipment preparation

Scanning

Needle insertion

Local anesthetic injection and needle repositioning

Catheter insertion

Confirmation of catheter position

Securing and dressing the catheter site

Authors' clinical practice

Suggested reading

Chapter 18 Infraclavicular continuous perineural catheter

Introduction

Ultrasound anatomy review

Orienting structure axillary artery (Figure 18.1)

Equipment

Technique summary

Patient and equipment preparation

Scanning

Needle insertion

Local anesthetic injection and needle repositioning

Catheter insertion

Confirmation of catheter position

Securing and dressing the catheter at the skin

Authors´ clinical practice

Suggested reading

Chapter 19 Sciatic continuous perineural catheters proximal and lateral popliteal fossa

Introduction

Ultrasound anatomy review

Distal thigh (lateral popliteal fossa) approach

Orienting structure (distal thigh approach) popliteal artery and biceps femoris muscle (Figures 19.1 and 19.2)

Subgluteal approach

Orienting structure (subgluteal approach) the greater trochanter (femur) and fascia (Figure 19.3)

Equipment

Technique summary

Patient and equipment preparation

Scanning

Distal thigh

Proximal thigh

Needle insertion

Local anesthetic injection and needle repositioning

Catheter insertion

Confirmation of catheter position

Securing the catheter at the skin

Authors' clinical practice

Suggested reading

Chapter 20 Femoral continuous perineural catheter

Introduction

Ultrasound anatomy review

Orienting structure femoral artery (Figure 20.1)

Equipment

Technique summary

Patient and equipment preparation

Scanning

Needle insertion

Local anesthetic injection and needle repositioning

Catheter insertion

Confirmation of catheter position

Securing and dressing the catheter at the skin

Authors' clinical practice

Suggested reading

Index

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