tailieunhanh - Ebook Atlas of ultrasound-guided procedures in interventional pain management (2E): Part 2

(BQ) Part 2 book “Atlas of ultrasound-guided procedures in interventional pain management” has contents: Ultrasound-guided peripheral nerve blocks and catheters, diagnostic and musculoskeletal (MSK) ultrasound, diagnostic neurosonology, advanced and new applications of ultrasound. | Part IV Ultrasound-Guided Peripheral Nerve Blocks and Catheters Ultrasound-Guided Upper Extremity Blocks 19 Jason McVicar, Sheila Riazi, and Anahi Perlas Introduction Peripheral nerve block techniques have traditionally been performed based on nerve identification from surface anatomical landmarks and neurostimulation. Anatomical variation among individuals often makes these techniques difficult and may result in variable success and serious complications such as bleeding, nerve injury, local anesthetic systemic toxicity (LAST), and pneumothorax. Ultrasound is the first imaging modality to be broadly used in regional anesthesia practice. Ultrasound-guided regional anesthesia (UGRA) uses real-time imaging to appreciate individual anatomic variations, precisely guide needle advancement, minimize local anesthetic dose, and visualize drug deposition around target structures (Fig. ). These advantages over traditional methods have resulted in improved nerve block safety, efficacy, and efficiency [1, 2]. The brachial plexus and its branches are particularly amenable to sonographic examination, given their superficial location, with high-frequency (>10 MHz) linear array probes providing high-resolution images. Brachial Plexus Anatomy Thorough knowledge of brachial plexus anatomy is required to facilitate block placement and to optimize patient-specific block selection. The four traditional “windows” for brachial plexus block are the interscalene level (roots), supraclavicular level (trunks and divisions), infraclavicular level (cords), and axillary level (branches) (Fig. ). However, the brachial plexus is best thought of as a continuum that may be imaged and anesthetized almost anywhere along its course. J. McVicar · S. Riazi · A. Perlas (*) Department of Anesthesia, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada e-mail: The brachial plexus provides sensory and motor i­ nnervation to the upper limb. It .

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