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Ball RD, Scouras NE, Orebaugh S, Wilde J, Sakai T. Randomized, prospective, observational simulation study comparing residents' needle-guided vs free-hand ultrasound techniques for central venous catheter access. Br J Anaesth 2011; 108:72-9. [PMID: 22086510 DOI: 10.1093/bja/aer329] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Short-axis ultrasound-guided placement of central venous catheters (CVCs) is widely accepted as safe practice. However, utilizing the long-axis approach could further improve safety, as it allows for better visualization of the needle as it is advanced to the target vessel. However, the long-axis approach has not widely been used due to the technical difficulty. Recently, a new needle guidance device has become available to aid in the long-axis approach. We hypothesized that the use of a needle guide paired with the long-axis approach would facilitate puncture of the target vessel in a simulation model more effectively than similar free-hand techniques. METHODS A prospective observational study of anaesthesia residents using a CVC partial-task training device was conducted. Each resident performed needle puncture of the target vessel with three different techniques, assigned in random order: short-axis free hand (S-FH), long-axis free hand (L-FH), and long-axis needle guide (NG). To prove the effectiveness of the needle guide, the fraction of time the needle tip remained in view of the ultrasound was recorded and compared. Time required for completing the task and the number of needle sticks and needle re-directions were compared. RESULTS Thirty-three residents participated in the study. The fraction of time the needle tip remained in view of the ultrasound was significantly higher for the residents using NG [0.90 (0.10)] compared with residents using the other techniques [L-FH: 0.36 (0.20), S-FH: 0.18 (0.10)] (P<0.001). For each resident, the use of the needle guide in the long-axis approach increased visualization by 352 (276)% compared with that of L-FH and by 1028 (1804) % compared with that of S-FH. There was no significant difference in time required to puncture the target between NG [23.7 (14.6) s] and L-FH [30.3 (36.5) s] (P=0.21); however, both were significantly longer than S-FH [17.0 (13.3) s] (P=0.012). The numbers of needle sticks and of needle re-directions did not differ among the groups. CONCLUSIONS The needle guide device used in the long-axis approach improved the needle visualization compared with free-hand techniques. The needle guide used in the long-axis technique, however, did not facilitate puncture of the target vessel in this simulation model when compared with free-hand techniques.
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Affiliation(s)
- R D Ball
- Department of Anesthesiology, University of Pittsburgh Medical Center, University of Pittsburgh, Liliane S. Kaufmann Building, 3471 Fifth Avenue Suite 910, Pittsburgh, PA 15213, USA
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Hebard S, Hocking G, Murray K. Two-Dimensional Mapping to Assess Direction and Magnitude of Needle Tip Error in Ultrasound-Guided Regional Anaesthesia. Anaesth Intensive Care 2011; 39:1076-81. [DOI: 10.1177/0310057x1103900615] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We assessed whether echogenic needles reduce tip location error, by comparing three echogenic designs (Pajunk Sonoplex, Lifetech, B. Braun Stimuplex D+) with a non-echogenic control (Pajunk Uniplex), using a novel assessment technique in unembalmed human cadavers. Multiple images were taken of each needle at shallow (15 to 25°), moderate (35 to 45°) and steep (55 to 65°) insertion angles. Twenty anaesthetists with varied experience in ultrasound-guided nerve blocks identified needle tip position and stated their confidence level in estimates. Actual tip position was determined at the time of image generation but concealed from the anaesthetists. Two-dimensional mapping of ‘tip-error’ involved measurement of the distance and orientation of each clinician's estimate of tip position in relation to the actual tip position. There were no significant differences in confidence or overall needle visibility at shallow insertion angles. At steeper angles, the Sonoplex showed significantly higher confidence and visibility scores. The remaining echogenic designs did not show any significant differences from the non-echogenic control. Objective measurements of tip error followed the same pattern as the subjective data, although were not universally significant. Two-dimensional mapping showed that as needle visibility deteriorated, so precise tip location was lost but the needle shaft/insertion path remained well-identified. As visibility deteriorated further, accuracy in this axis was also lost. When inaccurate, clinicians generally assessed the needle tip to be more superficial and inserted less far than it actually was. This has important implications for the safety of ultrasound-guided regional anaesthesia. Effective echogenic needle technology has the potential to address these concerns.
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Affiliation(s)
- S. Hebard
- Department of Anaesthesia, Sir Charles Gairdner Hospital, Perth, Western Australia
| | - G. Hocking
- Department of Anaesthesia, Sir Charles Gairdner Hospital, Perth, Western Australia
| | - K. Murray
- Department of Anaesthesia, Sir Charles Gairdner Hospital, Perth, Western Australia
- School of Mathematics and Statistics, The University of Western Australia
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Nash H, Khoda B, Heppell S, Turner M. TAP blocks in breast reconstructions using abdominal wall tissue. Anaesthesia 2011; 66:750-1. [PMID: 21749351 DOI: 10.1111/j.1365-2044.2011.06798.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kandil E, Khalek MA, Alabbas H, Moroz K, Islam T, Friedlander P, Jaffe BM. Comparison of ultrasound-guided biopsy technique for thyroid nodules with respect to adequacy of cytological material. ORL J Otorhinolaryngol Relat Spec 2011; 73:177-81. [PMID: 21625193 DOI: 10.1159/000323005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 10/26/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Ultrasound-guided fine-needle aspiration cytology (FNAC) sampling of the thyroid represents a standard diagnostic procedure in the evaluation of thyroid nodules. The specimen can be acquired using either of two different techniques. In the first, the short axis is used with observation only of the tip of the needle whilst in the nodule. In the second technique, the long axis is used with the observation of the entire length of the needle. The decision to sample utilizing either technique was done randomly. This study is a retrospective review performed to compare these two techniques with regard to specimen adequacy. METHODS Ultrasound-guided FNACs were performed in 80 thyroid nodules between May 2008 and February 2009. One physician acquired the cytology specimens using one of these two methods after localization. Data on the type of technique and its diagnostic accuracy were collected. RESULTS Forty-nine of 80 thyroid nodules were sampled using the long-axis technique. The overall and deep-lesion diagnostic adequacies of specimens were significantly higher using this technique (93.9 and 95.1%, respectively, p < 0.01) than the short-axis technique. When comparing the long and short axes for superficial lesions, there was no significant difference in adequacy of the samples (p = 0.92). CONCLUSIONS This is the first study to compare long- and short-axis techniques with regard to specimen adequacy for thyroid nodules. The long-axis technique decreased the rate of inadequate material and provided more accurate cytological evaluation for deeper lesions.
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Affiliation(s)
- Emad Kandil
- Department of Surgery, Endocrine and Oncological Surgery Division, Tulane University School of Medicine, New Orleans, LA, USA.
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Echogenic Technology Can Improve Needle Visibility During Ultrasound-Guided Regional Anesthesia. Reg Anesth Pain Med 2011; 36:185-9. [DOI: 10.1097/aap.0b013e31820d4349] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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56
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Newly Designed, Self-Coiling Catheters for Regional Anesthesia-An Imaging Study. Reg Anesth Pain Med 2011; 36:171-6. [DOI: 10.1097/aap.0b013e31820d431a] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jung G, Kim BS, Shin KB, Park KB, Kim SY, Song SO. The optimal volume of 0.2% ropivacaine required for an ultrasound-guided stellate ganglion block. Korean J Anesthesiol 2011; 60:179-84. [PMID: 21490819 PMCID: PMC3071481 DOI: 10.4097/kjae.2011.60.3.179] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Revised: 08/23/2010] [Accepted: 08/29/2010] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This study was performed to find the optimal volume of local anesthetics needed for a successful ultrasound-guided stellate ganglion block (SGB) to treat head and neck pathology. METHODS Fifteen female and fourteen male sensory-neural hearing loss patients received 4 times SGBs with 0.2% ropivacaine in volumes of 6, 4, 3 and 2 ml at 1 to 3 day intervals. Using the transverse short-axis view of the neck that showed Chassaignac's tubercle at the C6 level, a 25-gauge, and 4 cm needle was inserted via the lateral paracarotid approach with out-of-plane targeting between the prevertebral fascia and the ventral surface of longus colli muscle (subfascial injection). A successful block was confirmed with the onset of ptosis (Horner's syndrome). RESULTS There were no significant statistical differences between the presence of Horner's syndrome and the volume of local anesthetics given. However, Horner's syndrome was present in all trials for the 4 ml and 6 ml groups. Six (20.7%) and three out (10.4%) of twenty-nine trials in the 2 ml and 3 ml groups, respectively, failed to elicit Horner's syndrome. The duration of action was significantly different in the 2 ml group compared to that of the 6 ml group, but there was no significant difference between the other groups, including the 4 ml vs. 6 ml groups. The side effects were not different between the groups. CONCLUSIONS This data suggests that the optimal volume of 0.2% ropivacaine for ultrasound-guided SGB to treat the head and neck pathology in daily practice is 4 ml.
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Affiliation(s)
- Gul Jung
- Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Bum Soo Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Kyung-Bae Shin
- Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Ki-Bum Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Sae Yeon Kim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Sun Ok Song
- Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea
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Ultrasound-guided perineural catheter insertion: three approaches but few illuminating data. Reg Anesth Pain Med 2011; 35:123-6. [PMID: 20216031 DOI: 10.1097/aap.0b013e3181d245a0] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lento PH, Strakowski JA. The Use of Ultrasound in Guiding Musculoskeletal Interventional Procedures. Phys Med Rehabil Clin N Am 2010; 21:559-83. [DOI: 10.1016/j.pmr.2010.04.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sell A. Nerve injury by needle nerve perforation in regional anaesthesia. Br J Anaesth 2010; 105:94; author reply 94-5. [PMID: 20551032 DOI: 10.1093/bja/aeq149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Venkatesan K. Echo-enhanced needles for short-axis ultrasound-guided vascular access. Int J Emerg Med 2010; 3:205. [PMID: 21031049 PMCID: PMC2926874 DOI: 10.1007/s12245-010-0164-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2009] [Accepted: 01/18/2010] [Indexed: 11/30/2022] Open
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Neubach Z, Shoham M. Ultrasound-Guided Robot for Flexible Needle Steering. IEEE Trans Biomed Eng 2010; 57:799-805. [DOI: 10.1109/tbme.2009.2030169] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Bloc S, Mercadal L, Dessieux T, Garnier T, Estebe JP, Le Naoures A, Komly B, Leclerc P, Morel B, Ecoffey C, Dhonneur G. The learning process of the hydrolocalization technique performed during ultrasound-guided regional anesthesia. Acta Anaesthesiol Scand 2010; 54:421-5. [PMID: 20085548 DOI: 10.1111/j.1399-6576.2009.02195.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Because poor echogenicity of the needle remains a safety issue, we decided to analyze the learning process of the hydrolocalization technique (Hloc) performed to continuously identify needle-tip anatomical position during many ultrasound-guided regional anesthesia procedures. METHODS Ten senior anesthesiologists naïve to the Hloc agreed to participate in the study. They were requested to perform 40 out-of-plane (OOP) approach ultrasound-guided axillary blocks (AB) each using the Hloc. The Hloc, which is a needle-tip localization principle, was performed by means of repetitive injections of a small amount of a local anesthetic solution (0.5-1 ml) under an ultrasound beam. Details of the learning process and skill acquisition of the Hloc were derived from the following parameters: the duration of block placement, a measure of the perceived difficulty of needle-tip visualization, a measure of block placement difficulty, and the amount of local anesthetics solution required for the technique. RESULTS Four hundred ABs were performed. The success rate of an ultrasound-guided AB was 98%. The Hloc was successful in all patients. Skill acquisition over time of the Hloc was associated with a significant reduction of both the duration and the perceived difficulty of ABs placement. Apprenticeship data revealed that 20 blocks were required to successfully place AB within 5 min in most cases using the Hloc. CONCLUSION The Hloc performed during the OOP approach of ultrasound-guided regional anesthesia is a simple technique with a relatively short learning process feasible for efficient placement of ABs.
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Affiliation(s)
- S Bloc
- Claude Galien Private Hospital, Quincy-Sous-Sénart, Paris, France
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65
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Stone MB, Moon C, Sutijono D, Blaivas M. Needle tip visualization during ultrasound-guided vascular access: short-axis vs long-axis approach. Am J Emerg Med 2010; 28:343-7. [DOI: 10.1016/j.ajem.2008.11.022] [Citation(s) in RCA: 146] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2008] [Revised: 10/25/2008] [Accepted: 11/20/2008] [Indexed: 11/24/2022] Open
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66
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Su J, Karpiouk A, Wang B, Emelianov S. Photoacoustic imaging of clinical metal needles in tissue. JOURNAL OF BIOMEDICAL OPTICS 2010; 15:021309. [PMID: 20459231 PMCID: PMC2859083 DOI: 10.1117/1.3368686] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Revised: 01/07/2010] [Accepted: 02/03/2010] [Indexed: 05/18/2023]
Abstract
The ability to visualize and track temporarily or permanently implanted metal devices is important in many applications ranging from diagnosis to therapy. Specifically, reliable imaging of metal needles is required in today's clinical settings. Currently, ultrasound is utilized to image a needle inserted into tissue in real time. However, the diagnostic value and tracking ability of these images depends highly on the orientation of the needle, and also its proximity to regions of interest in the tissue. We examine the use of photoacoustic imaging combined with current ultrasound imaging methods to obtain high-contrast images of commonly used needles in the body. Experiments were performed using 21 G and 30 G needles inserted into ex vivo porcine tissue and tissue-mimicking phantoms. The needles and surrounding tissue were imaged using an ultrasound imaging system interfaced with the pulsed laser source necessary for photoacoustic imaging. The results suggest that photoacoustic imaging, combined with ultrasound imaging, is capable of real-time, high-contrast, and high-spatial-resolution visualization of metal implants within anatomical landmarks of the background tissue.
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Affiliation(s)
- Jimmy Su
- The University of Texas at Austin, Department of Biomedical Engineering, 1 University Station C0800, Austin, Texas 78712, USA
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Abstract
STUDY DESIGN Case series. OBJECTIVE Evaluation of ultrasound and nerve stimulation-guided L5 nerve root block technique. SUMMARY OF BACKGROUND DATA Ultrasound-guided peripheral nerve block has become clinically applied. However, selective lumbosacral nerve root block is conducted under radiographic guidance, which involves patients and operators being exposed to radiation. In addition, it cannot be carried out easily during outpatient visits or at the bedside. We conducted L5 nerve root block, which is one of the most common lumbosacral nerve root block under ultrasonic guidance, using electrical nerve stimulation. METHODS We assessed the effectiveness of ultrasound and nerve stimulation-guided L5 nerve root block on 78 patients with L5 radicular syndrome. To compare ultrasonic guidance using electrical nerve stimulation with radiographic guidance, we used a contrast agent and assessed its distribution. RESULTS After nerve block, decreased sensation at L5 neural region and diminished/fully resolved pain was observed in all patients except for 3 in whom nerve block could not be conducted as their articular process protruded laterally. Concerning the response to stimulation, all except for these 3 felt the tapping sensation at their L5 neural regions, but no contraction of muscles was observed. The number of patients who showed an extraneural, paraneural, and intraneural pattern on contrast radiography was 71, 4, and 0, respectively. CONCLUSION Ultrasound-guided L5 nerve root block using electrical nerve stimulation is a safe and effective method.
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71
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Koscielniak-Nielsen ZJ, Rasmussen H, Hesselbjerg L. Long-Axis Ultrasound Imaging of the Nerves and Advancement of Perineural Catheters Under Direct Vision. Reg Anesth Pain Med 2008. [DOI: 10.1097/00115550-200809000-00013] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Romero AO, de Isasa DD, Rodríguez CDO, Ramos EM, Gil RR. [Portable ultrasound devices in regional anesthesia: the brachial plexus block]. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2008; 55:294-303. [PMID: 18661689 DOI: 10.1016/s0034-9356(08)70573-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Ultrasonography has received increasing attention in regional anesthesia in recent years because it allows visualization of the nerves, the needle, and the surrounding structures and makes it possible to monitor distribution of the local anesthetic. Ultrasound technology is unfamiliar to most anesthesiologists, unless they work with transesophageal echocardiography. Ultrasound-guided regional anesthesia relies entirely on the expertise of the person performing the technique and how that person interprets the images, though the latest portable ultrasound devices are ergonomically designed for fast, easy use, even by less experienced personnel. The high-frequency probes can identify the brachial plexus and produce excellent images of considerable educational value that differ only slightly from those provided by larger, more expensive equipment. Ultrasonography makes it possible to identify the brachial plexus, from the roots to the peripheral nerves of the arm. We describe the main approaches used in providing an ultrasound-guided brachial plexus block and explain the basic principles of ultrasound imaging.
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Affiliation(s)
- A Ortega Romero
- Departamento de Anestesiología, Hospital ASEPEYO, Coslada, Madrid.
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74
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Sandhu NS. Ultrasound imaging in anesthesia: an overview of vascular access and peripheral nerve blocks. ACTA ACUST UNITED AC 2007. [DOI: 10.1053/j.sane.2007.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Klein SM, Fronheiser MP, Reach J, Nielsen KC, Smith SW. Piezoelectric Vibrating Needle and Catheter for Enhancing Ultrasound-Guided Peripheral Nerve Blocks. Anesth Analg 2007; 105:1858-60, table of contents. [DOI: 10.1213/01.ane.0000286814.79988.0a] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
Accurate assessment and rapid decision-making are essential to save lives and improve performance in critical care medicine. Real-time point-of-care ultrasound has become an invaluable adjunct to the clinical evaluation of critically ill and injured patients both for pre- and in-hospital situations. However, a high level of quality is necessary, guaranteed by appropriate education, experience, credentialing, quality control, continuing education, and professional development. Although educational recommendations have been proposed by a variety of nonimaging specialties, to date they are still scattered and limited examples of standards for critical and intensive care professionals. The challenge of providing adequate specialty-specific training, as encouraged by major medical societies, is made even more difficult by the diversity of critical care ultrasound utilization by various subspecialties in a variety of settings and numerous countries. In order to meet this educational challenge, a standard core curriculum is presented in this manuscript. The proposed curriculum is built on a competence, performance, and outcomes-based approach that is tailored to setting-specific training needs and prioritized according to critical problem-based pathways, rather than traditional organ-based systems. A multiple goal-oriented style fully addresses the specialty-specific approach of critical and intensive care professionals, who typically deal with disease states in complex scenarios rather than individual organ complaints. Because of the variation in the concept of what constitutes critical care worldwide, and the rate of change of information and technology, this manuscript attempts to present a learning system addressing a variety of needs for a rapidly changing world.
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Affiliation(s)
- Luca Neri
- General Intensive Care Unit "Bozza," Niguarda Ca' Granda Hospital, Milan, Italy.
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78
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Abstract
Peripheral nerve blockade (PNB) for orthopedic surgery is usually performed without visual guidance, relying mainly on surface anatomic landmarks and electrical stimulation to localize nerves. Moreover, multiple trial and error attempts to place a needle can frustrate the operator, cause unwarranted pain to the patient, and waste valuable time in the operating room. Inaccurate needle placement and spread of local anesthetic account for most PNB failures, whereas "trial and error" needle manipulations for nerve localization can cause complications. The recent application of ultrasound (US) to PNB affords real-time imaging of the target nerve, needle, and surrounding vasculature, such that needle proximity to the nerve is ensured and vascular puncture avoided. This article reviews the advantages, principles, and techniques of US for the most common types of PNB.
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Affiliation(s)
- Richard Brull
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada.
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Hu P, Harmon D, Frizelle H. Ultrasound guidance for ilioinguinal/iliohypogastric nerve block: a pilot study. Ir J Med Sci 2007; 176:111-5. [PMID: 17570011 DOI: 10.1007/s11845-007-0017-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Accepted: 11/06/2006] [Indexed: 12/28/2022]
Abstract
BACKGROUND Ilioinguinal/iliohypogastric nerve block combined with general anaesthesia facilitates inguinal herniorrhaphy in an ambulatory setting by improving analgesia and reducing opioid requirements. Case reports in children indicate the possibility of colonic puncture and associated morbidity with blind ilioinguinal and iliohypogastric blockade. AIMS To investigate the feasibility of ultrasound guided ilioinguinal/iliohypogastric nerve block. METHODS Pilot study of four patients where ultrasound imaging was used to identify the ASIS, anterior abdominal muscle layers, the peritoneum and to guide local anaesthetic infiltration in patients undergoing inguinal hernia surgery and appendicectomy. RESULTS All patients had successful blocks, without complications. Mean visual analogue scores were 2/10 in the post anaesthesia care unit. Mean opioid consumption was 10 mg of intramuscular morphine in the first 24 h. CONCLUSIONS Ultrasound guidance for ilioinguinal and iliohypogastric nerve block in the inguinal region is both feasible and a promising technique.
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Affiliation(s)
- P Hu
- Department of Anaesthesia, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.
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Roh JH, Kim WO, Yoon KB, Yoon DM. The Success Rate of Caudal Block Under Ultrasound Guidance and the Direction of the Needle in the Sacral Canal. Korean J Pain 2007. [DOI: 10.3344/kjp.2007.20.1.40] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jang Ho Roh
- Department of Anesthesiology and Pain Medicine, MizMedi Hospital, Seoul, Korea
| | - Won Oak Kim
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea
- Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Bong Yoon
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea
- Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Duck Mi Yoon
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea
- Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
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81
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Needle Puncture Site and a “Walkdown” Approach for Short-Axis Alignment During Ultrasound-Guided Blocks. Reg Anesth Pain Med 2006. [DOI: 10.1097/00115550-200611000-00022] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Popovic J, Morimoto M, Wambold D, Blanck TJJ, Rosenberg AD. Current Practice of Ultrasound-Assisted Regional Anesthesia. Pain Pract 2006; 6:127-34. [PMID: 17309722 DOI: 10.1111/j.1533-2500.2006.00075.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jovan Popovic
- Department of Anesthesiology, New York University and NYU Hospital for Joint Diseases, New York University School of Medicine, New York 10016, USA.
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Bodenham AR. Editorial II: Ultrasound imaging by anaesthetists: training and accreditation issues. Br J Anaesth 2006; 96:414-7. [PMID: 16549625 DOI: 10.1093/bja/ael032] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Reply to Drs. Tsui and Finucane. Reg Anesth Pain Med 2005. [DOI: 10.1097/00115550-200511000-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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New perspectives in regional anesthesia: the use of ultrasound-past, present, and future. Can J Anaesth 2005. [DOI: 10.1007/bf03023081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Affiliation(s)
- Andrew T Gray
- University of California, Department of Anesthesia, San Francisco 94110, USA
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