Incidence of local anesthetic systemic toxicity and postoperative neurologic symptoms associated with 12,668 ultrasound-guided nerve blocks: an analysis from a prospective clinical registry.

Background And Objectives: There are varying reports on the incidence of major morbidity associated with peripheral regional anesthesia. Our objective was to contribute to the knowledge regarding the incidence of local anesthetic systemic toxicity and postoperative neurologic symptoms in the setting of ultrasound-guided peripheral regional anesthesia.

Methods: During an 8-year period, 12,668 patients undergoing peripheral regional anesthesia were evaluated.

Ultrasound-guided common peroneal nerve block at the level of the fibular head.

A common peroneal nerve block at the fibular head is uncommon in clinical practice. The case of a 41 year old, morbidly obese woman requiring right total ankle replacement is presented. Ultrasound-guided common peroneal nerve block was performed at the fibular head after an unsuccessful popliteal approach.

Musculoskeletal sonopathology and ultrasound-guided regional anesthesia.

The use of real-time ultrasound guidance has revolutionized the practice of regional anesthesia. Ultrasound is rapidly becoming the technique of choice for nerve blockade due to increased success rates, faster onset, and potentially improved safety. In the course of ultrasound-guided regional anesthesia, unexpected pathology may be encountered.

Ultrasound-guided regional anesthesia for peripheral nerve blocks: an evidence-based outcome review.

Ultrasound-guided regional anesthesia (UGRA) has increased in popularity over the past 5 years. This interest is reflected by the plethora of publications devoted to technique development, as well as randomized and controlled trials. Despite the excitement around ultrasonography, skeptics argue that there is a lack of evidence-based medicine to support the unequivocal adoption of UGRA as a "standard of care.

Clinical sonopathology for the regional anesthesiologist: part 2: bone, viscera, subcutaneous tissue, and foreign bodies.

The use of ultrasound to facilitate regional anesthesia is an evolving area of clinical, education, and research interests. As our community's experience grows, it has become evident that anesthesiologists performing "routine" ultrasound-guided blocks may very well be confronted with atypical or even pathologic anatomy. As an educational resource for anesthesiologists, the following articles present examples of common sonopathology that may be encountered during ultrasound-guided regional anesthesia.

Clinical sonopathology for the regional anesthesiologist: part 1: vascular and neural.

The use of ultrasound to facilitate regional anesthesia is an evolving area of clinical, education, and research interests. As our community's experience grows, it has become evident that anesthesiologists performing "routine" ultrasound-guided blocks may very well be confronted with atypical or even pathologic anatomy. As an educational resource for anesthesiologists, the following articles present examples of common sonopathology that may be encountered during ultrasound-guided regional anesthesia.

Ultrasound does not improve the success rate of a deep peroneal nerve block at the ankle.

Background: The deep peroneal nerve is 1 of 5 nerves anesthetized when performing an ankle block. Multiple techniques of blocking the deep peroneal nerve have been described, but little evidence exists to delineate the efficacy of any one technique. We hypothesized that ultrasound would increase both the success rate and the quality of a deep peroneal nerve block at the ankle.

Ultrasound improves the success rate of a tibial nerve block at the ankle.

Background: The tibial nerve provides the majority of sensation to the foot. Although multiple techniques have been described, there exists little evidence-based medicine evaluating different techniques for blocking the tibial nerve at the ankle. We hypothesized that an ultrasound (US)-guided tibial nerve block at the ankle would prove more successful than a conventional approach based on surface landmarks.

Ultrasound-guided posterior approach for the placement of a continuous interscalene catheter.

Background And Objectives: The posterior approach to performing a continuous brachial plexus block at the level of the nerve roots has been described using traditional superficial landmarks. We describe an ultrasound-guided approach for the placement of a continuous interscalene brachial plexus catheter at the level of the nerve roots using a posterior approach. In addition, we provide the clinical characteristics of the first 16 catheters placed at our institution utilizing this approach.

Ultrasound improves the success rate of a sural nerve block at the ankle.

Background And Objectives: : During ankle block performance, anesthetizing the sural nerve is important for generating complete anesthesia of the lateral aspect of the foot. We hypothesized that an ultrasound-guided perivascular approach, utilizing the lesser saphenous vein as a reference, would prove more successful than a conventional approach based on surface landmarks.

Methods: : Eighteen healthy volunteers were prospectively randomized into this controlled and blinded study.

Ultrasound guidance in regional anesthesia: state of the art review through challenging clinical scenarios.

Ultrasound guided regional anesthesia (UGRA) for peripheral nerve blockade is becoming increasingly popular. The advantage of ultrasound technology is that it affords the anesthesiologist the real time ability to visualize neural structures, needle advancement, and local anesthetic spread. Recent data suggest that UGRA generates improved success rates and reductions in performance times in comparison to traditional approaches.