Anestéziológia a intenzívna medicína 1/2012

Quo vadis, regional anesthesia?

Conventional as well as nerve stimulator guided peripheral nerve blocks are performed without visual guidance, thus are highly dependent on surface anatomical landmarks. These regional techniques have a failure rate of up to 20%. In patients with difficult anatomy, multiple needle insertions can lead to iatrogenic injury as well as increased periprocedural pain. The first ultrasound guided nerve blocks have been described in 1978. With the help of ultrasound, the anesthesiologist visualises the location of nerves, vessels, bones , viscera as well as the course of the blocking needle, which enables him to insert the needle in the right direction and depth, avoiding injury to the adjacent tissue. The ability to see and influence the local anesthetic spread in real time makes the block more reliable and decreases the volume of local anesthetic. Ultrasound guided regional anesthesia is a modern state of the art anesthetic procedure.

Keywords: regional anesthesia, ultrasound, nerve stimulation, cardiotoxicity.