Ultrasound-Guided Neuraxial Anesthesia
- PDF / 336,593 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 109 Downloads / 197 Views
OTHER PAIN (N VADIVELU AND AD KAYE, SECTION EDITORS)
Ultrasound-Guided Neuraxial Anesthesia Jinlei Li 1 & Ramya Krishna 1 & Yang Zhang 2 & David Lam 1 & Nalini Vadivelu 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review There has been a recent surge of interest in clinical applications of ultrasound, which has revolutionized acute pain management. This review is to summarize the current status of ultrasound utilization in neuraxial anesthesia, the most common type of regional anesthesia. Recent Findings Ultrasound-assisted and ultrasound-guided neuraxial anesthesia has improved clinical accuracy and patient safety through landmark identification including proper vertebral level and midline, as well as via measurements on neuraxial space. Direct needle or catheter visualization during the entire procedure has not yet been achieved consistently. Summary The recent introduction of ultrasound into neural anesthesia has clinical performance benefits and patient safety implications, with documented improvement on overall efficacy with higher first attempt success rate as well as less needle pass. More controlled studies are needed for the overall impact of ultrasonography in neuraxial anesthesia in obstetric and nonobstetric patients. Keywords Neuraxial anesthesia . Obstetric neuraxial blockade . Ultrasound
Introduction Neuraxial anesthesia has a long history of efficacy and safety in many types of surgery providing analgesia and anesthesia. The success rate with landmark alone is less than desirable and can be challenging in patients with distorted anatomy (history of back surgery, kyphosis, scoliosis), high body mass index This article is part of the Topical Collection on Other Pain * Jinlei Li [email protected] Ramya Krishna [email protected] Yang Zhang [email protected] David Lam [email protected] Nalini Vadivelu [email protected] 1
Department of Anesthesiology, Yale University, New Haven, CT, USA
2
Department of Anesthesiology and Perioperative Medicine, University of Rochester, Rochester, NY, USA
(BMI), or during pregnancy. Fluoroscopy has improved the accuracy but is associated with radiation. The introduction of ultrasound into neuraxial anesthesia is new and has exhibited its positive impacts on the efficacy and accuracy of this common reginal anesthesia technique.
Neuraxial Anesthesia Prior to Ultrasound Era With the continued development of medical technologies and desire for progress, medical practices and techniques have also evolved. Dr. Carl Koller, an ophthalmologist who injected cocaine solution on the cornea in 1884, was the catalyst in the development of regional anesthesia [1]. In 1885, James Corning begun experimenting with injecting cocaine between the spinous processes of the spine in dogs and human subjects and he would author the first publication describing the concepts of neuraxial blockade [2]. In 1891, Wynter and Quicke attempted to treat raised intracranial hypertension and were the first to aspirate cerebrospi
Data Loading...
