Ultrasonography in Pain Medicine and Regional Anesthesia Expert Consensus

Abstract

Ultrasound has revolutionized interventional pain medicine and regional anesthesia. It allows visualization of nervoussystem structures, which are the primary targets in pain management and regional anesthesia procedures. Precise andsafe deposition of local anesthetics around nerve structures is made possible with ultrasound, resulting in rapid regionalanesthesia and modulation of pathological pain signals. In diagnostic and prognostic pain treatments, the precisionof drug administration and deposition of small volumes are crucial. Proper identification of the nerve responsible fortransmitting pathological pain signals is key to achieving the desired effect in neurodestructive procedures such asneurolysis, cryoablation, thermocoagulation, or pulsed neuromodulation. Visualization of structures to avoid, such asblood vessels or parenchymal organs, reduces the risk of adverse events like hematoma or damage to sensitive internalorgans. Real-time needle tracking during procedures shortens the duration and increases precision. Monitoring thespread of the administered therapeutic substance during the procedure enhances the effectiveness and selectivityof the block. When combined with X-ray imaging, using ultrasound reduces procedure time and exposure to X-rayradiation. Furthermore, ultrasound does not expose clinicians and patients to harmful X-ray radiation. Widespreadadoption of ultrasound in imaging nervous system structures during regional anesthesia and interventional painprocedures necessitates the development of new procedural standards.