Ultrasound-Guided Nerve Blocks

Abstract

In recent years, there has been increasing interest and enthusiasm for using ultrasound guidance in performing peripheral nerve blocks. The use of ultrasound guidance in regional anesthesia has led to increased use of peripheral nerve blocks and greater acceptance by healthcare providers across different specialties. Ultrasound-guided nerve blocks offer effective and safe alternatives to achieve pain control and perform a variety of medical procedures in the acute care settings. They are associated with numerous benefits including improved analgesia, decreased intravenous narcotic use, decreased complications, and reduced length of stay. Ultrasound allows real-time visualization of the anatomy of the region of interest and path of the needle resulting in accurate deposition and spread of local anesthetic around the target nerve. Ultrasound guidance has been shown to improve operator confidence and overall success rates of peripheral nerve blocks. In this chapter, we will review the basic principles of ultrasound-guided nerve blocks and a variety of upper and lower extremity ultrasound-guided nerve block techniques including the brachial plexus, forearm (median, radial, and ulnar nerves), femoral, and posterior tibial nerve blocks. These nerve blocks are described in a way that they can be incorporated into your clinical setting with already available equipment and supplies.