Ultrasound-guided Regional Anesthesia

Abstract

University of California, Irvine, Orange, California. jcahn@uci.eduBy Fernando L. Arbona, M.D., Babak Khabiri, D.O., John A. Norton, D.O. New York, Cambridge University Press, 2011. Pages: 206. Price: $99.00.The relatively recent incorporation of ultrasound technology for placement of peripheral nerve blocks and perineural nerve catheters has revolutionized the field of regional anesthesia. For those practitioners who have trained using the nerve stimulator technique, incorporating ultrasound into their busy practice may seem like a daunting task. As the title suggests, Ultrasound-guided Regional Anesthesia : A Practical Approach to Peripheral Nerve Blocks and Perineural Catheters targets not only this audience but also current trainees by providing a pragmatic guide for those interested in learning ultrasound-guided regional anesthesia.Well written with a straightforward style, Ultrasound-guided Regional Anesthesia presents a comprehensive yet concise introduction to ultrasound-guided nerve blocks. Visually interesting, the book is filled with ample illustrations along with photographs of mock patients and their corresponding ultrasound images. The text reads easily and it often feels as if the authors are conversing and instructing you in person. Detailed instructions on how to identify the target structures, set up for the procedures, and perform the blocks are methodical and easy to follow. The “Author's Clinical Practice” section at the end of each procedure references the authors' individual practices and gives the reader practical insight into how these techniques translate to real life. In addition, each chapter is peppered with a highlighted “Key Points” or “Additional Considerations” section filled with relevant clinical pearls and useful tips designed to maximize success.The text is divided into four major sections. The first section focuses on fundamental concepts, including the pharmacology of local anesthetics, ultrasound physics, and the clinical application of ultrasound in regional anesthesia. The second and third sections are dedicated to upper and lower extremity blocks, respectively. Each of these sections begins with a review of relevant anatomy, contraindications to the procedure, potential complications, and, finally, instructions on how to perform the block. Descriptions of the procedure are further organized into categories, including equipment, scanning techniques, needle insertion, and local anesthetic injection. The final section of the book details peripheral perineural catheter placement and management. The first chapter in this section discusses proper patient selection and both inpatient and outpatient management. Dosing regimens and pump selection are reviewed, and the authors describe catheter insertion techniques for both solo and dual practitioners. The remaining chapters cover catheter placement for the various blocks reviewed in the book's previous chapters.Writing a book with the primary intent to teach procedural techniques can be a challenge, but Ultrasound-guided Regional Anesthesia : A Practical Approach to Peripheral Nerve Blocks and Perineural Catheters is a well-executed guide. As the title suggests, this book is practical: the text is easy to digest, the instructions are clear, and the graphics and clinical insights are beneficial. This book would make a welcome addition to any library as a fast and useful reference for the busy anesthesia provider wishing to incorporate ultrasound-guided regional anesthesia in his or her practice.University of California, Irvine, Orange, California. jcahn@uci.edu