The use of ultrasound for regional anesthesia is relatively new, however interest in this application is growing rapidly.
Ultrasound guided nerve blocks were first described as early as 1978, but it was not until the advent of advanced ultrasound
technology in the 1990's that interest in this field grew. Published reports of ultrasound guided regional anesthesia have
largely focused on brachial plexus blockade in the interscalene, supraclavicular, infraclavicular and axillary regions.
Recent studies examining the efficacy of ultrasound guidance for femoral, sciatic, psoas compartment, celiac plexus and
stellate ganglion blocks are promising, while ultrasound visualization of the epidural space can facilitate neuraxial blockade in children, adults and parturients.
The materials on this website describe both the techniques for single shot and continuous nerve blocks of the brachial plexus and lumbosacral
plexus, as well as techniques for neuraxial blockade. Each technique is described in an easy step-by-step manner and is accompanied by a list of selected
references. The goal of the materials on this website is to impart a greater understanding of ultrasound imaging for regional anesthesia to anesthesia practitioners and pain management clinicians.
Conventional peripheral nerve block techniques that are performed without visual guidance are highly dependent on surface anatomical landmarks for localization of the
target nerve. It is therefore not surprising that regional anesthetic techniques are associated with a reported failure rate of up to 20%
presumably because of incorrect needle and/or local anesthetic placement. Multiple trial-and-error attempts to locate the target nerve can lead to
operator frustration, unwarranted patient pain, and time delay in the operating room, especially in patients with difficult anatomical landmarks.
Imaging technology such as MRI and CT scan can successfully localize neural structures. However, ultrasound is the most practical imaging tool for
regional anesthesia as it is portable, relatively easy to learn, moderately priced, and does not pose any radiation risk. Ultrasound provides real time imaging guidance during a nerve block procedure.