Sites Brian D, Brull Richard
Department of Anesthesiology, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
Curr Opin Anaesthesiol. 2006 Dec;19(6):630-9. doi: 10.1097/ACO.0b013e3280101423.
This article introduces the use of ultrasound to facilitate peripheral regional anesthesia.
Regional anesthesia, despite its well known clinical benefits, has not gained the popularity of general anesthesia. This is secondary to multiple shortcomings including a defined failure rate, lack of simplicity, and the potential for patient discomfort or injury. Many of the negative aspects of regional anesthesia evolve from the reality that current nerve-localization techniques are unreliable. Given the great variation in human anatomy it is not surprising that even the most veteran clinician can be challenged by techniques that demand anatomical assumptions. The recent use of ultrasound imaging for nerve localization is an innovative application of an old technology which addresses many of the shortcomings of current techniques. Specifically, ultrasound imaging allows the operator to see neural structures, guide the needle under real-time visualization, navigate away from sensitive anatomy, and monitor the spread of local anesthetic.
Ultrasound technology represents an ideal mechanism by which the regional anesthesiologist can attain the safety, speed, and efficacy of general anesthesia. Ultimately, it is the correct peri-neural spread of local anesthetic around a nerve that provides safe, effective, and efficient anesthetic conditions.
本文介绍超声在辅助外周区域麻醉中的应用。
区域麻醉尽管有众所周知的临床益处，但尚未像全身麻醉那样普及。这是由于多种缺点所致，包括一定的失败率、缺乏简便性以及患者不适或受伤的可能性。区域麻醉的许多负面因素源于当前神经定位技术不可靠这一现实。鉴于人体解剖结构差异很大，即使是经验最丰富的临床医生也可能在需要解剖学假设的技术面前面临挑战，这并不奇怪。最近将超声成像用于神经定位是一项旧技术的创新应用，解决了当前技术的许多缺点。具体而言，超声成像使操作者能够看到神经结构，在实时可视化下引导穿刺针，避开敏感解剖结构，并监测局部麻醉药的扩散。
超声技术是区域麻醉医生实现全身麻醉的安全性、速度和有效性的理想手段。最终，局部麻醉药在神经周围正确的神经周围扩散才能提供安全、有效和高效的麻醉条件。
