Brull Richard, Perlas Anahi, Chan Vincent W S
Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada.
Curr Pain Headache Rep. 2007 Feb;11(1):25-32. doi: 10.1007/s11916-007-0018-6.
Peripheral nerve blockade (PNB) for orthopedic surgery is usually performed without visual guidance, relying mainly on surface anatomic landmarks and electrical stimulation to localize nerves. Moreover, multiple trial and error attempts to place a needle can frustrate the operator, cause unwarranted pain to the patient, and waste valuable time in the operating room. Inaccurate needle placement and spread of local anesthetic account for most PNB failures, whereas "trial and error" needle manipulations for nerve localization can cause complications. The recent application of ultrasound (US) to PNB affords real-time imaging of the target nerve, needle, and surrounding vasculature, such that needle proximity to the nerve is ensured and vascular puncture avoided. This article reviews the advantages, principles, and techniques of US for the most common types of PNB.
骨科手术的周围神经阻滞（PNB）通常在无视觉引导的情况下进行，主要依靠体表解剖标志和电刺激来定位神经。此外，多次反复尝试进针会让操作者感到沮丧，给患者带来不必要的疼痛，并在手术室浪费宝贵的时间。局部麻醉药的针放置不准确和扩散是大多数PNB失败的原因，而用于神经定位的“反复尝试”进针操作可能会导致并发症。超声（US）最近应用于PNB可对目标神经、针和周围血管系统进行实时成像，从而确保针靠近神经并避免血管穿刺。本文综述了超声用于最常见类型PNB的优点、原理和技术。
