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超声引导区域麻醉的新技术趋势

The new technological trends in ultrasound-guided regional anesthesia.

作者信息

Choquet Olivier, Abbal Bertrand, Capdevila Xavier

机构信息

Department of Anesthesiology and Critical Medicine, Lapeyronie University Hospital and Inserm U1046, Montpellier, France.

出版信息

Curr Opin Anaesthesiol. 2013 Oct;26(5):605-12. doi: 10.1097/01.aco.0000432512.15694.dd.

Abstract

PURPOSE OF REVIEW

Real-time two-dimensional ultrasound guidance is undoubtedly one of the most important evolutions in the field of regional anesthesia techniques, for peripheral nerve blocks and neuraxial anesthesia. The recent literature has been analyzed for studies concerning new technological trends in ultrasound-guided regional anesthesia. This review focuses on electromagnetic tracking systems for ultrasound guidance and three/four-dimensional ultrasound imaging in regional anesthesia.

RECENT FINDINGS

Electromagnetic tracking can facilitate needle-beam alignment for in-plane approaches and indicates where the needle crosses the beam during out-of-plane ultrasound-guided procedures. Three-dimensional ultrasound imaging can provide more detailed anatomical information and better spatial orientation than two-dimensional imaging. Four-dimensional ultrasound imaging enhances the visualization of a particular anatomy and offers real-time assessment of local anesthetic spread during ultrasound-guided regional anesthesia. These techniques have some limitations and drawbacks limiting their expansion.

SUMMARY

This article describes the principles, technology and development of electromagnetic tracking system for ultrasound guidance and three/four-dimensional ultrasound imaging in regional anesthesia, considering whether these new technologies will have impending applications in clinical practice.

摘要

综述目的

实时二维超声引导无疑是区域麻醉技术领域(包括外周神经阻滞和椎管内麻醉)最重要的进展之一。本文分析了近期关于超声引导区域麻醉新技术趋势的文献。本综述聚焦于超声引导的电磁跟踪系统以及区域麻醉中的三维/四维超声成像。

最新发现

电磁跟踪有助于平面内进针时的针-波束对齐,并在平面外超声引导操作过程中指示针穿过波束的位置。与二维成像相比,三维超声成像可以提供更详细的解剖信息和更好的空间定位。四维超声成像增强了对特定解剖结构的可视化,并在超声引导区域麻醉期间提供局部麻醉药扩散的实时评估。这些技术存在一些限制和缺点,限制了它们的推广。

总结

本文描述了超声引导的电磁跟踪系统以及区域麻醉中的三维/四维超声成像的原理、技术和发展,探讨了这些新技术是否即将在临床实践中得到应用。

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