Ultrasound Guidance in Regional Anaesthesia 2nd Edition PDF – Principles and Practical Implementation
5.07 MB PDF
The practice of regional anaesthesia and peripheral nerve blocks in particular has changed substantially over the past decade. In fact, it would not be an overstatement to say that the new technical developments in the field tether of making some of the old teaching to the brink of obsolete. Most significant developments are the results of technical advances or, more specifically, the introduction of ultrasound monitoring for the placement of needles and catheters. The ability to monitor the disposition of the local anesthetic is now a key factor in acquiring an unprecedented control over technique execution. Ultrasound monitoring gives the practitioner insight into the block dynamics and disposition of the local anesthetics around peripheral nerves and plexuses. All of this new information has had a cumulative impact on our understanding of the mechanisms of neural blockade and the relationship between the volume of local anesthetics and a successful blockade. The idiosyncrasy of nerve stimulation, which was the gold standard for nerve localization prior to the introduction of ultrasound, is also much better understood.
However, ultrasound guidance during the administration of peripheral nerve blocks and increasingly, other regional anaesthesia techniques, was not an overnight success. Significant efforts were expended, both in advancing and improving on the ultrasound technology, to provide an image quality level that allows reliable imaging of the peripheral nerves and needle visualization. The industry clearly deserves accolades for their efforts to bring this technology within the reach of practising clinicians. However, these developments would not have been possible without the pioneering efforts of an international group of anaesthesiologists with extraordinary technical knowledge and drive. Indeed, it was the regional anaesthesiologists who fervently guided the industry to improve the equipment, and who then used every advance to test the applicability of the new technology for use in neural imaging and the administration of regional anaesthesia. It is for this reason that compendiums of knowledge from these very think tank echelons are particularly valuable. Professor Peter Marhofer and his Viennese group of collaborators are uniquely suited to create such a text. They have worked at the forefront to steer the ultrasound industry and the focus of clinical practice towards the application of ultrasound for use in regional anaesthesia since the mid-nineties.
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