Document Detail

Limitations and technical considerations of ultrasound-guided peripheral nerve blocks: edema and subcutaneous air.
MedLine Citation:
PMID:  18675747     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Despite advantages of ultrasound-guided peripheral nerve blocks as compared with established techniques, various limitations may exist. We present 2 trauma patients in whom the usefulness of ultrasound techniques was limited by edema and subcutaneous air. CASE REPORT: Two male patients were admitted to the Intensive Care Unit due to multiple trauma. In the first patient, tissue edema and obesity (body mass index, calculated as weight [kg]/height [m(2)] = 35), and in the second patient, subcutaneous emphysema, were significant limitations for the application of ultrasound-guided peripheral nerve blocks. These factors made 2-dimensional ultrasound imaging difficult despite the use of tissue harmonic technique and advanced ultrasound equipment. Neurostimulation technique alone, or combined with ultrasound imaging eventually led to successful nerve block. CONCLUSIONS: Ultrasound technique limitations do exist. We present 2 conditions, edema and subcutaneous air, which contributed to ultrasound failure to provide a clear image of the targeted nerves.
Theodosios Saranteas; Dimitrios Karakitsos; Anastasia Alevizou; John Poularas; Georgia Kostopanagiotou; Andreas Karabinis
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Regional anesthesia and pain medicine     Volume:  33     ISSN:  1532-8651     ISO Abbreviation:  Reg Anesth Pain Med     Publication Date:    2008 Jul-Aug
Date Detail:
Created Date:  2008-08-04     Completed Date:  2008-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9804508     Medline TA:  Reg Anesth Pain Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  353-6     Citation Subset:  IM    
Intensive Care Unit, General State Hospital of Athens, Athens, Greece.
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MeSH Terms
Edema / ultrasonography
Middle Aged
Nerve Block / methods*
Peripheral Nerves / ultrasonography*
Subcutaneous Emphysema / ultrasonography
Subcutaneous Tissue

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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