(Loco)Regionale Technieken

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Ultrasound-Guided Techniques


Ultrasound-Guided Superficial Cervical Plexus Block

The goal of the ultrasound-guided technique of superficial cervical plexus block is to deposit local anesthetic in the vicinity of the sensory branches of the nerve roots C2, C3, and C4.
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Ultrasound-Guided Interscalene Brachial Plexus Block

The interscalene approach to brachial plexus blockade results in anesthesia of the shoulder and upper arm. Inferior trunk for more distal anesthesia can also be blocked by additional, selective injection, deeper in the plexus. 
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Ultrasound-Guided Supraclavicular Brachial Plexus Block

The supraclavicular approach to the brachial plexus blockade results in anesthesia of the upper limb below the shoulder because all trunks and divisions can be anesthetized. The medial skin of the upper arm (intercostobrachial nerve, T2), however, is never anesthetized by any technique of the brachial plexus block and when needed can be blocked by an additional subcutaneous injection just distal to the axilla.
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Ultrasound-Guided Infraclavicular Brachial Plexus Block

The ultrasound-guided infraclavicular brachial plexus block is in some ways both simple and challenging. It is simple in the sense that geometric measuring of distances and angles on the surface of the patient, as is the case with the nerve stimulator-based technique, is not required.
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Ultrasound-Guided Axillary Brachial Plexus Block

The axillary brachial plexus block offers several advantages over the other approaches to the brachial plexus. The technique is relatively simple to perform, and may be associated with a relatively lower risk of complications as compared with interscalene (e.g., spinal cord or vertebral artery puncture) or supraclavicular brachial plexus block (e.g., pneumothorax).
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Ultrasound-guided Wrist Block

The wrist block is an effective method to provide anesthesia of the hand and fingers without the arm immobility that occurs with more proximal brachial plexus blocks. Traditional wrist block technique involves advancing needles using surface landmarks toward the three nerves that supply the hand, namely the median, ulnar, and radial nerves. 
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Ultrasound-guided Femoral Nerve Block

The ultrasound-guided technique of femoral nerve blockade differs from nerve stimulator or landmark-based techniques in several important aspects. Ultrasound application allows the practitioner to monitor the spread of local anesthetic and needle placement and make appropriate adjustments, should the initial spread be deemed inadequate. 
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Ultrasound-Guided Fascia Iliaca Block

Typical indications for the infraclavicular brachial plexus block are surgery on the elbow, forearm, wrist and Fascia iliaca block is a low-tech alternative to a femoral nerve or a lumbar plexus block. The mechanism behind this block is that the femoral and lateral femoral cutaneous nerves lie under the iliacus fascia. Therefore, a sufficient volume of local anesthetic deposited beneath the fascia iliaca, even if placed some distance from the nerves, has the potential to spread underneath the fascia and reach these nerves.
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Ultrasound-Guided Obturator Nerve Block

In recent years there has been a growing interest in the practice of regional anesthesia and, in particular, peripheral nerve blocks for surgical anesthesia and postoperative analgesia. Peripheral nerve blocks have been found to be superior to general anesthesia (1) as they provide effective analgesia with few side effects (2) and can hasten patient recovery.(3)...
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Ultrasound-Guided Saphenous Nerve Block

The saphenous nerve is the terminal sensory branch of the femoral nerve. It supplies innervation to the medial aspect of the leg down to the ankle and foot. Blockade of the nerve can be sufficient for superficial procedures in this area; however, it is most useful as a supplement to a sciatic block for foot and ankle procedures that involve the superficial structures in medial territory. 
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Ultrasound-Guided Sciatic Nerve Block: Anterior/Transgluteal/Subgluteal Approach

The anterior approach to sciatic block can be useful in patients who cannot be positioned in the lateral position due to pain, trauma, presence of external fixation devices interfering with positioning, and other issues. It also may be well-suited to patients who require postoperative blocks for analgesia following a total knee arthroplasty.
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Ultrasound-Guided Popliteal Sciatic Block Block

Sciatic nerve block results in anesthesia of the entire lower limb below the knee, both motor and sensory, with the exception of a variable strip of skin on the medial leg and foot, which is the territory of the saphenous nerve, a branch of the femoral nerve. 
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Ultrasound-Guided Ankle Block

Ankle block involves anesthetizing five separate nerves: 2 deep nerves and 3 superficial nerves. The 2 deep nerves are tibial (TN) and deep peroneal nerve (DPN). The superficial nerves are superficial peroneal, sural and saphenous.
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Ultrasound Guided Truncal and Cutaneous Blocks

Transducer position and needle insertion to accomplish a transverse abdominal plane block. Transducer position and needle insertion to accomplish iliohypogastric and ilioinguinal nerve blocks. Transducer position and needle insertion to accomplish rectus sheath block. Transducer position and needle insertion to accomplish a lateral femoral cutaneous nerve (LFCN) block.
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Ultrasound-Guided Spinal and Epidural Block Block

Ultrasound scanning (US) can offer several advantages when used to guide placement of the needle for centroneuraxial blocks (CNBs). It is noninvasive, safe, simple to use, can be performed expeditiously, provides real-time images, is devoid from adverse effects, and it may be beneficial in patients with abnormal or variant spinal anatomy. 
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Ultrasound-Guided Thracic Paravertebral Block

Thoracic paravertebral block (PVB) is a well-established technique for perioperative analgesia in patients having thoracic, chest wall, or breast surgery or for pain management with rib fractures. Ultrasound guidance can be used to help identify the paravertebral space (PVS) and needle placement, and to monitor the spread of the local anesthetic. 
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