Additional Information
Book Details
Abstract
Step-by-step images, board-style review questions, and coverage of new blocks make this highly respected title a must-have reference for clinical practice. Written by Andrew T. Gray, MD, PhD, one of the pioneers of the use of ultrasound to guide needle placement, Atlas of Ultrasound-Guided Regional Anesthesia, 3rd Edition, shows you how to safely and effectively use the latest methods and applications of this technique.
- Helps ensure correct needle placement with numerous 3-D and long-axis views that clearly depict surrounding structures.
- Includes coverage of 11 new blocks: Adductor Canal, Posterior Femoral Cutaneous, Pectoral, Quadratus Lumborum, Pudendal, Paravertebral, Transversus thoracis, Supraorbital, Transtracheal, Greater Occipital and Lesser Occipital.
- Presents several new chapters, including Regional Anesthesia in Resource-Constrained Environments and Safety of Ultrasound Guided Regional Blocks.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Atlas of Ultrasound-Guided Regional Anesthesia | i | ||
| Copyright Page | ii | ||
| Dedication | iii | ||
| Preface | iv | ||
| Contributors | v | ||
| Table Of Contents | vii | ||
| Video Contents | ix | ||
| 1 Introduction to Ultrasound Imaging | 1 | ||
| 1 Ultrasound | 2 | ||
| Abstract | 2.e1 | ||
| Keywords | 2.e1 | ||
| Reference | 2 | ||
| 2 Speed of Sound | 3 | ||
| Abstract | 3.e1 | ||
| Keywords | 3.e1 | ||
| References | 3 | ||
| 3 Attenuation | 5 | ||
| Abstract | 5.e1 | ||
| Keywords | 5.e1 | ||
| Reference | 5 | ||
| 4 Reflection | 7 | ||
| Abstract | 7.e1 | ||
| Keywords | 7.e1 | ||
| References | 8 | ||
| 5 Beam Width (Slice Thickness) | 11 | ||
| Abstract | 11.e1 | ||
| Keywords | 11.e1 | ||
| References | 11 | ||
| 6 Anisotropy | 13 | ||
| Abstract | 13.e1 | ||
| Keywords | 13.e1 | ||
| References | 13 | ||
| 7 Spatial Compound Imaging | 15 | ||
| Abstract | 15.e1 | ||
| Keywords | 15.e1 | ||
| Reference | 16 | ||
| 8 Doppler Imaging | 19 | ||
| Abstract | 19.e1 | ||
| Keywords | 19.e1 | ||
| References | 19 | ||
| 9 Ultrasound Transducers | 21 | ||
| Abstract | 21.e1 | ||
| Keywords | 21.e1 | ||
| Reference | 21 | ||
| 10 Transducer Manipulation | 22 | ||
| References | 22 | ||
| 11 Needle Imaging | 24 | ||
| Abstract | 24.e1 | ||
| Keywords | 24.e1 | ||
| Insertion Angle (Angle of Insonation) | 24 | ||
| Needle Gauge | 24 | ||
| Bevel Orientation | 24 | ||
| Receiver Gain | 25 | ||
| Needle Motion and Test Injections | 25 | ||
| Echogenic Modifications | 25 | ||
| Spatial Compound Imaging | 25 | ||
| References | 26 | ||
| 12 Approach and Techniques | 28 | ||
| Abstract | 28.e1 | ||
| Keywords | 28.e1 | ||
| Offline Markings | 28 | ||
| Online Guidance | 28 | ||
| Out-of-Plane Approach | 28 | ||
| In-Plane Approach | 29 | ||
| Needle Redirection During in-Plane Technique | 29 | ||
| References | 29 | ||
| 13 Sonographic Signs of Successful Injections | 32 | ||
| Abstract | 32.e1 | ||
| Keywords | 32.e1 | ||
| Reference | 32 | ||
| 14 Ultrasound-Guided Continuous Peripheral Nerve Blocks | 34 | ||
| Introduction | 34 | ||
| Suggested Technique | 34 | ||
| Discussion | 34 | ||
| References | 35 | ||
| 15 Three-Dimensional Ultrasound | 42 | ||
| Abstract | 42.e1 | ||
| Keywords | 42.e1 | ||
| References | 42 | ||
| 2 Structures | 45 | ||
| 16 Anatomic Structures | 46 | ||
| Abstract | 46.e1 | ||
| Keywords | 46.e1 | ||
| Reference | 46 | ||
| 17 Skin and Subcutaneous Tissue | 47 | ||
| Abstract | 47.e1 | ||
| Keywords | 47.e1 | ||
| References | 47 | ||
| 18 Peripheral Nerves | 48 | ||
| Abstract | 48.e1 | ||
| Keywords | 48.e1 | ||
| References | 49 | ||
| 19 Muscle | 53 | ||
| Abstract | 53.e1 | ||
| Keywords | 53.e1 | ||
| References | 54 | ||
| 20 Tendons and Ligaments | 56 | ||
| Abstract | 56.e1 | ||
| Keywords | 56.e1 | ||
| References | 57 | ||
| 21 Arteries | 60 | ||
| Abstract | 60.e1 | ||
| Keywords | 60.e1 | ||
| 22 Veins | 64 | ||
| Abstract | 64.e1 | ||
| Keywords | 64.e1 | ||
| References | 64 | ||
| 23 Bone | 66 | ||
| Abstract | 66.e1 | ||
| Keywords | 66.e1 | ||
| Reference | 66 | ||
| 24 Pleura | 67 | ||
| Abstract | 67.e1 | ||
| Keywords | 67.e1 | ||
| References | 67 | ||
| 25 Peritoneum | 68 | ||
| Abstract | 68.e1 | ||
| Keywords | 68.e1 | ||
| References | 68 | ||
| 26 Lymph Nodes | 69 | ||
| Abstract | 69.e1 | ||
| Keywords | 69.e1 | ||
| 3 Upper Extremity Blocks | 70 | ||
| 27 Supraclavicular Nerve Block (of the Cervical Plexus) | 71 | ||
| Abstract | 71.e1 | ||
| Keywords | 71.e1 | ||
| Suggested Technique | 71 | ||
| References | 71 | ||
| 28 Interscalene and Supraclavicular Blocks (of the Brachial Plexus) | 74 | ||
| Abstract | 74.e1 | ||
| Keywords | 74.e1 | ||
| Sonoanatomy of the Posterior Cervical Triangle | 74 | ||
| Anatomic Variation | 74 | ||
| Suggested Technique | 74 | ||
| References | 76 | ||
| 29 Phrenic Nerve Imaging | 84 | ||
| Abstract | 84.e1 | ||
| Keywords | 84.e1 | ||
| References | 84 | ||
| 30 Dorsal Scapular Nerve Imaging | 87 | ||
| Abstract | 87.e1 | ||
| Keywords | 87.e1 | ||
| References | 87 | ||
| 31 Suprascapular Nerve Block (Anterior Approach above the Clavicle) | 89 | ||
| Abstract | 89.e1 | ||
| Keywords | 89.e1 | ||
| Limitations to Traditional Approach to Blocks at the Suprascapular Notch | 89 | ||
| Suggested Technique | 89 | ||
| Selectivity | 90 | ||
| Clinical Assessment | 90 | ||
| References | 90 | ||
| 32 Infraclavicular Block | 93 | ||
| Abstract | 93.e1 | ||
| Keywords | 93.e1 | ||
| Suggested Technique | 94 | ||
| Comments | 94 | ||
| References | 96 | ||
| 33 Axillary Block | 104 | ||
| Abstract | 104.e1 | ||
| Keywords | 104.e1 | ||
| Suggested Technique | 104 | ||
| References | 106 | ||
| 34 Musculocutaneous Nerve Block | 117 | ||
| Abstract | 117.e1 | ||
| Keywords | 117.e1 | ||
| Suggested Technique | 117 | ||
| References | 118 | ||
| 35 Forearm Blocks | 125 | ||
| Abstract | 125.e1 | ||
| Keywords | 125.e1 | ||
| References | 125 | ||
| 36 Radial Nerve Block | 126 | ||
| Abstract | 126.e1 | ||
| Keywords | 126.e1 | ||
| Suggested Technique | 126 | ||
| Neurologic Assessment | 127 | ||
| References | 127 | ||
| 37 Median Nerve Block | 132 | ||
| Abstract | 132.e1 | ||
| Keywords | 132.e1 | ||
| Suggested Technique | 132 | ||
| Neurologic Assessment | 132 | ||
| References | 133 | ||
| 38 Ulnar Nerve Block | 138 | ||
| Abstract | 138.e1 | ||
| Keywords | 138.e1 | ||
| Suggested Technique | 138 | ||
| Neurologic Assessment | 138 | ||
| References | 139 | ||
| 4 Lower Extremity Blocks | 143 | ||
| 39 Lateral Femoral Cutaneous Nerve Block | 144 | ||
| Abstract | 144.e1 | ||
| Keywords | 144.e1 | ||
| Suggested Technique | 144 | ||
| References | 146 | ||
| 40 Fascia Iliaca Block | 150 | ||
| Abstract | 150.e1 | ||
| Keywords | 150.e1 | ||
| Suggested Technique | 150 | ||
| References | 151 | ||
| 41 Femoral Nerve Block | 156 | ||
| Abstract | 156.e1 | ||
| Keywords | 156.e1 | ||
| Suggested Technique | 156 | ||
| References | 158 | ||
| 42 Adductor Canal Block | 169 | ||
| Abstract | 169.e1 | ||
| Keywords | 169.e1 | ||
| Suggested Technique | 170 | ||
| Quadriceps Weakness | 171 | ||
| References | 173 | ||
| 43 Obturator Nerve Block | 174 | ||
| Abstract | 174.e1 | ||
| Keywords | 174.e1 | ||
| Suggested Technique | 174 | ||
| References | 175 | ||
| 44 Sciatic Nerve Block | 179 | ||
| Abstract | 179.e1 | ||
| Keywords | 179.e1 | ||
| Suggested Technique | 179 | ||
| References | 181 | ||
| 45 Anterior Sciatic Nerve Block | 189 | ||
| Abstract | 189.e1 | ||
| Keywords | 189.e1 | ||
| Suggested Technique | 189 | ||
| References | 189 | ||
| 46 Popliteal Block | 193 | ||
| Abstract | 193.e1 | ||
| Keywords | 193.e1 | ||
| Suggested Technique | 193 | ||
| References | 195 | ||
| 47 Posterior Femoral Cutaneous Nerve Block | 200 | ||
| Abstract | 200.e1 | ||
| Keywords | 200.e1 | ||
| Suggested Technique | 200 | ||
| Proximal Block of the Posterior Femoral Cutaneous Nerve (Subgluteal Region) | 200 | ||
| Neurologic Assessment | 200 | ||
| Distal Block of the Posterior Femoral Cutaneous Nerve (Popliteal Region) | 201 | ||
| References | 201 | ||
| 48 Ankle Blocks | 204 | ||
| Abstract | 204.e1 | ||
| Keywords | 204.e1 | ||
| References | 204 | ||
| 49 Saphenous Nerve Block in the Leg | 205 | ||
| Abstract | 205.e1 | ||
| Keywords | 205.e1 | ||
| Suggested Technique | 205 | ||
| References | 206 | ||
| 50 Deep Peroneal Nerve Block | 208 | ||
| Abstract | 208.e1 | ||
| Keywords | 208.e1 | ||
| Suggested Technique | 208 | ||
| References | 209 | ||
| 51 Superficial Peroneal Nerve Block | 214 | ||
| Abstract | 214.e1 | ||
| Keyword | 214.e1 | ||
| Suggested Technique | 214 | ||
| References | 216 | ||
| 52 Sural Nerve Block | 221 | ||
| Abstract | 221.e1 | ||
| Keywords | 221.e1 | ||
| Suggested Technique | 221 | ||
| References | 222 | ||
| 53 Tibial Nerve Block | 227 | ||
| Abstract | 227.e1 | ||
| Keywords | 227.e1 | ||
| Suggested Technique | 227 | ||
| References | 228 | ||
| 5 Trunk Blocks | 233 | ||
| 54 Intercostal Nerve Block | 234 | ||
| Abstract | 234.e1 | ||
| Keywords | 234.e1 | ||
| Suggested Technique | 234 | ||
| References | 235 | ||
| 55 Pectoral Nerve Block (the Pecs Block) | 239 | ||
| Abstract | 239.e1 | ||
| Keywords | 239.e1 | ||
| Suggested Technique | 239 | ||
| Neurologic Assessment of Block | 239 | ||
| Relation With Other Blocks | 239 | ||
| References | 240 | ||
| 56 Transversus Thoracis Muscular Plane Block | 244 | ||
| Abstract | 244.e1 | ||
| Keywords | 244.e1 | ||
| The Transversus Thoracis Muscle | 244 | ||
| Internal Mammary Vessels | 244 | ||
| Suggested Technique | 244 | ||
| Anatomic Considerations | 244 | ||
| Anatomic Variation | 245 | ||
| References | 246 | ||
| 57 Rectus Sheath Block | 249 | ||
| Abstract | 249.e1 | ||
| Keywords | 249.e1 | ||
| Suggested Technique | 249 | ||
| References | 251 | ||
| 58 Ilioinguinal and Iliohypogastric Nerve Blocks | 259 | ||
| Abstract | 259.e1 | ||
| Keywords | 259.e1 | ||
| Suggested Technique | 259 | ||
| References | 262 | ||
| 59 Transversus Abdominis Plane Blocks | 267 | ||
| Anatomic Background | 267 | ||
| Indications and Contraindications for the Procedure | 267 | ||
| Suggested Technique | 267 | ||
| Subcostal Transversus Abdominis Plane Block | 267 | ||
| Ilioinguinal Transversus Abdominis Plane Block | 268 | ||
| Continuous Catheter Transversus Abdominis Plane Blocks | 268 | ||
| Pharmacokinetics | 269 | ||
| Discussion and Comments | 269 | ||
| Lateral Transversus Abdominis Plane Block | 269 | ||
| Transversus Abdominis Plane Block in Laparoscopic Surgery | 270 | ||
| References | 270 | ||
| 60 Quadratus Lumborum Blocks | 277 | ||
| Abstract: | 277.e1 | ||
| Keywords | 277.e1 | ||
| Clinical Anatomy/Sonoanatomy | 277 | ||
| Nomenclature and Points of Injection | 277 | ||
| 1-Lateral Quadratus Lumborum (QLB1) | 277 | ||
| 2-Posterior Quadratus Lumborum (Qlb2 Block) | 277 | ||
| 3-Anterior Quadratus Lumborum (Qlb3, or Transmuscular QLB, Transmuscular Quadratus Lumborum Block) | 278 | ||
| Patient Positioning and Equipment Selection | 278 | ||
| Ultrasound Probe | 278 | ||
| Patient Position | 279 | ||
| Acknowledgments | 279 | ||
| References | 279 | ||
| 61 Thoracic Paravertebral Block | 286 | ||
| Abstract | 286.e1 | ||
| Keywords | 286.e1 | ||
| Introduction | 286 | ||
| Gross Anatomy | 286 | ||
| Communications of the Thoracic Paravertebral Space | 287 | ||
| Mechanism of Blockade | 290 | ||
| Thoracic Paravertebral Block—Anatomical Landmark Based Techniques | 291 | ||
| Ultrasound-Guided Thoracic Paravertebral Block | 292 | ||
| Sonoanatomy Relevant for Thoracic Paravertebral Block | 293 | ||
| Basic Considerations | 293 | ||
| Transverse Scan of the Thoracic Paravertebral Region | 294 | ||
| Sagittal Scan of the Thoracic Paravertebral Region | 299 | ||
| Three Dimensional Sonoanatomy of the Thoracic Paravertebral Region | 307 | ||
| Techniques of Ultrasound-Guided Thoracic Paravertebral Block | 309 | ||
| Transverse Scan With Short-Axis Needle Insertion (Technique 1) | 309 | ||
| Paramedian Sagittal Scan With in-Plane Needle Insertion (Technique 2) | 309 | ||
| Intercostal Approach to the Thoracic Paravertebral Space (Technique 3) | 311 | ||
| Conclusion | 313 | ||
| Acknowledgments | 314 | ||
| References | 314 | ||
| 62 Pudendal Nerve Block in Children | 316 | ||
| Abstract | 316.e1 | ||
| Keywords | 316.e1 | ||
| Introduction | 316 | ||
| Suggested Technique | 316 | ||
| Discussion and Comments | 316 | ||
| References | 317 | ||
| 63 Neuraxial Block | 319 | ||
| Abstract | 319.e1 | ||
| Keywords | 319.e1 | ||
| Introduction | 319 | ||
| Suggested Technique for Offline Lumbar Epidural Catheter Placement | 320 | ||
| Comments | 322 | ||
| Skin Markings | 322 | ||
| Level Estimation | 322 | ||
| High-Resolution Ultrasound Imaging of the Neuraxis | 322 | ||
| Outcomes | 323 | ||
| References | 323 | ||
| 64 Caudal Epidural Block | 328 | ||
| Abstract | 328.e1 | ||
| Keywords | 328.e1 | ||
| Suggested Technique | 329 | ||
| References | 330 | ||
| 6 Head and Neck Blocks | 336 | ||
| 65 Supraorbital Nerve Block | 337 | ||
| Abstract | 337.e1 | ||
| Keywords | 337.e1 | ||
| Suggested Technique | 337 | ||
| Comments | 338 | ||
| Incomplete Block | 338 | ||
| Hematoma and Swelling | 338 | ||
| Motor Block of Facial Muscles | 338 | ||
| References | 339 | ||
| 66 Mental Nerve Block | 342 | ||
| Abstract | 342.e1 | ||
| Keywords | 342.e1 | ||
| Suggested Technique | 342 | ||
| References | 343 | ||
| 67 Superior Laryngeal Nerve Block | 347 | ||
| Abstract | 347.e1 | ||
| Keywords | 347.e1 | ||
| Suggested Technique | 347 | ||
| References | 348 | ||
| 68 Transtracheal Block | 353 | ||
| Abstract | 353.e1 | ||
| Keywords | 353.e1 | ||
| Identification of the Cricothyroid Membrane | 353 | ||
| Suggested Technique | 353 | ||
| Anatomic Variation | 354 | ||
| References | 355 | ||
| 69 Greater Occipital Nerve Block | 357 | ||
| Abstract | 357.e1 | ||
| Keywords | 357.e1 | ||
| Suggested Technique | 357 | ||
| Discussion and Comments | 358 | ||
| References | 359 | ||
| 70 Lesser Occipital Nerve Block | 363 | ||
| Abstract | 363.e1 | ||
| Keywords | 363.e1 | ||
| Suggested Technique | 363 | ||
| References | 364 | ||
| 71 Great Auricular Nerve Block | 366 | ||
| Abstract: | 366.e1 | ||
| Keywords | 366.e1 | ||
| Suggested Technique | 366 | ||
| References | 366 | ||
| 72 Cervical Plexus Block | 372 | ||
| Abstract | 372.e1 | ||
| Keywords | 372.e1 | ||
| Introduction | 372 | ||
| Anatomic Background | 372 | ||
| Indications and Contraindications | 372 | ||
| Suggested Technique | 372 | ||
| Nomenclature of Cervical Plexus Blocks | 372 | ||
| Ultrasound Guidance | 372 | ||
| Sonographic Landmarks | 373 | ||
| Choice of Blocking Technique | 375 | ||
| Suggested Technique (Intermediate Cervical Plexus Block) | 377 | ||
| Discussion | 377 | ||
| Current Debates and Limitations | 377 | ||
| References | 380 | ||
| 73 Stellate Ganglion Block (Cervicothoracic Sympathetic Ganglion Block) | 381 | ||
| Abstract | 381.e1 | ||
| Keywords | 381.e1 | ||
| Anatomic Structures to Be Identified for Stellate Ganglion Block | 381 | ||
| Esophagus | 381 | ||
| Inferior Thyroid Artery | 381 | ||
| Vertebral Artery and Vein | 381 | ||
| Anterior and Posterior Tubercles | 381 | ||
| Phrenic Nerve | 381 | ||
| Longus Colli Muscle | 382 | ||
| Approach and Suggested Technique | 382 | ||
| References | 383 | ||
| 7 Safety Issues | 388 | ||
| 74 Safety | 389 | ||
| Vascular Complications | 389 | ||
| Practical Suggestions for Reducing the Risk of Vascular Trauma | 389 | ||
| Local Anesthetic Systemic Toxicity | 391 | ||
| Incidence and Risk Factors for Last | 391 | ||
| Practical Suggestions for Reducing the Risk of Last | 393 | ||
| Neurological Complications Associated With Peripheral Nerve Blockade | 393 | ||
| Incidence of Peripheral Nerve Injury Due to Peripheral Nerve Block | 393 | ||
| Microanatomy of the Peripheral Nerve and Relevance to Nerve Injury | 394 | ||
| Practical Suggestions for Reducing Risk of Neurologic Complications Including Avoiding Intraneural Trauma | 397 | ||
| Respiratory Complications | 399 | ||
| Practical Suggestions for Reducing Risk of Phrenic Nerve Block and Hemi-Diaphragmatic Paralysis | 399 | ||
| Practical Suggestions for Reducing Risk of Pneumothorax | 400 | ||
| Other Considerations | 400 | ||
| Other Complications | 400 | ||
| References | 401 | ||
| 75 Regional Anesthesia in Resource-Constrained Environments | 405 | ||
| Abstract | 405.e1 | ||
| Keywords | 405.e1 | ||
| Introduction | 405 | ||
| Technique Selection and Preferred Blocks | 405 | ||
| Equipment Challenges | 406 | ||
| Challenges With Consumables | 407 | ||
| Ultrasound Gel | 407 | ||
| Transducer Covers | 408 | ||
| Medications | 408 | ||
| Needles | 409 | ||
| Training and Staffing | 409 | ||
| Ethics and Safety of Regional US in LMICs | 410 | ||
| References | 411 | ||
| Appendix 1 | e1 | ||
| Self-Assessment Questions: Text | e1 | ||
| Answers to Text Questions | e3 | ||
| Appendix 2 | e7 | ||
| Self-Assessment Questions: Images | e7 | ||
| Answers to Image Questions | e18 | ||
| Appendix 3 | e31 | ||
| Advanced Self-Assessment Questions: Text | e31 | ||
| Answers to Text Questions | e31 | ||
| Appendix 4 | e33 | ||
| Advanced Self-Assessment Questions: Images | e33 | ||
| Answers to Image Questions | e36 | ||
| Index | 413 | ||
| A | 413 | ||
| B | 413 | ||
| C | 413 | ||
| D | 414 | ||
| E | 414 | ||
| F | 415 | ||
| G | 415 | ||
| H | 415 | ||
| I | 415 | ||
| L | 416 | ||
| M | 417 | ||
| N | 417 | ||
| O | 418 | ||
| P | 418 | ||
| Q | 419 | ||
| R | 419 | ||
| S | 419 | ||
| T | 420 | ||
| U | 421 | ||
| V | 422 | ||
| W | 422 | ||
| Inside Back Cover | ibc1 |