This handbook is an up-to-date, evidence based quick, easy reference guide for expert regional anesthesia providers. It will also be an invaluable tool and a great entry point for amateurs' sonographers who wish to understand the basics of ultrasound, its uses for diagnosis and treatment, current guidelines and standards of care. It presents in details challenges, stratification of risks, techniques, and approaches to facilitate effective ultrasound use in perioperative pain control and emergency room pain management. This uses an outline, schematic approach for easy understanding and retention.
The applications of ultrasound are vast and cover the full spectrum of ultrasound guided regional anesthesia. This book concentrates and encompasses the most clinically relevant information as a first aid use of perioperative ultrasound. The chapters are concise, focusing on clinical presentations, diagnosis, differential diagnosis which will help you to deliver patient care in a timely and skillful manner. This compact book is packed with relevant, remarkable information related to ultrasound guided techniques and evidence-based protocols and latest guidelines for regional anesthesia, nerve blocks, and opioid-reducing analgesia to promote early recovery after surgery.
Concise, practical, and clinically applicable for various specialties, this book fills the unmet need for understanding the usefulness and techniques of ultrasound and its application in perioperative pain management, in particular regional anesthesia and nerve blocks. This handbook enables every physician, nurse, resident and all medical staff to understand the essentials of ultrasound and regional anesthesia, its evolving techniques, and the use of modern equipment to provide patient care safely.
Author(s): Jinlei Li, Wei Jiang, Nalini Vadivelu
Publisher: Springer
Year: 2023
Language: English
Pages: 667
City: Cham
Contents
Contributors
Part I: Ultrasound Guided High-Yield Perioperative Regional Anesthesia
Safe Practice of Ultrasound Guided Regional Anesthesia
1 Summary
References
Sonographic Image of Head and Neck Regional Anesthesia
1 Ultrasound Image of Superficial Cervical Plexus
1.1 High Frequency Probe; Short-Axis
2 Ultrasound Image of Cervical Root
2.1 High Frequency Probe; Short-Axis
2.2 High Frequency Probe; Short-Axis
2.3 High Frequency Probe; Short-Axis
2.4 High Frequency Probe; Short-Axis
3 Ultrasound Image of Great Auricular Nerve
3.1 High Frequency Probe; Short-Axis
4 Ultrasound Image of Lesser Occipital Nerve
4.1 High Frequency Probe; Short-Axis
5 Ultrasound Image of Greater Occipital Nerve
5.1 High Frequency Probe; Short-Axis
6 Ultrasound Image of Superior Laryngeal Nerve
6.1 High Frequency Probe; Long-Axis
7 Ultrasound Image of Cricothyroid Membrane
7.1 High Frequency Probe; Short-Axis
8 Ultrasound Image of Supraorbital Nerve
8.1 High Frequency Probe; Short-Axis
9 Ultrasound Image of Infraorbital Nerve
9.1 High Frequency Probe; Short-Axis
10 Ultrasound Image of Auriculotemporal Nerve
10.1 High Frequency Probe; Short-Axis
11 Ultrasound Image of Facial Nerve
11.1 High Frequency Probe; Short-Axis
Sonographic Image of Upper Extremity Regional Anesthesia
1 Ultrasound Image of Brachial Plexus
1.1 Ultrasound Image of Interscalene Brachial Plexus
1.1.1 High Frequency Probe; Short-Axis
1.2 Ultrasound Image of Supraclavicular Brachial Plexus
1.2.1 High Frequency Probe; Short-Axis
1.3 Ultrasound Image of Infraclavicular Brachial Plexus
1.3.1 High Frequency Probe; Short-Axis
1.4 Ultrasound Image of Costoclavicular Brachial Plexus
1.4.1 High Frequency Probe; Short-Axis
1.5 Ultrasound Image of Axillary Brachial Plexus
1.5.1 High Frequency Probe; Short-Axis
2 Ultrasound Image of Radial Nerve
2.1 High Frequency Probe; Short-Axis
2.2 High Frequency Probe; Short-Axis
3 Ultrasound Image of Ulnar Nerve
3.1 High Frequency Probe; Short-Axis
3.2 High Frequency Probe; Short-Axis
4 Ultrasound Image of Medial Nerve
4.1 High Frequency Probe; Short-Axis
4.2 High Frequency Probe; Short-Axis
5 Ultrasound Image of Musculocutaneous Nerve
5.1 High Frequency Probe; Short-Axis
6 Ultrasound Image of Intercostobrachial Nerve
6.1 High Frequency Probe; Short-Axis
6.2 High Frequency Probe; Short-Axis
7 Ultrasound Image of Axillary Nerve
7.1 High Frequency Probe; Short-Axis
7.2 High Frequency Probe; Short-Axis
8 Ultrasound Image of Long Thoracic Nerve
8.1 High Frequency Probe; Short-Axis
8.2 High Frequency Probe; Short-Axis
9 Ultrasound Image of Thoracodorsal Nerve
9.1 High Frequency Probe; Short-Axis
10 Ultrasound Image of Suprascapular Nerve
10.1 High Frequency Probe; Short-Axis
10.2 High Frequency Probe; Short-Axis
11 Ultrasound Image of Dorsal Scapular Nerve
11.1 High Frequency Probe; Short-Axis
Sonographic Image of Lower Extremity Regional Anesthesia
1 Ultrasound Image of Femoral Nerve
1.1 High Frequency Probe; Short-Axis
2 Ultrasound Image of Fascia Iliaca Block
2.1 High Frequency Probe; Short-Axis
3 Ultrasound Image of Obturator Nerve
3.1 High Frequency Probe; Short-Axis
3.2 High Frequency Probe; Short-Axis
4 Ultrasound Image of Lateral Femoral Cutaneous Nerve
4.1 High Frequency Probe; Short-Axis
5 Ultrasound Image of Saphenous Nerve
5.1 High Frequency Probe; Short-Axis
6 Ultrasound Image of Sacral Plexus
6.1 Low Frequency Probe; Long-Axis
6.2 Low Frequency Probe; Short-Axis
7 Ultrasound Image of Sciatic Nerve
7.1 Low Frequency Probe; Short-Axis
7.2 High Frequency Probe; Short-Axis
7.3 High Frequency Probe; Short-Axis
7.4 Low Frequency Probe; Short-Axis
8 Ultrasound Image of Posterior Femoral Cutaneous Nerve
8.1 High Frequency Probe; Short-Axis
9 Ultrasound Image of Pudendal Nerve
9.1 Low Frequency Probe; Short-Axis
10 Ultrasound Image of Peroneal Nerve
10.1 High Frequency Probe; Short-Axis
10.2 High Frequency Probe; Short-Axis
10.3 High Frequency Probe; Short-Axis
11 Ultrasound Image of Tibial Nerve
11.1 High Frequency Probe; Short-Axis
11.2 High Frequency Probe; Short-Axis
Sonographic Image of Thoracic Spine and Chest Regional Anesthesia
1 Ultrasound Image of Thoracic Paravertebral Space
1.1 Low Frequency Probe; Short-Axis
1.2 Low Frequency Probe; Long-Axis
2 Ultrasound Image of Erector Spinae Plane
2.1 Low Frequency Probe; Short-Axis
2.2 Low Frequency Probe; Long-Axis
3 Ultrasound Image of Serratus Plane
3.1 High Frequency Probe; Short-Axis
4 Ultrasound Image of Pectoralis Plane Blocks
4.1 High Frequency Probe
4.2 High Frequency Probe
5 Ultrasound Image of Intercostal Nerve
5.1 High Frequency Probe; Short-Axis
Sonographic Image of Lumbar-Sacral Spine and Abdomen Regional Anesthesia
1 Ultrasound Image of Transversus Abdominis Plane
1.1 High Frequency Probe; Short-Axis
1.2 High Frequency Probe; Short-Axis
1.3 High Frequency Probe; Short-Axis
2 Ultrasound Image of Quadratus Lumborum Plane
2.1 Low Frequency Probe; Short-Axis
3 Ultrasound Image of Rectus Sheath Plane
3.1 High Frequency Probe; Short-Axis
4 Ultrasound Image of Ilioinguinal and Iliohypogastric Nerve
4.1 High Frequency Probe; Short-Axis
5 Ultrasound Image of Lumbar Plexus
5.1 Low Frequency Probe; Short-Axis
5.2 Low Frequency Probe; Short-Axis
5.3 Low Frequency Probe; Long-Axis
6 Ultrasound Image of Posterior Ramus of Spinal Nerve
6.1 Low Frequency Probe; Short-Axis
6.2 Low Frequency Probe; Long-Axis
7 Ultrasound Image of Sacral Canal
7.1 High Frequency Probe; Long-Axis
7.2 High Frequency Probe; Short-Axis
8 Ultrasound Image of Spinal Canal
8.1 Low Frequency Probe; Short-Axis
8.2 Low Frequency Probe; Long-Axis
Part II: Evidence-Based Utilization of Opioid and Non-opioid Analgesics
Acetaminophen
1 Introduction
2 Mechanism of Action
3 Clinically-Relevant Pharmacodynamics and Pharmacokinetics
3.1 Metabolic Pathways for Acetaminophen
3.1.1 Pharmacokinetics of Oral Versus Intravenous Acetaminophen
4 Practical Perioperative Use
5 Indications
6 Contraindications
7 Dosage Choice
8 Duration of Usage
9 How to Titrate Up and Down If Relevant
10 How to Continue/Stop Medication Preoperatively
11 How to Restart Postoperatively
12 Toxicity
12.1 Mechanism of Acetaminophen Toxicity
13 How to Use in Opioid Naïve Patients
14 How to Use in Chronic Pain Patients
15 How to Use in Hepatic or Renal Insufficient Patients (Including Dialysis Patients)
16 Evidence of Efficacy and Safety of Perioperative Use and Use in ERAS Protocols
References
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
1 Mechanism of Action
2 Pharmacology
3 Adverse Effects
3.1 Anaphylaxis/Asthma
3.2 Hematologic
3.3 Gastrointestinal
3.4 Renal
3.5 Hepatic
3.6 Cardiovascular
3.7 Central Nervous System
3.8 Pharmacologic
4 Perioperative Use
References
Anticonvulsants
1 Essential Basics
2 Practical Perioperative Use
2.1 Dosage
2.2 Toxicity and Adverse Reactions
2.3 Use in Renal and Hepatic Impairment
2.4 Use in Perioperative Care
References
Muscle Relaxants
1 Antispasmodics
2 Antispastics
3 Do Antispasmodics Help with Pain?
4 Perioperative Management of SMRs
References
Antidepressants
1 Introduction
2 Mechanism of Action
3 Pharmacology
4 Dosing Summary
5 Adverse Effects
5.1 SSRIs
5.2 SNRIs
5.3 TCAs
5.4 MAO Inhibitors
6 Perioperative Use
7 Summary
References
Alpha-2 Adrenergic Agonists
1 Introduction
2 Pharmacology of α-2 Receptor Agonists
2.1 Mechanism of Action
2.2 Pharmacodynamics and Pharmacokinetics
3 Practical Perioperative Uses
3.1 Dexmedetomidine
3.2 Clonidine
3.3 Tizanidine
4 Indications and Contraindications
4.1 Clonidine
4.2 Dexmedetomidine
5 Alpha-2 Adrenoreceptor Withdrawal
6 Perioperative Management of α-2 Agonists
7 Potential Toxicity of α-2 Adrenoreceptor
8 Chronic Pain
9 Use in Enhanced Recovery After Surgery Protocols
10 Conclusion
References
Ketamine
1 Essential Basics
1.1 Pharmacokinetics
1.2 Mechanism of Action
2 Practical Perioperative Use
2.1 Indications
2.2 Safety and Use in ERAS Protocols
2.3 Contraindications
2.4 Dosing
2.5 Monitoring
2.6 Adverse Effects
2.7 Dependence
References
Methadone
1 Mechanism of Action
2 Pharmacokinetics and Pharmacodynamics
3 Indications/Contraindications
4 Dosing and Titration
4.1 How to Recognize and How to Treat Withdrawal
4.2 How to Continue Methadone Preoperatively
4.3 Evidence of Efficacy and Safety of Perioperative Use
References
Buprenorphine, Buprenorphine/Naloxone (Suboxone)
1 Essential Basics
1.1 Introduction
1.2 Pharmacodynamics of Buprenorphine
1.3 Pharmacodynamics of Buprenorphine Metabolites
1.4 Pharmacokinetics
1.5 Metabolism
1.6 Indications, Formulation and General Dosing
2 Perioperative Use
2.1 How to Choose Among Similar Medications Within the Same Class
2.2 Indications and Contraindications
2.3 Dosing/How to Titrate Up or Down
2.4 Withdrawal
2.5 Toxicity
2.6 How to Continue or Stop Preoperatively and How to Restart Postoperatively
References
Complimentary Non-pharmacological and Non-opioid Options
1 Introduction
2 Relaxation and Distraction Techniques
2.1 Essential Basics
2.2 Practical Perioperative Use
3 Cognitive Behavioral Therapy
3.1 Essential Basics
3.2 Practical Perioperative Use
4 Relaxation Acupuncture
4.1 Essential Basics
4.2 Practical Perioperative Uses
5 TENS Therapy
5.1 Essential Basics
5.2 Practical Perioperative Use
6 Massage
6.1 Essential Basics
6.2 Practical Perioperative Use
7 Cryotherapy
7.1 Essential Basics
7.2 Practical Perioperative Use
8 Biofeedback
8.1 Essential Basics
8.2 Practical Perioperative Use
References
Part III: Acute Pain Management Protocols for Surgical Procedures
Acute Pain Management Protocol for Cranial Procedures
1 Summary
References
Acute Pain Management Protocol for Ophthalmic Procedures
1 Summary
2 Summary
3 Summary
4 Summary
5 Summary
6 Summary
References
Acute Pain Management Protocol for Neck Procedures
1 Superficial Cervical Plexus Block
2 Glossopharyngeal Block, Superior Laryngeal Block, Transtracheal (Recurrent Laryngeal) Block
3 Interscalene Brachial Plexus Block, Superficial Cervical Plexus Block
4 Local Anesthetic Systemic Toxicity/Seizures
4.1 Mechanism of Action
4.2 Treatment Modalities
References
Acute Pain Management Protocol for Proximal Upper Extremity: Shoulder and Proximal Humerus Procedures
1 Summary
References
Acute Pain Management Protocol for Distal Upper Extremity: Elbow, Wrist and Hand Procedures
1 Summary
References
Acute Pain Management Protocol for Pelvic, Hip and Proximal Femur Procedures
1 Summary
References
Acute Pain Management Protocol for Distal Femur, Proximal Tibia/Fibula and Knee Procedures
1 Summary
References
Acute Pain Management Protocol for Distal Tibia/Fibula, Ankle and Foot Procedures
1 Lower Extremity Nerve Blocks
1.1 Introduction
1.1.1 Femoral Nerve Block
2 Summary
2.1 Adductor Canal Nerve Block
3 Summary
3.1 Popliteal-Sciatic Nerve Block
4 Summary
4.1 Ankle Blocks
5 Summary
6 Summary
References
Acute Pain Management Protocol for Unilateral and Bilateral Chest/Thoracic Procedures
1 Summary
2 Summary
3 Summary
References
Acute Pain Management Protocol for Breast Procedures, with and Without Reconstruction
1 Summary
References
Acute Pain Management Protocol for Cardiac Procedures
1 Abstract References: [1–4]
References
Acute Pain Management Protocol for Gastrointestinal Procedures
1 Discussion
1.1 Open Surgery/Minimally Invasive Surgery
1.2 Anorectal
2 Summary
References
Acute Pain Management Protocol for Urological Procedures: Kidney, Bladder, Prostate
1 Summary
References
Acute Pain Management Protocol for Biliary-Hepatic, Spleen, Pancreatic Procedures
1 Incisions for Robotic and Open Pancreatectomy and Splenectomy
1.1 Any Difference in Postoperative Pain?
1.2 What Type of Regional Blocks Can we Use?
1.3 What Are the Concerns for Selecting a Different Type of Block?
2 What History of this Patient Should we Be Concerned about for Postoperative Analgesia?
2.1 What Factors Should we Consider when Choosing a Single Shot Injection or Catheter Infusion?
3 Ultrasound Guided Regional Anesthesia Technique and Surgical Approach
3.1 Laparoscopic Approach
3.1.1 Transversus Abdominal Plane (TAP) Block
3.2 Open Approach
3.2.1 Thoracic Epidural
3.2.2 Erector Spinae Plane (ESP) Block (Fig. 2)
3.2.3 Paravertebral Block (Fig. 2)
3.2.4 Quadratus Lumborum (QL1, QL2, QL3) Block
References
Acute Pain Management Protocol for Hernia Repair: Umbilical, Inguinal, Femoral Hernia
1 Summary
References
Acute Pain Management Protocol in Major Vascular Procedures
1 Summary
References
Acute Pain Management Protocol in Minor Vascular Procedures
References
Acute Pain Management Protocol for Spine Procedures
References
Must-Known Special Considerations for Acute Pain Management in Pediatric Patient Population
1 Introduction
2 Special Considerations for Regional Anesthesia in Children
3 Upper Extremity Blocks
4 Blocks for Lower Extremity Surgery
4.1 Ankle Block
4.2 Lumbar Plexus
4.3 Femoral Nerve Block
4.4 Adductor Canal Block
4.5 Saphenous Nerve Block
4.6 Fascia Iliaca Block
4.7 Neuraxial Blockade
5 Truncal Blocks: Anterior Trunk
5.1 Neuraxial Blocks: Block Type and Dosing
5.2 TAP Blocks vs. QLB
6 Posterior Trunk: Spine/Back
References
Must-Known Special Considerations for Acute Pain Management in Geriatric Patient Population
1 Summary
References
Must-Known Special Considerations for Acute Pain Management in Trauma and Non-OR Patients
1 Summary
References
Index
