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==Background==
==Background==
Regional nerve block reduce the need for pain control medications, sedation and procedural sedation. When apply to emergency department setting it contribute to decreased length of ED stay, post-procedural observation period and also improve patient's satisfaction. <ref>Wilson JE. et al. Oligoanalgesia in the emergency department. Am J Emerg Med. 1989 Nov;7(6):620-3.</ref><ref>McQuay HJ. et al. Postoperative orthopaedic pain-the effect of opiate premedication and local anaesthetic blocks.Pain. 1988 Jun;33(3):291-5.</ref><ref>Liebmann O. et al.Feasibility of forearm ultrasonography-guided nerve blocks of the radial, ulnar, and median nerves for hand procedures in the emergency department. Ann Emerg Med. 2006 Nov;48(5):558-62.</ref><ref>Stone MB. et  al.Ultrasound-guided supraclavicular brachial plexus nerve block vs procedural sedation for the treatment of upper extremity emergencies. Am J Emerg Med. 2008 Jul;26(6):706-10.</ref><ref>Blaivas M et al.Ultrasound-guided interscalene block for shoulder dislocation reduction in the ED.Am J Emerg Med. 2006 May;24(3):293-6.</ref><ref>Beaudoin FL. et al.Ultrasound-guided femoral nerve blocks in elderly patients with hip fractures.Am J Emerg Med. 2010 Jan;28(1):76-81.</ref> Newer ultrasound technology that comes with high-resolution image, ultrasound-guided nerve block, either alone or in combination with other methods is more favourable due to more success rate than suing other methods alone used for localising the nerve. This technique can be utilised for both regional and peripheral nerve block. <ref>Lewis SR. et al. Ultrasound guidance for upper and lower limb blocks.Cochrane Database Syst Rev. 2015 Sep 11;(9)</ref><ref>Walker KJ. et al. Ultrasound guidance for peripheral nerve blockade.Cochrane Database Syst Rev. 2009 Oct 7;(4)</ref><ref>Neal JM. et al. The ASRA evidence-based medicine assessment of ultrasound-guided regional anesthesia and pain medicine: Executive summary.Reg Anesth Pain Med. 2010 Mar-Apr;35(2 Suppl):S1-9</ref>
Regional nerve block reduces the need for pain control medications, sedation and procedural sedation. When applying to emergency department setting it contributed to decreased length of ED stay, post-procedural observation period and also improve patient's satisfaction. <ref>Wilson JE. et al. Oligoanalgesia in the emergency department. Am J Emerg Med. 1989 Nov;7(6):620-3.</ref><ref>McQuay HJ. et al. Postoperative orthopaedic pain-the effect of opiate premedication and local anaesthetic blocks.Pain. 1988 Jun;33(3):291-5.</ref><ref>Liebmann O. et al.Feasibility of forearm ultrasonography-guided nerve blocks of the radial, ulnar, and median nerves for hand procedures in the emergency department. Ann Emerg Med. 2006 Nov;48(5):558-62.</ref><ref>Stone MB. et  al.Ultrasound-guided supraclavicular brachial plexus nerve block vs procedural sedation for the treatment of upper extremity emergencies. Am J Emerg Med. 2008 Jul;26(6):706-10.</ref><ref>Blaivas M et al.Ultrasound-guided interscalene block for shoulder dislocation reduction in the ED.Am J Emerg Med. 2006 May;24(3):293-6.</ref><ref>Beaudoin FL. et al.Ultrasound-guided femoral nerve blocks in elderly patients with hip fractures.Am J Emerg Med. 2010 Jan;28(1):76-81.</ref> Newer ultrasound technology that comes with high-resolution image made ultrasound-guided nerve block, either alone or in combination with other methods to localise the nerve become more favourable due to more success rate comparing to the use of other methods alone. This technique can be utilised for both regional and peripheral nerve block. <ref>Lewis SR. et al. Ultrasound guidance for upper and lower limb blocks.Cochrane Database Syst Rev. 2015 Sep 11;(9)</ref><ref>Walker KJ. et al. Ultrasound guidance for peripheral nerve blockade.Cochrane Database Syst Rev. 2009 Oct 7;(4)</ref><ref>Neal JM. et al. The ASRA evidence-based medicine assessment of ultrasound-guided regional anesthesia and pain medicine: Executive summary.Reg Anesth Pain Med. 2010 Mar-Apr;35(2 Suppl):S1-9</ref>


==Indications==
==Indications==

Revisión del 23:34 14 dic 2016

Background

Regional nerve block reduces the need for pain control medications, sedation and procedural sedation. When applying to emergency department setting it contributed to decreased length of ED stay, post-procedural observation period and also improve patient's satisfaction. [1][2][3][4][5][6] Newer ultrasound technology that comes with high-resolution image made ultrasound-guided nerve block, either alone or in combination with other methods to localise the nerve become more favourable due to more success rate comparing to the use of other methods alone. This technique can be utilised for both regional and peripheral nerve block. [7][8][9]

Indications

Technique

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Abnormal

Pearls and Pitfalls

Documentation

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Abnormal Exam

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See Also

References

  1. ↑ Wilson JE. et al. Oligoanalgesia in the emergency department. Am J Emerg Med. 1989 Nov;7(6):620-3.
  2. ↑ McQuay HJ. et al. Postoperative orthopaedic pain-the effect of opiate premedication and local anaesthetic blocks.Pain. 1988 Jun;33(3):291-5.
  3. ↑ Liebmann O. et al.Feasibility of forearm ultrasonography-guided nerve blocks of the radial, ulnar, and median nerves for hand procedures in the emergency department. Ann Emerg Med. 2006 Nov;48(5):558-62.
  4. ↑ Stone MB. et al.Ultrasound-guided supraclavicular brachial plexus nerve block vs procedural sedation for the treatment of upper extremity emergencies. Am J Emerg Med. 2008 Jul;26(6):706-10.
  5. ↑ Blaivas M et al.Ultrasound-guided interscalene block for shoulder dislocation reduction in the ED.Am J Emerg Med. 2006 May;24(3):293-6.
  6. ↑ Beaudoin FL. et al.Ultrasound-guided femoral nerve blocks in elderly patients with hip fractures.Am J Emerg Med. 2010 Jan;28(1):76-81.
  7. ↑ Lewis SR. et al. Ultrasound guidance for upper and lower limb blocks.Cochrane Database Syst Rev. 2015 Sep 11;(9)
  8. ↑ Walker KJ. et al. Ultrasound guidance for peripheral nerve blockade.Cochrane Database Syst Rev. 2009 Oct 7;(4)
  9. ↑ Neal JM. et al. The ASRA evidence-based medicine assessment of ultrasound-guided regional anesthesia and pain medicine: Executive summary.Reg Anesth Pain Med. 2010 Mar-Apr;35(2 Suppl):S1-9


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