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. 2014:2014:920538.
doi: 10.1155/2014/920538. Epub 2014 Jan 19.

A standardized method for 4D ultrasound-guided peripheral nerve blockade and catheter placement

N J Clendenen  1 , C B Robards  2 , S R Clendenen  2
Affiliations

A standardized method for 4D ultrasound-guided peripheral nerve blockade and catheter placement

N J Clendenen et al. Biomed Res Int. 2014.

Abstract

We present a standardized method for using four-dimensional ultrasound (4D US) guidance for peripheral nerve blocks. 4D US allows for needle tracking in multiple planes simultaneously and accurate measurement of the local anesthetic volume surrounding the nerve following injection. Additionally, the morphology and proximity of local anesthetic spread around the target nerve is clearly seen with the described technique. This method provides additional spatial information in real time compared to standard two-dimensional ultrasound.

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Figures

Figure 1
Figure 1
Image of the sciatic nerve at the popliteal fossa in short and long axis view obtained simultaneously in x-Plane mode. The yellow outlines are added for clarity.
Figure 2
Figure 2
Standard view of the sciatic nerve from the popliteal fossa in 4D mode. The white crosshair corresponds to the same location on the sciatic nerve in short axis (a), long axis (b), and coronal view (c). (d) is a three-dimensional composite image that updates in real time.
Figure 3
Figure 3
Infraclavicular brachial plexus block volume calculated as 21.2 milliliters demonstrating epineural local anesthetic spread. Injected local anesthetic volume was 20 milliliters.
Figure 4
Figure 4
Infraclavicular brachial plexus block volume calculated as 41 milliliters demonstrating circumneural local anesthetic spread. Injected local anesthetic volume was 40 milliliters.
See this image and copyright information in PMC

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