Image-guided techniques for peripheral nerve blocks

Success of plexus nerve block is most dependent upon the correct positioning of the local anaesthetic solution within proximity to the corresponding nerve trunk. With the aim of verifying the close approximation of needle and nerve, and increasing the corresponding success rate, in the course of the history of regional anaesthesia, and in addition to the classical methods like seeking of paraesthesia, different mechanical aids have been used for nerve detection. In the last two decades, important medical diagnostic and therapeutic advances in imaging technology have been presented. In this review we will analyse the role such imaging diagnostic procedures will play in regional anaesthesia practice.

Last developments in the field have produced increased interest in the application of imaging techniques in regional anaesthesia. Of special interest are ultrasound and low radiation x-ray techniques for location of the needle in relation with neural structures.

In this paper we will analyse which imaging techniques are of relevance to anaesthesia in terms of clinical outcome, research and teaching of regional anaesthetic techniques, and the clinical impact of such imaging techniques upon anaesthesia practice.