Maverick Medical Education is committed to teaching different forms of pain relief in our courses, but also ensuring that our students receive all the tools and skills they need for each encounter with a patient to be successful. Through repetition in our courses like our Regional Anesthesia Essentials and Advanced, students get the hands on experience they need to build proficiency, but we also use additional tools, like ultrasound for perfect placement, every time.
Background
Originally, and still largely used throughout medical practices today, nerve stimulation was the primary source of recognizing correct placement of a block. This proved problematic as, occasionally, nerve stimulation wouldn’t take place leading to incorrect placement or multiple attempts to place a block which could cause discomfort, increase risks, or simply take too much time. The use of ultrasound to guide needle placement in blocks began just over two decades ago and was originally used for axillary nerve blocks. Through ultrasound, anesthesiologists were able to see the needle tip at all times ensuring the anesthesia was administered exactly where it needed to be. This usage led to less complications and proved to be a contributing factor to more effective blocks. Over the past twenty years, more medical groups have been using ultrasound in additional blocks, each proving this assistance to be a valuable resource.
Advantages
There are a number of advantages to using ultrasound guidance in addition to placement making the anesthesia more effective. By viewing the needle throughout placement, the risk of puncturing arteries or blood vessels is reduced. This minimizes the chances of hematoma, pneumothorax, and accidental toxicity. Additionally, according to Anesthesiology Research and Practice, “ease of visualization does result in increased success rate in experienced hands and reduced performance time when compared to nerve stimulation alone.” By reducing the time in administering these blocks, patients will be able to experience the relief they are desiring much quicker. There is also documentation that, with superficial blocks, less local anesthetic needs to be used because of the ease with which an ultrasound guided block can be placed.
Outcomes
Use of ultrasound for any block is used in conjunction with knowledge of the anatomy present to guide the block. This should be intuitive though as ultrasound uses similar anatomical landmarks to assist in viewing. While nerve stimulation has long been a practice for placing nerve blocks, ultrasound guided nerve blocks appears to be more efficient. In some studies, both nerve stimulation and ultrasound guidance proved equal in providing pain relief for patients, but ultrasound shortened the time to receive the block. Ultrasound guidance does have less efficacy with overweight patients, which means repetition and practice with our Maverick instructors will be beneficial in learning how to work with many different methods. Additionally, deep peripheral blocks may need to be placed further than ultrasound is capable of viewing easily, which means understanding the anatomy and technique needed in performing these blocks in addition to using the available technology.
Maverick Medical Education believes in teaching the anatomy behind different blocks and in using ultrasound guidance when best for the patient. To learn more about the pain relief courses we provide, see our course calendar. Through our unique flipped model classroom, you can begin learning through online modules as soon as you register for a course, in preparation for the in person proficiency lab you will attend later. For more information, contact us today.
