Introduction “Atlas of Ultrasound-Guided Procedures in Interventional Pain Management”
Atlas of Ultrasound-Guided Procedures in Interventional Pain Management was a huge undertaking. For much of the past decade, fluoroscopy held sway as the favorite imaging tool of many practitioners performing interventional pain procedures. Quite recently, ultrasound has emerged as a “challenger” to this well-established modality. The growing popularity of ultrasound application in regional anesthesia and pain medicine reflects a shift in contemporary views about imaging for nerve localization and target-specific injections. For regional anesthesia, ultrasound has already made a marked impact by transforming antiquated clinical practice into a modern science. No bedside tool ever before has allowed practitioners to visualize needle advancement in real time and observe local anesthetic spread around nerve structures. For interventional pain procedures, I believe this radiation-free, point-of-care technology will also find its unique role and utility in pain medicine and can complement some of the imaging demands not met by fluoroscopy, computed tomography, and magnetic resonance imaging. And over time, practitioners will discover new benefits of this technology, especially for dynamic assessment of musculoskeletal pain conditions and improving accuracy of needle injection for small nerves, soft tissue, tendons, and joints.
Ultrasound application for pain medicine is an evolving subspecialty area
Most conventional pain interventionists skilled in fluoroscopy will find it necessary to undertake some special learning and training to acquire a new set of cognitive and technical skills before they can optimally integrate ultrasound into their clinical practices. Although continuing medical educational events help facilitate the learning process and skill development, they are often limited in breadth, depth, and training duration. This is why the arrival of this comprehensive text, Atlas of Ultrasound-Guided Procedures in Interventional Pain Management, is so timely and welcome. To my knowledge, this is the first illustrative atlas of its kind that addresses the educational void for ultrasound-guided pain interventions.
Review of Atlas of Ultrasound-Guided Procedures in Interventional Pain Management
Preparation of this atlas, containing 6 parts and 30 chapters and involving more than 30 authors, is indeed a huge undertaking. The broad range of ultrasound topics selected in this book provides a good, solid educational foundation and curriculum for pain practitioners both in practice and in training. Included is the current state of knowledge relating to the basic principles of ultrasound imaging and knobology, regional anatomy specific to interventional procedures, ultrasound scanning and image interpretation, and the technical considerations for needle insertion and injection. The ultrasound-guided techniques are described step-by-step in an easy-to-follow, “how to do it” manner for both acute and chronic pain interventions. The major topics include somatic and sympathetic neural block in the head and neck, limbs, spine, abdomen, and pelvis. Using a large library of black-and-white images and colored illustrative artwork, the authors elegantly impart scientific knowledge through the display of anatomic cadaveric dissections, sonoanatomy correlates, and schematic diagrams showing essential techniques for needle insertion and injection. The information in the last two chapters of this book is especially enlightening and unique and is not commonly found in other standard pain textbooks. One chapter describes how ultrasound can be applied as an extension of physical examination to aid pain physicians in the diagnosis of musculoskeletal pain conditions. With ultrasound as a screening tool, pain physicians now have new opportunities to become both a diagnostician and an interventionist. The last chapter discussing advanced ultrasound techniques for cervicogenic headache, stimulating lead placement, and cervical disk injection gives readers a glimpse of future exciting applications.
Fig.1 Short-axis sonogram showing the two sacral cornua (asterisk) as two hyperechoic reversed U-shaped structures. Arrows indicate the sacrococcygeal ligament covering the sacral hiatus.
Author
This book is a distinguished product carefully prepared by Dr. Samer Narouze, the editor, and his handpicked group of contributors from all over the world. The authors are all recognized opinion leaders in anesthesiology, pain medicine, anatomy, and radiology. I believe this quick reference book containing useful practical information will become a standard resource for any practitioner who seeks to learn ultrasound-guided interventional pain procedures for relief of acute, chronic noncancer, and cancer pain. I am sure the readers will find this atlas comprehensive, inspiring, practical, and easy to follow.
Vincent W. S. Chan,
Department of Anesthesia, University of Toronto
Toronto, ON, Canada
