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Atlas of Ultrasound-Guided Procedures in Interventional Pain Management

Author: Samer Narouze

Atlas of Ultrasound-Guided Procedures in Interventional Pain Management is the #1 primer and a must-read for both novices and experts performing invasive procedures for pain relief.
  • PRACTICAL. Step-by-step guidance from the world’s leading USPM experts in their area of subspecialty expertise.
  • UNDERSTAND. Coverage of acute perioperative pain, chronic pain clinic settings, and MSK applications.
  • BE INSPIRED. NextLevel NYSORA will motivate you to study with our proprietary visual cognitive aids for a unique journey through courses and lessons.

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Atlas of Ultrasound-Guided Procedures in Interventional Pain Management , Review

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

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Table of contents

  • Introduction
  • C-Arm FDCT
  • Ultrasound
  • Intra-Articular Injections
  • Trigger Point and Muscular Injections
  • Zygapophyseal and Medial Branch Blocks
  • Epidural Blocks
  • Sympathetic Blocks
  • Combined US and CT/Fluoroscopy
  • Conclusion
  • References
  • Basic Principles of B-Mode US
  • Generation of Ultrasound Pulses
  • Ultrasound Wavelength and Frequency
  • Ultrasound-Tissue Interaction
  • Recent Innovations in B – Mode Ultrasound
  • Conclusion
  • References
  • Frequency and Probe Selection
  • Depth
  • Gain
  • Time Gain Compensation
  • Focus
  • Presets
  • Color Doppler
  • Power Doppler
  • Compound Imaging
  • Tissue Harmonic Imaging
  • Optimization Button
  • Freeze Button and Image Acquisition
  • References
  • Training and Phantom Simulation
  • High-Fidelity Simulation
  • Combined Ultrasound and Fluoroscopic Phantom Simulators
  • Procedural Needle: Related Visibility Factors
  • Acoustic Impedance as the Basis for Procedure Needle Visualization
  • Size (Gauge) of the Procedure Needle and Its Echogenicity
  • The Skin Insertion Site Selected and Angle of Procedure Needle Passage
  • Echogenic Procedure Needles
  • Procedure Needle Tip
  • The Ultrasound Device and Procedure Needle Visibility
  • Impact of Various Sonographic Modes on Procedure Needle Visibility
  • Frequency of the Ultrasound Probe (AKA Depth) Acoustic Power and Gain
  • Time Gain Compensation and Harmonic Imaging
  • Brightness, Motion, and Doppler Modes
  • 3D and 4D Ultrasound Imaging
  • Recent Advances in Ultrasound Imaging and Procedure Needle Visibility
  • Needle-Probe Alignment
  • “In-Plane” and “Out-Of-Plane” Needle Approach: Classical Probe-Needle Interpositions
  • Oblique Plane Needle Approach for Ultrasound-Guided Pain Management
  • Biplane Needle Imaging Approach for Ultrasound-Guided Pain Management
  • Mechanical and Optical Procedure Needle Guides
  • Advanced Procedure Needle Positioning Systems
  • The “ART” of Scanning for Better Procedure Needle Visualization
  • Ergonomics for Better Procedure Needle Visibility
  • Enhancement and Techniques to Improve Procedure Needle Localization
  • Enhancement with Priming, Insertion of Stylet or Guide Wire, and Vibration
  • Hydrolocalization of the Procedure Needle
  • Procedure Needle Visibility by Agitated Solutions or with Ultrasound Contrast Agents
  • Localization of the Procedure Needle Tip with the Aid of Nerve Stimulation
  • Summary
  • References
  • Cervical Spine
  • Thoracic Spine
  • Lumbar Spine
  • Sacrum
  • Sonoanatomy of the Cervical Spine: Superficial
  • Sonoanatomy of the Cervical Spine: Deep
  • Sonoanatomy of the Thoracic Spine: Superficial
  • Sonoanatomy of the Thoracic Spine: Deep
  • Sonoanatomy of the Lumbar Spine: Superficial
  • Sonoanatomy of the Lumbar Spine: Deep
  • Sonoanatomy of the Sacrum and Sacroiliac Joint: Superficial
  • Sonoanatomy of the Sacrum and Sacroiliac Joint: Deep
  • Indications for Cervical Medial Branch Block
  • Why Ultrasound-Guided Facet Nerve Block? The Literature and our Experience
  • Possible Advantages of Ultrasound for Cervical Facet Nerve Blocks
  • Limitations of Ultrasound
  • Ultrasound-Guided Technique for TON and Cervical Medial Branch Block
  • Identifying the Correct Level: Method 1
  • Identifying the Correct Level: Method 2
  • Practical Performance of Block
  • Conclusion
  • References
  • Indications for Cervical Zygapophyseal Joint Intra-Articular Injection
  • Literature Review of Ultrasound-Guided Cervical Facet Injections
  • Ultrasound-Guided Technique for Cervical Facet Intra-Articular Injection
  • Posterior Approach
  • References
  • Indications
  • Limitations of the Fluoroscopy-Guided Techniques
  • Literature Review and Advantages of Ultrasound-Guided Cervical Nerve Root Block
  • Identification of Small Critical Vessels
  • Why Ultrasound?
  • Sonoanatomy of the Cervical Spine and Identification of the Cervical Level
  • Ultrasound-Guided Technique for Cervical Selective Nerve Root Block
  • References
  • Anatomy
  • Mechanism of Blockade
  • Techniques of TPVB
  • Ultrasound-Guided TPVB
  • Sonoanatomy Relevant for TPVB
  • Techniques of USG TPVB
  • Conclusion
  • References
  • Anatomy
  • Literature Review
  • Scanning Technique
  • Injection Technique
  • Intraarticular Lumbar Zygapophyseal Joint Injection
  • Limitations of Ultrasound-Guided Zygapophysial Nerve and Joint Injection
  • References
  • Ultrasound-Guided Technique
  • Limitations of the Ultrasound-Guided Technique
  • References
  • History
  • Ultrasound Imaging of the Spine
  • Axis of Scan
  • Spinal Sonoanatomy
  • The Water-Based Spine Phantom
  • Ultrasound Imaging of the Sacrum
  • Ultrasound Imaging of the Lumbar Spine
  • Ultrasound Imaging of the Thoracic Spine
  • Ultrasound-Guided CNB
  • Caudal Epidural Injection
  • Lumbar Epidural Injection
  • Thoracic Epidural Injection
  • Spinal Injection
  • The Evidence
  • Education and Training
  • Conclusion
  • References
  • Indications for Caudal Epidural Injection
  • Limitations of the Landmark “Blind” Technique
  • Literature Review of Ultrasound-Guided Caudal Epidural Injections
  • Ultrasound-Guided Caudal Injection Is Better Than the “Blind” Technique
  • Ultrasound-Guided Caudal Injection Is as Effective as the Fluoroscopy-Guided Technique
  • Ultrasound-Guided Technique for Caudal Epidural Injection
  • Limitations of the Ultrasound-Guided Technique
  • References
  • Indications for SIJ Injection
  • Literature Review on Ultrasound-Guided SIJ Injection
  • Technique of Ultrasound-Guided SIJ Injection
  • Limitations of Ultrasound-Guided SIJ Injection
  • References
  • Anatomy
  • The Classic Approach
  • Ultrasound-Guided Technique
  • Ultrasound-Guided TAP Catheter
  • Summary
  • References
  • Anatomy of the Celiac Plexus
  • Current Techniques of the Celiac Plexus Block
  • The Anterior Percutaneous Approach
  • Advantages of US-Guided Anterior Approach
  • Limitations of US-Guided Anterior Approach
  • Sonoanatomy of the Epigastrium and Relevant Structures
  • Percutaneous Ultrasound-Guided Celiac Plexus Block Technique
  • References
  • Ilioinguinal, Iliohypogastric, and Genitofemoral Neuralgia
  • Anatomy
  • Literature Review on Injection Techniques for Ilioinguinal, Iliohypogastric, and Genitofemoral Nerve Block
  • Ultrasound-Guided Technique of Ilioinguinal, Iliohypogastric, and Genitofemoral Nerve Blockade
  • Genital Branch of Genitofemoral Nerve
  • Piriformis Syndrome
  • Anatomy
  • Literature Review on Piriformis Muscle Injections
  • Ultrasound-Guided Technique for Piriformis Muscle Injection
  • Pudendal Neuralgia
  • Anatomy
  • Literature Review on Pudendal Nerve Injections
  • Ultrasound-Guided Technique for Pudendal Nerve Injection
  • Conclusion
  • References
  • Indications
  • Limitations of the Current Technique
  • Literature Review on Ultrasound-Guided Ganglion Impar Block
  • Technique of Ultrasound-Guided Ganglion Impar Block
  • Limitations of the Ultrasound-Guided Technique
  • References
  • Brachial Plexus Anatomy
  • Interscalene Block
  • Supraclavicular Block
  • Infraclavicular Block
  • Axillary Block
  • Anesthetizing Distal Peripheral Nerves in the Upper Extremity
  • Summary
  • References
  • Femoral Nerve Block
  • Anatomy
  • Preparation and Positioning
  • Ultrasound Technique
  • Single-Injection Technique
  • Continuous Catheter Technique
  • Sciatic Nerve Block
  • Anatomy
  • Preparation and Positioning
  • Ultrasound Technique
  • Sciatic Nerve Blockade in the Popliteal Fossa
  • Anatomy
  • Preparation and Positioning
  • Ultrasound Technique
  • Lumbar Plexus Block
  • Anatomy
  • Preparation and Positioning
  • Ultrasound Technique
  • Obturator Nerve Block
  • Anatomy
  • Preparation and Positioning
  • Ultrasound Technique
  • Lateral Femoral Cutaneous Nerve Block
  • Anatomy
  • Preparation and Positioning
  • Ultrasound Technique
  • Saphenous Nerve Block
  • Anatomy
  • Preparation and Positioning
  • Ultrasound Technique
  • Ankle Block
  • Anatomy
  • Preparation and Positioning
  • Ultrasound Technique
  • Blockade of the Posterior Tibial Nerve
  • Blockade of the Deep Peroneal Nerve
  • Blockade of the Proximal Superficial Peroneal Nerve
  • References
  • Applications
  • Overview of Ultrasound-Guided Perineural Catheter Insertion
  • Nerve in Short Axis: Needle Out-of-Plane Approach
  • Nerve in Long Axis: Needle In-Plane
  • Preparation for Ultrasound-Guided Perineural Catheter Insertion
  • Standard Perineural Catheter Equipment
  • Ultrasound-Guided Perineural Catheter Insertion Techniques for Common Surgical Procedures
  • Infraclavicular CPNB
  • Femoral CPNB
  • Subgluteal Sciatic CPNB
  • Popliteal Sciatic CPNB
  • Transversus Abdominis Plane (TAP) CPNB
  • Conclusions
  • References
  • Scanning Technique
  • Ultrasound-Guided Injection Technique for Superficial Trigeminal Nerves
  • Conclusions
  • References
  • Anatomy and Topography of the GON and Adjacent Structures
  • Traditional Method of GON Block: Limitations and Disadvantages
  • Ultrasound-Guided GON Block: Our Technique and Experience
  • Nerve Block
  • Experience and Outlook
  • Conclusion
  • References
  • Anatomy
  • Existing Techniques
  • Technique for Ultrasound-Guided Injection
  • References
  • Lateral Femoral Cutaneous Nerve Block
  • Anatomy
  • Literature Review of Injection Techniques
  • Ultrasound-Guided Block Technique
  • Suprascapular Nerve Block
  • Anatomy
  • Literature Review of Injection Techniques
  • Ultrasound-Guided Block Technique
  • Intercostal Nerve Block
  • Anatomy
  • Literature Review of Injection Techniques
  • Ultrasound-Guided Block Technique
  • Conclusion
  • References
  • Subacromial/Subdeltoid Bursa
  • Anatomy
  • Clinical Presentation
  • Limitations of the Blind Approach
  • Ultrasound-Guided Technique
  • Biceps Tendon Sheath (Biceps – Long Head)
  • Ultrasound-Guided Technique
  • Acromioclavicular Joint
  • Clinical Presentation
  • Ultrasound-Guided Technique
  • Glenohumeral Joint
  • Clinical Presentation
  • Limitations of the Blind Approach
  • Ultrasound-Guided Technique
  • The Rotator Interval Approach
  • Subscapularis Tendon/Subscapularis Bursa
  • Clinical Presentation
  • Ultrasound-Guided Technique
  • Sternoclavicular Joint
  • Clinical Presentation
  • Ultrasound-Guided Technique
  • Conclusion
  • References
  • Anatomy Ultrasound-Guided Carpal Tunnel Injections
  • Literature Review on Ultrasound-Guided Carpal Tunnel Injections
  • Ultrasound-Guided Technique for Carpal Tunnel Injections
  • Anatomy Ultrasound-Guided Trigger Finger Injections
  • Literature Review on Ultrasound-Guided Trigger Finger Injections
  • Ultrasound-Guided Technique for Trigger Finger Injections
  • Anatomy Ultrasound-Guided Wrist Injections
  • Literature Review on Ultrasound-Guided Wrist Injections
  • Ultrasound-Guided Technique for Wrist Injections
  • Anatomy Ultrasound-Guided Injections for Tendon Dysfunction
  • Tendon Dysfunction
  • Ultrasound-Guided Technique for Tendon Dysfunction
  • Anatomy Ultrasound-Guided Elbow Injections
  • Literature Review on Ultrasound-Guided Elbow Injections
  • Ultrasound-Guided Elbow Injection Technique
  • References
  • Anatomy of the Hip Joint
  • Intra-articular Hip Injections
  • Limitations of the Blind Technique
  • Evidence for Ultrasound-Guided Hip Injections
  • Technique of Ultrasound-Guided Hip Injections
  • Conclusions
  • References
  • Limitations of the Current Surface Landmarks Technique
  • Technique for Ultrasound-Guided Knee Joint Injection
  • Conclusion
  • References
  • Technique
  • Nerve Anatomy
  • Nerve Injury
  • Neuritis
  • Nerve Subluxation
  • Nerve Entrapment/Impingement
  • Nerve Transection/Neuroma
  • Nerve Mass Lesions/Tumors
  • Ultrasound-Guided Perineural Injection
  • References
  • Diagnostic Criteria
  • Etiology
  • Occipital Nerve Entrapment
  • The Role of Ultrasound in Diagnosis and Treatment
  • Interventional Ultrasound
  • References
  • Anatomy of the Atlanto-Axial and AtlantoOccipital Joints
  • Ultrasound-Guided Atlanto-Axial and Atlanto-Occipital Joint Injection Technique
  • References
  • Current Evidence
  • Patient Selection and Role of Neurolysis
  • Anatomical Considerations
  • Radial Nerve Stimulation
  • Ulnar Nerve Stimulation
  • Median Nerve Stimulation
  • Sciatic Nerve at Popliteal Bifurcation
  • Posterior Tibial Nerve
  • Conclusion
  • References
  • Limitations of the Current ONS Technique
  • Anatomy of the GON
  • Occipital Field Stimulation Versus Peripheral Nerve Stimulation
  • Technique of US-Guided ONS Lead Implant
  • References
  • Limitations of the Current Technique
  • Groin Field Stimulation Versus Peripheral Nerve Stimulation
  • Technique of Ultrasound-Guided IL/IH PNS Lead Implant
  • References
  • Limitations of the Fluoroscopically Guided Cervical Diskography
  • Technique of Ultrasound-Assisted Cervical Diskography
  • References

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Atlas of Ultrasound-Guided Procedures in Interventional Pain Management is the #1 primer and a must-read for both novices and experts performing invasive procedures for pain relief.