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Development of Guidance Techniques for Regional Anesthesia: Past, Present and Future

Authors
  • Wu, Zehao1
  • Wang, Yun1
  • 1 Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020
Type
Published Article
Journal
Journal of Pain Research
Publisher
Dove Medical Press
Publication Date
Jun 09, 2021
Volume
14
Pages
1631–1641
Identifiers
DOI: 10.2147/JPR.S316743
PMID: 34135627
PMCID: PMC8200162
Source
PubMed Central
Keywords
Disciplines
  • Review
License
Unknown

Abstract

Regional anesthesia has been widely used in clinical practice. Over the past 30 years, various guidance techniques have been developed for regional anesthesia ranging from paresthesia progressing to neurostimulation and currently ultrasound guidance. Especially, the use of point-of-care ultrasound greatly enhances the success rate of regional anesthesia. However, the poor imaging quality of ultrasound in patients with obesity, fat infiltration, etc., limits the use of ultrasound. The combined use of ultrasound with neurostimulator, electromyography, pressure monitoring, etc. is advocated in order to facilitate regional anesthesia in this cohort of patients. The accumulated evidence has shown that the ultrasound combined with other techniques (UCOT) can help to solve the difficulties of puncture location caused by obesity, anatomical variation, and other factors when using ultrasound guidance alone. In recent years, with the development of medical image fusion and medical image artificial intelligence identification technology, guidance techniques for regional anesthesia have advanced considerably. To understand the advantages and disadvantages of the various guidance techniques for regional anesthesia developed in recent years and to guide their rational clinical application, this paper reviews these techniques, describing the progression from the early use of paresthesia to the latest UCOT, as well as the latest research on UCOT, and the prospects for the development of new guidance techniques for regional anesthesia.

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