Einsatz von Ultraschall zur Durchführung peripherer Nervenblockaden

 

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Kernaussagen zum Artikel

• Zur Identifikation von Nerven bei peripheren Nervenblockaden eignen sich besonders Ultraschallsysteme mit Hochfrequenzschallköpfen.

• Kenntnisse über die Besonderheiten der Sonografie und der Gerätetechnik sind für die Interpretation der Ultraschallbilder unerlässlich.

• Fundierte Kenntnisse der Anatomie sind die Voraussetzung, um die mit der Sonografie dargestellten Strukturen sicher identifizieren zu können.

• Nerven können ihre Erscheinung im Ultraschallbild durch die Veränderung des Einschallwinkels verändern.

• Nerven haben ein typisches Schallmuster, das ihrem histologischen Aufbau entspricht.

• Mit der Sonografie gelingt neben der Identifikation der Nerven auch die Darstellung potenziell durch die Punktion gefährdeter Begleitstrukturen.

• Bei der Punktion ohne Führungshilfen quer zur Schallebene ist darauf zu achten, dass der Eintritt der Kanülenspitze in die Schallebene sicher identifiziert wird.

• Mit der ultraschallgeführten Nervenblockade gelingt es, die Ausbreitung des Lokalanästhetikums während der Injektion zu kontrollieren.

• Ultraschallgeführte periphere Nervenblockaden zeichnen sich durch kurze Anschlagszeiten und sehr hohe Erfolgsraten aus.

Main statements of the article

• Ultrasound systems with high-frequency probes are particularly suitable for identifying nerves for peripheral nerve blocks.

• Knowledge of the special features of sonography and the equipment technology is essential for interpreting ultrasound images.

• In-depth knowledge of anatomy is required for reliably identifying structures visualized with sonography.

• The appearance of nerves on an ultrasound image can change due to a change in application angle.

• Nerves have a typical sound pattern corresponding to their histological structure.

• With sonography nerves can be identified and accompanying structures possibly at risk due to puncture can be visualized.

• During puncture without a guide transverse to the sound plane, it must be ensured that the entrance of the cannula tip on the sound plane is reliably identified.

• Ultrasound-guided nerve blocks make it possible to control the spread of a local anesthetic during injection.

• Ultrasound-guided peripheral nerve blocks are characterized by a short time to take effect and very high success rates.

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PD Dr. Ulrich Schwemmer

Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg, Zentrum Operative Medizin

97080 Würzburg

Phone: ++ 49/9 31/20 13 00 40

Fax: ++ 49/9 31/20 13 00 49

Email: Schwemmer_U@klinik.uni-wuerzburg.de