[Risk management in ultrasound-guided regional anesthesia]. 2011

Masato Kitayama
Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562.

The innovation of ultrasound-guided regional anesthesia technique has enabled the anesthesiologist to secure an accurate needle position and to monitor the distribution of the local anesthetic in real time. However, the evidence is necessary concerning increased benefits and reduced complications compared to conventional guidance techniques. This article highlights the importance of acquiring an understanding and knowledge of the complications related to regional anesthesia itself, including neural injury, local anesthetics systemic toxicity and vascular injury. Common complications of nerve blocks can be avoided with major principles of ultrasound-guided technique, which involves similar risk of complications and requires similar amount of knowledge for management. It is necessary to establish the recommendations for the scope of practice, teaching curriculum and the opinion for implementing the medical practice of ultrasound-guided regional anesthesia.

UI MeSH Term Description Entries
D009339 Needles Sharp instruments used for puncturing or suturing. Hypodermic Needles,Hypodermic Needle,Needle,Needle, Hypodermic,Needles, Hypodermic
D009407 Nerve Block Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain. Chemical Neurolysis,Chemodenervation,Nerve Blockade,Block, Nerve,Blockade, Nerve,Blockades, Nerve,Blocks, Nerve,Chemical Neurolyses,Chemodenervations,Nerve Blockades,Nerve Blocks,Neurolyses, Chemical,Neurolysis, Chemical
D010525 Peripheral Nerves The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. Endoneurium,Epineurium,Perineurium,Endoneuriums,Epineuriums,Nerve, Peripheral,Nerves, Peripheral,Perineuriums,Peripheral Nerve
D001808 Blood Vessels Any of the tubular vessels conveying the blood (arteries, arterioles, capillaries, venules, and veins). Blood Vessel,Vessel, Blood,Vessels, Blood
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000776 Anesthesiology A specialty concerned with the study of anesthetics and anesthesia.
D000779 Anesthetics, Local Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate. Anesthetics, Conduction-Blocking,Conduction-Blocking Anesthetics,Local Anesthetic,Anesthetics, Topical,Anesthetic, Local,Anesthetics, Conduction Blocking,Conduction Blocking Anesthetics,Local Anesthetics,Topical Anesthetics
D012308 Risk Management The process of minimizing risk to an organization by developing systems to identify and analyze potential hazards to prevent accidents, injuries, and other adverse occurrences, and by attempting to handle events and incidents which do occur in such a manner that their effect and cost are minimized. Effective risk management has its greatest benefits in application to insurance in order to avert or minimize financial liability. (From Slee & Slee: Health care terms, 2d ed) Hospital Incident Reporting,Incident Reporting, Hospital,Hospital Incident Reportings,Incident Reporting,Incident Reportings, Hospital,Management, Risks,Reporting, Hospital Incident,Reportings, Hospital Risk,Voluntary Patient Safety Event Reporting,Hospital Risk Reporting,Hospital Risk Reportings,Incident Reportings,Management, Risk,Reporting, Hospital Risk,Reporting, Incident,Reportings, Hospital Incident,Reportings, Incident,Risk Reporting, Hospital,Risk Reportings, Hospital,Risks Management
D057785 Catheters A flexible, tubular device that is used to carry fluids into or from a blood vessel, hollow organ, or body cavity. Catheter
D059348 Peripheral Nerve Injuries Injuries to the PERIPHERAL NERVES. Peripheral Nerve Injury,Nerve Injuries, Peripheral,Nerve Injury, Peripheral

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