Ultrasound Equipment
Steven L. Orebaugh
Paul E. Bigeleisen
A variety of equipment is necessary for conducting ultrasound-guided peripheral nerve block. Some practitioners prefer to use nerve stimulation along with sonography to verify or confirm the nerve target before injection. Although both methods have proponents, it is not clear that either technique is superior, and efficacy appears similar.1
Equipment
Whether blocks are conducted in the operating room, the preoperative holding area, or a formal block area, patients should have an intravenous catheter initiated, monitors placed, and supplemental oxygen delivered prior to the block (Fig. 5.1). The induction of regional anesthesia has risks that are similar to those of general anesthesia. For this reason, a block cart stocked with equipment for regional block should also contain appropriate equipment and drugs for resuscitation in the event of an anesthetic catastrophe (Fig. 5.2).2 Judicious sedation and analgesia, along with a kind bedside manner, will prepare most patients for regional anesthesia but will also avoid a depth of anesthesia that precludes feedback to the anesthesiologist (Fig. 5.3).
Intravenous catheter and bAlanced salt solution
Blood pressure monitoring
Pulse oximetry monitoring
Electrocardiographic monitoring (necessary for patients with cardiac disease or dysrhythmias)
Supplemental oxygen by face mask or cannula
Medications for anxiolysis (e.g., midazolam, propofol, dexmedetomidine) and analgesia (fenTanyl)
Equipment for airway management (e.g., laryngoscopes, endotracheal tubes, bag and face mask, oral airways, laryngeal airways)
Pharmaceuticals for resuscitation (e.g., propofol, epinephrine, 20% intralipid, vasopressin, amiodarone)