Masui. The Japanese journal of anesthesiology
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Ultrasound-guided neuraxial block has provided safe and accurate analgesia. Although the classic anatomical landmark technique is still standard for completing epidural or subarachnoid puncture, it is difficult to identify the anatomical structure in some cases such as pregnant women, obese patients and patients with spinal deformity. Preparatory ultrasound scanning enables to identify the midline and determine the point of insertion, which reduces the number of puncture attempts and failure rate of procedure. ⋯ Cerebrospinal puncture is an important procedure for diagnosis of some critical conditions such as subarachnoid hemorrhage and central nervous system infections. Ultrasound imaging contributes to smooth procedure and fewer complications. This review summarizes the basic ultrasound-guided technique for expected difficult neuraxial block patients, presenting recent findings.
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Ultrasound guidance for regional anesthesia has gained enormous popularity in the past decade. The usage of ultrasound guidance has reawaken many block techniques in daily clinical practice. In this review, the author described how the ultrasound guidance has changed the manner of intraoperative and postoperative analgesic methods. ⋯ Those success rates increased using sonography, whereas the complications decreased. Advanced sonography shows the clear images of the detailed nerve tissues, so that we can perform the more pin-pointed nerve block considering postoperative benefits of patients. However, it must never be forgotten that both the pre-scan examination before a needle insertion and the continuous watching of an advancing needle tip are essential to perform safer regional anesthesia techniques.