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This book offers a comprehensive but straightforward, practical handbook on ultrasound (US)-guided nerve blocks. It presents the normal US anatomy of peripheral nerves, clinical aspects of nerve entrapment and different procedures / techniques for each block. Axial or peripheral chronic radicular pain can be particularly severe and debilitating for the patient. The aim of treatment is to provide medium-/ long-term pain relief, and consequently to restore function. The therapeutic nerve block, performed with a perineural injection of anaesthetic, steroid or painkiller, is generally used once conservative treatments have proven unsuccessful and is aimed to avoid surgical options.
Ultrasound guidance, offering the direct and real-time visualization of the needle and adjacent relevant anatomic structures, significantly increases the accuracy and safety of nerve blocks reducing the risk of intraneural or intravascular injection and the potential damage to the surrounding structures, but also enhances the efficacy of the block itself, reducing its onset and drug doses.
This practical volume addresses the needs of physicians dealing with pain management, e.g. anaesthesiologists, radiologists, orthopaedists and physiatrists, with various levels of experience, ranging from physicians in training to those who already perform peripheral nerve blocks with traditional techniques and who want to familiarize with US guided procedures.
Enzo Silvestri is a specialist in diagnostic imaging and has been chief of the Department of Diagnostic Imaging at Ospedale Evangelico Interanzionale in Genoa (Italy) since 2008. He is also a consultant for a number of sport associations and Italian soccer teams. Dr.Silvestri gained his degree in medicine and surgery from the University of Genoa in 1983, where he also completed his specialization in diagnostic imaging in 1987. Between 1987 and 2008, he combined his radiological practice with teaching and research at the Institute of Radiology at the University of Genoa (Italy). In 2017 he was elected president of the Musculoskeletal Radiology Section of the Italian Society of Radiology (SIRM) .
He has presented original research at a number of congresses and is the author of more than 300 publications in national and international journals.
Fabio Martino completed his medical studies at Bari University's School of Medicine. He started his specialty training in radiology at the university's Radiology School in 1977 and was attending radiologist at the Institute of Radiology there between 1978 and 1981. He completed his fellowships in management in radiology and in thoracic and musculoskeletal radiology research. In 1999 he became chief of radiology at the Department at Giovanni XXIII Paediatric Hospital of Bari, Italy. In 2009 he became (and currently is) consultant radiologist at the Territorial Sanitary Department of Bari (A.S.L. Bari), Italy. In 2006, he was elected as president of the Musculoskeletal Section of the Italian Society of Radiology. Martino's areas of research include musculoskeletal and thoracic imaging, paediatric radiology, quality management in radiology and health services. His publications focus on musculoskeletal imaging, ultrasound and paediatric radiology.
Filomena Puntillo is assistant professor of anaesthesia and pain therapy at the Department of Emergency and Organ Transplantation, University of Bari, Italy and she is chief of the Pain Center, at the Policlinico Hospital of Bari. Her principal area of interest is the treatment of acute and chronic pain syndromes, especially interventional pain procedures: ultrasound guided nerve block, radiofrequency denervation for neck and back pain, peripheral nerve stimulation and spinal cord stimulation, intrathecal infusion. In 1993 she graduated from the School of Medicine of Bari University, where she specialized in anaesthesiology, intensive care and pain therapy in 1997. Since 2014 she has coordinated a 2nd master's degree in pain management at Bari University and chaired of the Regional Committee on Heath Technology Assessment in Pain Therapy. She is a member of several national pain societies: SIAARTI, AISD, INS-Italian chapter. She combines her pain practice with teaching and research, and she has authored 16 papers in international peer-reviewed anaesthesia and intensive care journals.
FUNDAMENTALS.- Basic principles.- Doppler and Sonoelastographic Imaging.- Normal anatomy NORMAL US ANATOMY AND SCANNING TECHNIQUE.- Basic principles and US scanning technique.- Brachial plexus.- Upper limb peripheral nerves.- Lower limb peripheral nerves.- US PATHOLOGIC FINDINGS.- Compressive syndrome.- Traumatic injuries.- Tumors and tumor-like conditions.- NERVE ENTRAPMENT SYNDROME.- Physiopathologic findings.- Clinical and sonographic considerations.- Entrapment syndromes: the upper limb.- Entrapment syndromes: the lower limb.- USGUIDED NERVE BLOCKS: PROCEDURE TECHNIQUE.- General considerations.- Indications and contraindications.- Setting and patient preparation.- Drugs and materials requirements.- US guidance and Navigation systems.- Interscalene block.- Supraclavicular block.- Infraclavicular block.- Axillary block.- Median nerve block.- Ulnar nerve block.- Radial nerve block.- Thoracic paravertebral block.- Transversus abdominis plane (TAP) block.- Rectus sheat block.- Lumbar plexus block.- Iliohypogastric and ilioinguinal nerve block. - Lateral femoral-cutaneous nerve block.- Femoral nerve block.- Saphenous nerve block.- Sciatic nerve block.- Popliteus nerve block.- Tibial nerve block. - Ankle block.
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