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Ultrasound Guided Regional Blocks – NYSORA

Ultrasound guided nerve blocks (UGNB)

Since many decades general anaesthesia( where patients are made to lose consciousness which is reversible) and spinal anaesthesia ( where an injection is given to the lower back to make your limbs and abdomen numb) have been considered as gold standard practices throught out the world. Never the less, last decade has seen the rise of ultrasound guided nerve blocks since it has many unique advantages over decades of standard practices. ADVANTAGES of UGNB

  • It does not compromise your cardio respiratory system
  • Selectively Anaesthetise the part to be operated
  • Excellent Pain relief which also extends for many hours after operation.
  • Minimal nausea and vomiting
  • You can resume normal diet after couple of hours after operation.
  • It avoids all the complications of general anaesthesia and spinal anaesthesia. (including awareness duing surgery)
  • Very suitable for DAYCARE surgery.
  • High comfort levels while the block is being performed.
  • High success rate.

What exactly is UGNB ?

It is an alternative to general anesthesia / spinal anaesthesia, where the anaesthesiologist blocks the peripheral nerves under direct vision by using real time image seen on ultrasound machine. It is a relatively new technique which is becoming popular for its obvious advantages. Earlier it used to be a blind technique to block the nerves by assuming the landmarks on skin surface. For example: if you need an operation on your hand , a small needle is passed underneath the skin at around shoulder area to block the nerves supplying the hand.

Is it painful while block is being performed?

It is equal to any other simple injections you might have experienced before. Moreover the injection is being performed after administering some opioids and benzodiazepines( both of which make you a little sleepy and comfortable)

Is it a safe procedure?

Yes it is a safe procedure. Earlier the blocks was performed as a blind technique, with multiple pricks and some discomfort. Now with the advancement in technology, arrival of new medicines with higher safety of margin, and overall greater understanding of nerve blocks, the technique has become safer.

What happens after block is given?

Once the nerve block is performed, the affected part becomes numb, and you gradually lose control over that part in 10 – 20 minutes.

Will I be fully awake during the operation?

Yes, you will be awake during the operation. But many patients will be given tranquillizers so that they are asleep and do not remember the events during operation.

What if the block given to me fails?

The success rate using this new technique (ultrasound guided nerve blocks) is as high as 100%. But having said that failures can still happen in a very few cases. In such case you will be given general anaesthesia as a backup plan.

Is this a new technique in anaesthesia practice?

Well yes this is a new technique though introduced a couple of decades ago. This is widely practiced in United Kingdom and many parts of Europe as a fundamental tool for pain management in major operations. In our country this has started to gain popularity in last 5 years or so.

In which kind of patients nerve blocks are given as first choice ?

In last 5 years we have been using this technique frequently as a soul anaesthetic and as well as for pain management after major operations. It has made a huge difference in management of very critical and sick patients coming for operation. It also has a major role in some deserving patients like for example

  • Patients with heart ailments
  • Very elderly patients (> 70 years)
  • Respiratory problems(asthma, smokers)
  • Very fat patients with OSA
  • In emergency situations
  • Patients with obstructive sleep apnea (OSA)