Cadaveric ultrasound imaging for training in ultrasound-guided peripheral nerve blocks: lower extremity.

摘要

This Images in Anesthesia feature demonstrates the image quality obtainable from scanning the lower extremity of a cadaver in order to facilitate ultrasound-guided peripheral nerve blocks (PNB). Training methods to improve the performance of ultrasound-guided PNB are required, but have yet to be sandardized. A novel approach is to use cadaveric model simulations, which provide the learner with anatomic examination and the ability to practice nerve blocks in a stress-free environment without time constraints and the potential for patient discomfort. Cadaveric ultrasound imaging can also help the learner of these techniques to acquire an in-depth knowledge of the relevant regional anatomy in order to facilitate successful identification of nerve structures under ultrasound guidance, and to acquire expertise and confidence in performing these blocks. Dissections can be performed to confirm nerve or blood vessel identity whenever uncertainty exists (e.g., small nerves of the periphery). The cadaver model can also be used to acquire the critical skills necessary to accurately align the needle and probe to ensure visibility of the entire needle, while tracking or following the needle to the target nerve.