USG central neuraxial block
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ABSTRACT :
Central neuraxial blocks (CNB) are the preferred blocks in the practice of regional anesthesia. Palpation of the anatomical landmarks is used for the identification of the space, which is not always the best method when CNB is performed in overweight patients or patients having atypical spines like scoliosis. Ultrasound (US) has recently been utilized to facilitate CNB. However, CNB US can be difficult, because the structures need to be visualized by US are surrounded by bones, which do not allow ultrasound rays to pass through. Therefore in order to allow deeper penetration, the ultrasound probe used for CNB is a curved probe of low frequency of 2-5 mHz, as it allows deeper penetration at the expense of image resolution. There are two scanning planes; transverse and longitudinal which supplements each other. US for CNB helps in determining the intercristal line, exact intervertebral level, midline, ideal point of insertion, distance to ligamentum flavum and needle trajectory. US for CNB has improved patient safety by decreasing the number of attempts, chances of dural puncture and damage to conus medullaris. It has also improved patient satisfaction and has proved to be an ideal learning tool for the trainees......

http://www.apicareonline.com/ultrasound-guided-central-neuraxial-block/
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