Revista Mexicana de Anestesiología

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>Revistas >Revista Mexicana de Anestesiología >Año 2008, No. 4

Zaragoza-Lemus G, Mejía-Terrazas GE, Peralta-Zamora E
Bloqueo de nervios periféricos guiados por ultrasonido
Rev Mex Anest 2008; 31 (4)

Idioma: Español
Referencias bibliográficas: 62
Paginas: 282-297
Archivo PDF: 345.15 Kb.

Texto completo


En los últimos años los avances tecnológicos han permitido aplicar nuevas técnicas de imagen a la realización de bloqueos de nervios periféricos en un afán de mejorar la calidad anestésica, así como la seguridad del paciente. Por lo tanto en los años 50 se incorporó la ultrasonografía para la realización de bloqueo de nervios periféricos, pero esto tiene implicaciones varias debido a que existen tres niveles bien definidos de aprendizaje como son: La necesidad de conocer y aprender las bases de la ultrasonografía (sonoanatomía), adaptarnos a las modificaciones de los abordajes que normalmente utilizamos debido a que el transductor produce una modificación de los mismos, y probablemente la tarea más importante en este aprendizaje es el poder identificar el nervio o plexo en una imagen en tiempo real. Este artículo es una guía para orientar en el manejo del ultrasonido y la realización de los distintos bloqueos nerviosos de mayor interés para los anestesiólogos.

Palabras clave: Anestesia regional, bloqueo de nervios periféricos, ultrasonido.


  1. Hirschel G. Local and Regional Anesthesia. William Wood and Company. New York, 1914.

  2. Wright B. A new use for block-aid monitor. Anesthesiology 1969:30:336-337.

  3. Sia S, Bartoli M, Lepri A, Marchini O. Multiple injection axillary brachial plexus block: A comparison of two methods of nerve localization: nerve stimulation versus paresthesia. Anesth Analg 2000:91: 647-651.

  4. Borgeat A, Ekatodramis G, Kalberer F, Benz C. Acute and nonacute complications associated with interscalenic block and shoulder surgery: A prospective study. Anesthesiology 2001;95:875-880.

  5. La Grange P, Foster P, Pretorious L. Application of the Doppler ultrasound blood flow detector in supraclavicular brachial plexus block. Br J Anaesth 1978:50:965-976.

  6. Abramowitz HB, Cohen CH. Use of Doppler ultrasound guided axillary block. Anesthesiology 1981:5:603.

  7. Wong G, Brown DL, Miller GM, Cahill DR. Defining the cross-sectional anatomy important to interscalene brachial plexus block with magnetic resonance imaging. Reg Anesth Pain Med 1998;23:77-80.

  8. Kapral S, Krafft P, Klemens E. Ultrasound-guided supraclavicular approach for regional anesthesia of the brachial plexus. Anesth Analg 1994;78:507-513.

  9. Moorty SS. Fluoroscopic imaging during supraclavicular lateral paravascular brachial plexus block. Reg Anesth Pain Med 2000;25:327-328.

  10. Ting PL, Sivagnanratnam V. Ultrasonographic study of the spread of local anesthetic during axillary brachial plexus block. Br J Anaesth 1989:63:326-329.

  11. Chan VW. Nerve localization-seek but not so easy to find? Reg Anesth Pain Med 2002;27:245-24.

  12. Williams SR, Chouinard P, Arcand G. Ultrasound guidance speeds execution and improves quality of supraclavicular block. Anesth Analg 2003;97:1518-1523.

  13. Shanewise JS, Cheung AT, Aronson S, Stewart WJ, Weiss RL, Mark JB, Savage RM, Sears-Rogan P, Mathew JP, Quinones MA, Cahalan MK, Savino JS. ASE/SCA guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination. Anesth Analg 1999;89:870-884.

  14. Fornage BD, Sneige N, Edeiken BS. Interventional breast sonography. Eur J Radiol 2002;42:17-31.

  15. Hopkins RE, Bradley M. In vitro visualization of biopsy needles with ultrasound: A comparative study of standard and echogenic needles using and ultrasound. Clin Radiol 2001;56:499-502.

  16. McGahan JP. Laboratory assessment of ultrasonic needle and catheter visualization. J Ultrasound Med 1986;5:373-377.

  17. Gebhard RE, Al-Samsam T, Greger J, Khan A, Chelly JE. Distal nerve blocks at the wrist for outpatient carpal tunnel surgery offer intraoperative cardiovascular stability and reduce discharge time. Anesth Analg 2009;95:351-355.

  18. Silvestri E, Martinoli C, Derchi LE, Bertolotto M, Chiaramondia M, Rosenberg I. Echotexture of peripheral nerves: Correlation between US and histologic findings and criteria of differentiate tendons. Radiology 1995;197:291-296.

  19. Borgeat A. Regional Anesthesia, Intraneural injection, and nerve injury. Anesthesiology 2006;105:647-648.

  20. Gruber H, Peer S, Kovacs P. the ultrasonographic appearance of the femoral nerve and cases of iatrogenic impairment. J Ultrasound Med 2003;22:163-172.

  21. Yang WT, Chui PT, Metrewelli C. Anatomy of the normal brachial plexus revealed by sonography guidance in anesthesia of the brachial plexus. Am J Roentgenol 1998;171:1631-1636.

  22. Kapral S, Krafft P, Eibenberger K. Ultrasound-guided supraclavicular approach for regional anesthesia of the brachial plexus. Anesth Analg 1994;78:507-513.

  23. Sandhu NS, Capan LM. Ultrasound-guided infraclavicular brachial plexus block. Br J Anaesth 2002;89:254-259.

  24. Perlas A, Chang VW, Simona M. Brachial plexus examination and localization using ultrasound and electrical stimulation. Anesthesiology 2003;99:429-435.

  25. Perlas A, Chan VW. Ultrasound-guided interscalene brachial plexus block: 2004;8:143-148.

  26. Chan VW, Perlas A, Rawson R, Odukoya O. Ultrasound-guided supraclavicular brachial plexus block. Anest Analg 2003;97:1514-1517.

  27. Kapral S, Krafft P, Eibenberger K. Ultrasound guided supraclavicular approach for regional anesthesia of the brachial plexus. Anesth Analg 1994;78:507-513.

  28. Arcand G, Williams St, Chouinard Ph, Boudreault D, Harris P, Ruel M, Girar F. Ultrasound-guided infraclavicular versus supraclavicular block. Anesth Analg 2005;101:886-890.

  29. Williams A, McMahon SB. Peripheral nerve injury caused by injection needles used in regional anaesthesia: Influence of bevel configuration, studied in a rat model. Br J Anaesth 1992;69:433-438.

  30. Fanelli G, Casati A, Garancini P, Torri G. Nerve stimulator and multiple injection technique for upper and lower limb blockade: Failure rate, patient acceptance, and neurologic complications. Study on Regional Anesthesia. Anesth Analg 1999;88:847-52.31.

  31. Gray AT, Schafhalter-Zoppoth I. Ultrasound guidance for cubital nerve block in the forearm. Reg Anesth Pain Med 2003; 28:335-339.

  32. Nielsen KC, Klein SM, Steele SM. Femoral nerve blocks. Techn Reg Anesth Pain Manag 2003;7:8-17.

  33. Gray A, Collins A, Schafhalter-Zoppoth I. An introduction to femoral nerve and associated lumbar plexus nerve blocks under ultrasonic guidance. Tech Reg Anesth Pain Manag 2004;8:155-163.

  34. Hospodar PP, Ashman ES, Traub JA. Anatomic study of the lateral femoral cutaneuos nerve with respect to the ilioinguinal surgical dissection. J Orthop Trauma 1999;13:17-19.

  35. Peer S, Bodner G (eds). High-resolution sonography of the peripheral nervous system, Berlin, Springer Verlag, 2003.

  36. Breslin DS, Macleod DB. Central nervous system toxicity following the administration of levobupivacaine for lumbar plexus block: a report of two cases. Reg Anesth Pain Med 2003;28:144-147.

  37. Kirchmair L, Entner T, Wissel J. A study of the paravertebral anatomy of ultrasound-guided posterior lumbar plexus block. Anesth Analg 2001;93:477-481.

  38. Reid JG, Livingston LA, Pearsall DJ. The geometry of the psoas muscle as determined by magnetic resonance imaging. Arch Phys Med Rehabil 1994;75:703-708.

  39. Capdevila X, Macaire P, Dadure C. Continuous psoas compartment block for postoperative analgesia after total arthroplasty: new landmarks, technical guidelines, and clinical evaluation. Anesth Analg 2002;94:1606-1613.

  40. Raj PP, Parks RI, Watson TD, Jenkins MT. New single position suppine approach to sciatic-femoral nerve block. Anesth Analg 1975;54:489-493.

  41. Chang V, Nova H, Abbas S, McCartney C, Perlas A, Xu D. Ultrasound examination and localization of the sciatic nerve. 2006:104:309-314.

  42. Shackleford M, Broadman L. An introduction to ultrasonic-guided sciatic neuroblockade. Techniques in regional anesthesia and pain management 2004:8:167-170.

  43. Sinha A, Chan V. Ultrasound imaging for popliteal sciatic nerve block. Reg Anesth pain Med 2004:29:130-134.

  44. Stone BA. Transcutaneous stimulation of the saphenous nerve to locate injection site. Reg Anesth Pain Med 2003:28:153-154.

  45. Gray AT, Collins AB. Ultrasound-guided saphenous nerve block. Reg Anesth Pain Med 2003:28:148-153.

  46. Ilfeld BM, Morey TE, Wang RD, Enneking FK. Continuous popliteal fossa block for postoperative pain control at home. Anesthesiology 2002:97:959-965.

  47. Soong J, Schafhalter I, Gray A. Sonographic imaging of the obturator nerve for regional block. Reg Anesth Pain Med 2007:32:146-151.

  48. Gofeld M, Christakis M. Sonographically guided ilioinguinal nerve block. J Ultrasound Med 2006:25:1571-1575.

  49. Eichenberger U, Greher M, Kirchmair L, Curatolo M, Moriggi B. Ultrasound-guided blocis of the ilioinguinal and iliohypogastric nerve: accuracy of a selective new technique confirmed by anatomical dissection British Journal of Anaesthesia 2006:97:238-243.

  50. Willshke H, Marhofer P, Bosenberg A, Johnston S, Wanzel O, Cox G, Sitzwohl C, Kapral S. Ultrasonography for ilioinguinal/iliohypogastric nerve blocks in children. British Journal of Anaesthesia 2005:95:226-230.

  51. Byas-Smith M, Gulati A. Ultrasound-guided intercostal nerve cryoablation. Anesthesia and Analgesia 2006:103:1033-35.

  52. Kwang J, Cheon J, Yoon K, Kim W, Yoon D. Ultrasound-guided lumbar medial-branch block: A clinical study with fluoroscopy control. Reg Anesth Pain Med 2006:31:451-454.

  53. Greher M, Scharbert G, Kamolz L, Beck H, Gustorff B, Kirchmair L, Kapral S. Ultrasound-guided lumbar facet nerve block a sonoanatomic study of a new methodologic approach. Anesthesiology 2004;100:1242-1248.

  54. Eichenberger U, Greher M, Kapral S, Marhofer P, Wiest R, Remonda L, Bogduk N, Curatolo M. Sonographic visualization and ultrasound-guided block of the third occipital nerve. Anesthesiology 2006:104:3003-3008.

  55. Willschke H, Bosenberg A, Marhofer P, Johnston S, Kettener S, Wazel O, Kapral S. Ultrasonography-guided rectus sheath block in pediatric anaesthesia a new approach to and old technique British Journal of Anaesthesia 2006:97:244-249.

  56. Calvillo O, Skaribas I, Rockett C. Computed tomography-guided pudendal nerve block a new diagnostic approach to long-term anoperineal pain A report of two cases. Reg Anesth Pain Med 2000:25:420-423.

  57. Kovacs P, Gruber H, Piegger J, Bodner G. New simple ultrasound-guided infiltration of the pudendal nerve. Dis Colon Rectum 2001:44:1381-1385.

  58. Perlas A, Chan VWS, McCartney C. Ultrasound assement of paresthesia and electrical stimulation of nerve localization: A sensitivity study. Reg Anesth Pain Med 2004;29:178, A33.

  59. Urmey WF, Stanton J. Inability to consistently elicit a motor response following sensory paresthesia during interscalene block administration. Anesthesiology 2002;96:552-554.

  60. Williams S, Chouinard P, Arcad G, Harris P, Ruel M, Boudreault D, Girard F. Ultrasound guidance speeds execution and improves the quality of supraclavicular block. Anesth Analg 2003;97:1518-1523.

  61. Bigeleisen P. Nerve puncture and apparent intraneural injection during ultrasound-guided auxiliary block does not invariably result in neurologic injury. Anesthesiology 2006;N105:V4:779-783.

  62. Wedel DJ. Regional anesthesia and pain management: reviewing the past decade and predicting the future. Anesth Analg 2000;90:1244-1245.

>Revistas >Revista Mexicana de Anestesiología >Año2008, No. 4

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