Asian Pain Academy

In the mid-1990s, anaesthesiologists started the use of ultrasonography (USG) to perform peripheral nerve blocks (PNB), a technique previously unexplored for this purpose. While radiologists had already been utilizing ultrasound to direct needle placement for biopsies, its application in PNB represented a groundbreaking development. The effectiveness of ultrasound in supporting various regional anaesthesia procedures, such as brachial plexus and femoral nerve blocks, was soon established. Concurrently, technological advancements were made, including the introduction of more compact, portable ultrasound devices, enhanced imaging resolution, and sophisticated needle detection software. These improvements collectively enhanced the practicality of ultrasound in clinical settings for anaesthesiologists. Traditional methods for nerve block, such as nerve stimulation, palpation, fascial “clicks,” eliciting paraesthesia, and trans arterial techniques, lacked the capability to track the spread of local anaesthetic. In contrast, ultrasound guidance introduces several key advantages. It enables the clear visualization of the target region’s anatomy, facilitating a more precise needle trajectory to the intended site while circumventing potential damage to nearby structures. Additionally, ultrasound provides real-time tracking of the needle’s tip during insertion, ensuring it follows the correct path and minimizes the risk of accidental damage. Most importantly, ultrasound imaging allows continuous monitoring of the local anaesthetic’s distribution, ensuring its proper spread and allowing for adjustments in needle placement to enhance the effectiveness of the anaesthetic drug.