Schematic diagram of the ultrasound-guided nerve block puncture technique-Guangdong Baiyue Medical Device Co., Ltd. _ Ultrasonic Visualization _ Ethylene Oxide Sterilization

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Schematic diagram of the ultrasound-guided nerve block puncture technique

Release date:

2021-08-30 09:10

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Part of this article is excerpted from the summary of the “Shen Chao Da Ren” online course series, edited by Professor Zhao Daqiang—“Ultrasound-Guided Regional Anesthesia: Anatomy and Practice.”

Ultrasound-guided nerve block

Nerve block techniques are one of the core, indispensable technologies in clinical anesthesiology. In recent years, the rapid adoption of ultrasound imaging has opened up new avenues for advancing nerve‑block guidance. By utilizing ultrasound, anesthesiologists can more precisely localize nerves, guide the puncture needle in real time, and monitor the spread of the local anesthetic solution, thereby minimizing injury to adjacent structures, enhancing the success rate of nerve blocks, and reducing the incidence of complications. In the future, ultrasound‑guided nerve blocks will become a standard skill that all clinicians must master.

During needle insertion and puncture, it is often difficult to achieve optimal visualization when using standard puncture needles or electrostimulation needles. ZhiRen Medical has designed and manufactured an enhanced‑visibility ultrasound‑guided nerve block needle for anesthesiologists. Featuring a prismatic, precision‑machined design that boosts ultrasonic reflectivity, this needle helps improve visualization, increase puncture efficiency, and reduce the risk of nerve injury.

To facilitate the effective use of ultrasound‑guided nerve blocks, we have synthesized several key procedural guidelines based on “Ultrasound‑Guided Regional Anesthesia: Anatomy and Practice,” edited by Professor Zhao Daqiang, as well as clinical feedback and the product’s design features.

Schematic diagram of ultrasound-guided puncture

Fixation of the ultrasound probe:

1. Use the probe to obtain a satisfactory image; place the lateral side of your palm or rest your elbow against your waist, lean your body forward, and use your arm to transmit force while restricting arm movement to stabilize the probe.

Needle Holding and Needle Insertion:

1. The vernier scale is preset to the desired puncture depth, and the blue blade‑tip indicator aligns with the probe to ensure optimal visualization.

2. Ensuring that the puncture needle remains aligned with the ultrasound probe’s midline from the moment of needle insertion is a prerequisite for visualizing the needle on the ultrasound image; the midline can be established by marking a line.

3. During puncture, taking the right hand as an example, use the thumb and index finger to grasp the tail of the puncture needle, with the thumb below and the index finger above. Do not apply force with the fingers or the wrist; instead, let the elbow joint drive the forearm, and the forearm in turn drive the wrist joint, to advance the needle. Keep the fingers firmly gripping the needle’s tail, and make slight adjustments with the wrist as the forearm moves forward. This approach helps maintain the needle’s alignment in a consistent direction.

4. After advancing the needle a certain distance, return your gaze to the screen to assess the target nerve’s position and the clarity of the needle’s visualization. When performing a midline puncture, if the needle’s visualization is unclear, slightly adjust the probe’s position until the distal 1 cm of the needle is fully visualized.

Puncture Technique and Puncture Procedure

1. During in-plane puncture, it is essential to maintain parallelism between the puncture needle and the ultrasound probe’s midline; however, this does not always result in clear visualization of the needle. Keeping the needle aligned with the probe’s midline is a prerequisite for achieving adequate needle visualization on the ultrasound image. If visualization remains unclear, the needle should be withdrawn and re‑aimed to align with the probe’s midline before resuming the procedure.

Become proficient in ultrasound probe manipulation, master secure probe fixation and needle‑guidance techniques, and practice consistently to achieve seamless coordination among your hand, eye, and mind—ensuring that you can successfully perform well‑executed ultrasound‑guided regional anesthesia.